Feasibility of a self-reported digital fall risk assessment compared with the traditional functional balance and gait assessments performed during student led balance screening: A pilot study

Abstract

Background: One in four older adults in the age range 65 and above, report falls in the US each year. Some falls cause injuries or even deaths and can pose a significant economic burden on society. This pilot study compares two different methods of measuring fall risk in older adults. The goal of this research is to investigate the feasibility of a digital fall risk assessment tool, compared with the traditional functional gait and balance assessments. Methods: Community dwelling older adults aged 60 years or older were recruited. Physical therapy students guided the participants through the following traditional paper-based tests: Berg Balance Scale (BBS) or Fullerton Advanced Balance (FAB), 30 Second Chair Stand (30CST), 50-foot Walk Test, Balance Efficacy Scale (BES), and the Center for Epidemiologic Studies - Depression Scale (CES-D). All participants then independently completed the following digitally guided tests using the Health in Motion© (Blue Marble Health) remote therapeutic monitoring platform that comprised of Fall Risk Questionnaire (FRQ), One Leg Stand Test (OLST), 30 Second Sit to Stand Test (30STST), and 2 Question Depression Screen (2QDS). Results: This pilot study involved six female and one male community-dwelling older adults aged 67-90 years (81.57 ± 8.07). In general, the digital fall risk assessments correlated with some of the traditional paper-based fall risk tests. Specifically, there was a statistically significant moderate correlation between the digital fall risk questionnaire (FRQ) and the paper-based BES (r=0.77, p=0.043), and CES-D (r=0.76, p=.046). There was a statistically significant very strong correlation between the digital OLST and the 50-foot walk preferred speed (r=0.80, p=0.056), fast speed (r=0.92, p=.0009), and moderate correlation with 30CST (r=0.79, p=0.033). Further, there was a 100% match between both digital and paper-based depression tests. In terms of average total duration of administering the test, the digital fall risk assessment takes 7 minutes in comparison to 60 minutes with traditional balance and gait assessment. Conclusion: During the global COVID-19 pandemic and beyond, digital fall risk self-assessment tools can enable clinicians to collect asynchronous, objective, and standardized assessments prior to their telehealth visits. KEYWORDS: Fall Prevention, Fall Screening, Self-Assessment Mhealth App, Telehealth, Pro Bono Balance Clinic, Remote Patient Monitoring.