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.

Telehealth Implementation and Teaching Strategies During COVID-19 and Beyond in Gait, Balance, and Mobility Clinic for Community-Dwelling Older Adults

“…The SPTs were trained and educated on the mhealth platform called Health in Motion (HIM) app developed by Blue Marble Health Co. 43 This platform contains both assessment [44][45][46] and intervention 47 features. The intervention feature was utilized by the SPTs to create a personalized home exercise program (HEP) (Figure 2).…”