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SCI Care: What Really Matters
SCI Care: What Really Matters
World SCI Day 2025 Podcast
The podcast for World SCI Day 2025, themed “Fall Prevention, Spinal Cord Protection,” focuses on raising awareness about the critical issue of fall-related spinal cord injuries and how they can be prevented. Falls are one of the leading causes of SCI worldwide, especially among vulnerable populations such as the elderly and individuals in high-risk environments.
Discussion was based around the key risk factors contributing to falls, including environmental hazards, physical health issues, and lack of safety measures. Practical solutions, such as home and workplace safety tips, the importance of protective gear, and lifestyle adjustments, were shared to help listeners reduce their risk.
Additionally, the podcast explored the role of early intervention after a fall, advancements in SCI treatment, and the importance of rehabilitation. By raising awareness and sharing actionable advice, we aim to promote safer practices and protect spinal health globally.
On behalf of the ISCoS Prevention Committee, I am happy to invite you all to listen to this special SCI Day 2025 podcast and be a part of the movement to raise awareness.
Speakers (photos saved in Files)
1) Prof Belgin Erhan, MD
Chair, ISCoS Prevention Committee
Board Member, ISCoS
Professor and Faculty at Istanbul Medeniyet University, School of Medici
Head of the PMR Department at Istanbul Medeniyet University, School of Medicine
President, National Neurotoxin Society
2) Yannis Dionyssiotis, MD, MSc., PhD
Head of 2nd Medicine & Rehabilitation Department, National Rehabilitation Center (Ethniko Kentro Apokatastasis, EKA), Athens, Greece
A/Prof. of PMR, Medical School, University of Patras, Greece
The opinions of our host and guests are their own; ISCoS does not endorse any individual viewpoints, given products or companies.
You can follow us on Twitter and LinkedIn
The SCI Care: What Really Matters podcast aims to provide valuable insights and the most up-to-date information for those providing care to people with spinal cord injury (SCI) worldwide. The vision of the International Spinal Cord Society (ISCoS) is to "facilitate healthy and inclusive lives for people with spinal cord injury or dysfunction globally".
Contact us directly with any questions or comments at iscos@associationsltd.co.uk
Welcome everyone to this special spinal cord injury day podcast brought to you by the International Spinal Cord Society's Prevention Committee. I am Professor Belgin Erhan, the chair of the East Coast Prevention Committee. I am working at Medeniyet University, istanbul, medeniyet University, and I'm the head of the Department of PMR, and you know, today the theme of this podcast is SCI Day, and International Days are powerful tools to promote public awareness and to activate authorities on certain issues of concern, and since 2016, international Spinal Cord Society, iscos, has decided to observe the 5th of September as SCI Day every year, and each year it is celebrated under different slogans and themes. That highlights the most current issues of concern for SCI individuals, and I'm happy to share with you this year's slogan individuals and I'm happy to share with you this year's slogan, and this year's slogan is fall prevention and spinal cord protection. We come together under this important theme to raise awareness and to take action against one of the leading causes of ACI's worldwide.
Speaker 1:Falls can happen to anyone, at any age and in any setting, and every year, thousands of people experience life-changing injuries from something as ordinary as a sleep at home, a fall from a ladder or even a stumble on the street and false weather, at home, in the workplace or in public remain as significant yet preventable risk factors for SCI. When we look at the epidemiologic studies, we see that in many countries, falls are the second leading cause of SCI. Falls are the second leading cause of SCI and, in some countries, the first leading cause of SCI after motor vehicle accidents. On the other hand, for those living with SCI, preventing secondary injuries caused by falls is equal critical to maintaining independence and well-being. However, the good news is that these injuries can be prevented with awareness, practical steps and community actions. As the East Coast Prevention Committee, we are committed to promoting evidence-based strategies, fostering collaboration and empowering individuals to take proactive steps in fall prevention.
Speaker 1:I'm joined today by Assistant Professor Yanis Dionysiotis from Athens, greece, who will share valuable insights on why falls are such a critical issue and what can we do to prevent them, and I welcome you, yanis Dionysiotis. He is the head of second PMR department of National Rehabilitation Center, eca, athens, and also he is the assistant professor of PMR at University of Patras School of Medicine, and he's a member of the board of the Hellenic Foundation of Osteoporosis, member of International Osteoporosis Foundation and chair of Geriatric Section PRM in Greece. Also, he is the subcommittee of SEI Day Poster Contest and I welcome you again, my friend colleague Yanis. Together, we will explore risk factors, prevention strategies and how rising awareness on SCI Day can help us build a safer future.
Speaker 2:Thank you, Belgin. What a wonderful introduction. Introduction.
Speaker 1:I'm very happy to have this opportunity on this important podcast, because we have been working with Professor Dionysiotis for more than maybe six years or something else, and indeed we are dealing with prevention issues in various areas, and fall prevention is a very critical issue. And I would like to ask you my first question why fall is that much important for causing SCI? What do you think?
Speaker 2:Look Belgium. Spinal cord injury is particularly devastating. It often strikes out of the blue. So while road traffic crashes are the leading cause in low and middle income countries are the leading cause in low and middle-income countries, fall from AIDS is also a major contributor. Even in high-income countries, falls are one of the major causes of hospitalization in people over the age of 65. And it's therefore very important to prevent this falls, because the epidemiological data are changing and are shifting in favor of falls. So falls are getting the first cause of spinal cord injury in high-income countries and in ages more than 65 years. That means if we go to see the epidemiology of falls, what we find in the literature is that falls account for just over 40% of fall cases in Eastern Mediterranean and Southeast Asia regions. The African region reports lower percent of falls, with the other regions showing 27% and 36%. In my country, greece, false percent is 37%, so it is a very big problem.
Speaker 1:Yes, and especially older people living in nursing homes are more vulnerable to falls, and I have some statistics that says that 40% of them experience recurrent falls. The older people living in nursing homes are more vulnerable to falls. Homes are more vulnerable to falls, and so there are some groups who have greater risk.
Speaker 2:And let me just delve into this which groups are at higher risk? Now you remind me a basic principle of PROFANE, the fault prevention network group of the 80s. That means that PROFANE suggested a U-shaped association, that the most inactive and the most active people are at highest risk of faults, and this reveals the complex relationship between falls, activity and risk. The type and extent of environmental challenges that an old person chooses to embrace interact with the person's intrinsic risk factors, and some activities seem to increase the risk of falls, either by increasing exposure to risky environmental conditions. That means slippery or uneven floors, clutter areas, acute fatigue or unsafe practice in exercise sessions. So that means that young persons and the most frail persons are more susceptible to falls.
Speaker 1:And I think, in some hazardous environments, some workers who work in hazardous district like construction or agriculture.
Speaker 2:You mean the occupational injuries.
Speaker 1:Yes, yes. Also, people already have disabilities or health conditions such as vision impairments or some other impairments. They are more vulnerable to falling than the other groups.
Speaker 2:Right, correct. Just a word to add something in this occupational injury because it is an important issue, because a significant proportion of accidents leading to SCI occur in the workplace, particularly in the construction, agriculture and mining industries, and the most frequent external causes in work environments are falls from heights or being struck or crushed by a falling object. And the etiology of falls as injury-producing events is multifactorial. Working at heights involves completely different full risks than those found on workplace surfaces and floors, so it needs a multidisciplinary prevention approach, a mitigation approach for practitioners to overcome this issue and deal with this issue. Yes, please.
Speaker 1:As we know that after falls there are some impairments, we see fractures, limb fractures, especially hip fractures, upper limb fractures or traumatic brain injuries, even besides SCI. So I know that you are very interested in, and an expert on, osteoporosis and fragility fractures. What do you say on this? How can falls affect fracture risk in older people?
Speaker 2:Look, it depends. Not every fall leads to a fracture. However, not every fall leads to a fracture. However many falls may lead to fractures. So it is very difficult to say when a person, an aged person, will definitely fracture a bone born. For that reason and I do not know if the colleagues are aware that recently the world false guidelines were published for prevention and management of false of older people two years ago and these guidelines updated the guidelines existed 15 years ago.
Speaker 2:So many, many working groups walked in the direction to find all these factors leading to fall and they created scientists from all over the world combined the forces and created some working groups and ad hoc, ad hoc expert groups to have to assess and to treat and to find some algorithms and links. That states the stratification, the assessment and management of faults in older persons. And this is very important because now we have new guidelines and we can have some algorithms in order to stratify subjects and to assess subjects who will fall and so on. I believe this is very important for the scientific community that there are now available guidelines, world guidelines for fall prevention which need to be implemented in each country. This is a very huge work to do for our community, not only ISKOS, but all scientific communities dealing with this osteoporosis or fractures.
Speaker 1:Yes, and in recent years many good meta-analyses or reviews were published on the guidelines for prevention. And when we look at the gender, is there any difference between the full risk? As far as I know, both gender has the same risk, but there is some difference.
Speaker 2:Regarding spinal cord injury.
Speaker 1:Yes.
Speaker 2:That men are In men. It's happening more.
Speaker 1:It's more common Because it is taking behaviors Because of behavior.
Speaker 2:It's easy to go to this direction. To understand this, because in men we have more spinal cord injuries compared to women and more spinal cord injuries due to faults compared to women. It's spirochortinib is due to falls compared to women. It's logical.
Speaker 1:And there are some statistics that says that men are more at risk for fatal falls, women non-fatal falls resulting non-fatal injuries. But when men men falls, they become the because men may.
Speaker 2:Maybe it is because of the occupational yes accidents, or in the industry which we discussed previously.
Speaker 1:And because they are high levels of risk-taking behaviors, let me say, yeah, right, they are more courageous than women and they climb, or something. Yes, I agree. So is there any? So you said that there are many guidelines for fall prevention. Can we talk some practical preventive measures that we can just advise people in order to prevent falls?
Speaker 2:How do you want to hear?
Speaker 1:At home or something else at work.
Speaker 2:Right what can we say then we can group these practical solutions by home, workplace, lifestyle or evidence-based. Let's start with home safety. With home safety, for example, it's the simplest the lighting we need to have night lights we know that many accidents are happening at night. The floors and walkways we need to have a clear walk to walk in a clear corridor, for example, the stairs and the bathroom, to install grab bars, non-slip mats and so on, and other target home modifications we can make with the help of occupational therapists or physical therapists. And, if you allow me to go to the next level, in workplace. Workplace is a very important issue because here we need to follow some rules. We need not to be careful when climbing in ladders, we need to have fall protection at heights and some footwear Footwear needs sleep resistant shoes on slick floors and we need to have all the walkways clear, the walkways clear in the workplace. It's very important.
Speaker 1:Yes, and to summarize, we can give a quick list to prevent falls as aging, we all know that health conditions can change and older people have poor balance and may have some gait disturbance. So we just recommend them stay active and keep muscles strong it is very important, especially for the older adults and check vision and hearing regularly. We should just warn them. So make home and work environment safer. Use devices if needed. Most of the people reject using canes or some assistive devices. Walkers, although they have some balance problems, they think that it's a sign of oldness.
Speaker 2:Yes, but you know. It prevents them from falling and, if needed, but we Belgians, we as physicians we need to start to prescribe medications, because polypharmacy in old ages is a very big problem and we know that more than four drugs are a risk factor for falling. That means we need to review all the medication in these people to focus on deprescribing, which is a new idea, but we didn't learn that in the university. We need to learn how to do it. It's very important, I believe.
Speaker 1:Especially in some neurological or cardiological problems.
Speaker 2:Exactly, exactly, very important.
Speaker 1:And one should know the side effects of the drugs, especially in aging population.
Speaker 1:While prescribing medication, please be aware of fall risk and we should warn our young colleagues. And the most important thing may be spread awareness, because prevention saves lives. We know we have to spread awareness and I know that you are the subcommittee of SCI Day poster contest. This year we organized as prevention committee, we organized some contests, either photograph or video or poster contest, in order to spread awareness on fall protection and spinal cord prevention. So can you give us brief information this year?
Speaker 2:poster contest. How it is going? How many applications have you already received? I am in the 10th university of the SEI Day, and here we need to say that the SEI Day was an inception from Dr Chabra.
Speaker 1:Yes.
Speaker 2:We need to say that the pioneer of the ACI day and I believe it will be the most successful day because I see the submissions more than 25 till now and it's still coming. I couldn't believe that it was the first time so many submissions for a very important issue like FALSE, but it is so successful here for the SEI Day really in the 10th University and Dr Chabra should be very happy about this, Not only us.
Speaker 1:So would you like to?
Speaker 2:To say something more, because the contest will be. We will have a Zoom meeting on the 5th of September with all the participants who submitted the poster, and then there will be a committee and a panel of judges mostly members of the prevention committee will review the posters and then we will have the final decision and the three best posters will be awarded. So it will be a very hard competition this year, I believe, and a very good one, and congratulations to you also, belgin, because you did a great job to spread the word regarding this New Year's competition.
Speaker 1:Thank you. Thank you when we come together, we will do great jobs, because just promoting awareness is crucial, especially on falls, because they are preventable and if you prevent falls, you don't have SCI, you don't have hip fracture, even you don't die because of hip fracture or because of traumatic brain injury. So it's very important. Thank you, professor Yanis, for joining us and sharing your expertise. Thank you, professor Yanis, for joining us and sharing your expertise. And fall may seem like ordinary accidents but, as we have heard today, they can lead to devastating spinal cord injuries and, importantly, many of them are preventable. Many of them are preventable. On this SEI Day, we encourage everyone listening to take action, make home safer, look out for loved ones and advocate for safer communities. Small steps can prevent life-changing injuries, and this has been Professor Bergin, erhan Chair of the Prevention Committee. Thank you for tuning in and let's continue working together toward a world where fewer lives are impacted by preventable SCIs. Stay safe and take care.