We would like to congratulate Boswell-Ruys et al.1 on developing a specific scale (SCI-FCS) on falls concern in patients with spinal cord injury. It is useful in assessing the falls concern.

  • In the questionnaire structure subsection of results section, I note an error in text section, which provides contrasting information to Figure 1 in the article. Text states that items assessing higher level of concern were items 2,4–8,10,11 and 15, and items assessing lower level of concern were items 1,3,9,12–14,16.1 Figure 1 shows these items to be in exactly opposite section.

  • Item number 15 in the proposed scale–shopping seems nonspecific in a sense that it covers diverse activities (for example, pushing wheelchair±reaching for higher objects) carried out alone/combination (in scale itself) in varying scenarios.

  • I would also like to know whether authors considered getting input from patients in developing an item bank for the scale, in addition to limited number of clinicians (22 in total) nominating the items. Patients would seem to be the most likely group to nominate scenarios of their fall/falls concern.

  • Patients who suffered more falls reported significantly less concern as per the study. In the discussion section, authors state that participants may have learnt through experience how to reduce impact of falls from their wheelchairs. Is this statement derived from information provided by patients? This is an important issue, which affects validity of questionnaire.

  • Interestingly, none of the patients suffered injuries affecting their mobility in this study.