Assessing Fall Risk: Too Many Choices!

Disability due to falls has increased by 54% from 1990 to 2010, making falls a major concern for older adults and healthcare providers.1 The higher incidence also means clinicians need to be able to identify individuals at risk for falls as well as the components of fall prevention that put this group at an elevated risk. By selecting an appropriate outcome measure a clinician should be able to write accurate assessments and decrease fall risk.

Selecting Outcome Measures ­– Too Many Choices!

Using the following questions and recent evidence, a clinician should be able to select an appropriate outcome measure for their patient population/practice setting:

  • How feasible is the measure? (time/cost)
  • How portable is the measure? What equipment is needed?
  • Is performance better than self-report?
  • Has measure been evaluated in my patient population or setting?
  • What dimensions of risk/balance are captured?
  • Can I get better info using a set of measures?
  • Who needs to do the test? What is the training?
  • How easily can results be interpreted?
  • How should I use test findings in documentation?

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Psychometrics – Why Does it Matter?

Due to significant number of fall risk assessment tools and ethical value of providing the best patient care, it is important that a clinician selects an appropriate tool with strong psychometric properties and is feasible for a clinical setting.  

Using psychometric data a clinician can answer the following questions:

  • What tools should a clinician use for screening versus risk assessment?
  • How accurately does a particular test/measure evaluate balance and fall risk?
  • How reliable is the test/measure?
  • How should a clinician interpret test results? What is the best “cut score” as indicator of fall risk for the specific patient population?
  • What combination of tests/measures provide best information about future fall risk?
  • Did intervention make a difference?

Using the information you gain from our course, Improving Balance and Reducing Fall Risk, and answering the questions above you will be able to select appropriate assessment tools for your patient as well as write a thorough assessment with the goal of justifying your skilled therapy services.

References
  1. Stubbs B, Binnekade T, Eggermont L, Sepehry A, Patchay S, Schofield P. Pain and the risk for falls in community-dwelling older adults: Systematic review and meta-analysis. Archives of physical medicine and rehabilitation. 2013;95(1):175–187