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D. Fitzpatrick1, A. Golub-Victor1, A. Bloom1, M. Keeffe1
1Northeastern University, Department of Physical Therapy, Movement and Rehabilitation Sciences, Boston, United States
Background: Falls in community dwelling adults with intellectual disabilities (ID) are a growing public health issue. Those with ID are more likely to have comorbidities that are not properly managed. They also have limited equilibrium reactions, decreased physical capacity, and decreased cognition. Lastly, individuals with ID are largely underserved within the healthcare system, making them a vulnerable population. This leads to individuals that are at high risk for falls. The impact of falls not only causes physical and psychological harm to the individual, but can increase caregiver and family burden. Despite this problem, there is a lack of validated fall risk assessment tools to screen those with ID.
Purpose: The purposes of this scoping review were to examine the extent of research conducted on fall risk assessment tools in adults with ID, to map and summarize the findings and identify gaps in the exiting literature.
Methods: Study Selection: A scoping review was conducted using 3 databases: CINAHL, MedLine, PubMed. Data Extraction: From these articles, the following information was extracted: aims and purposes, demographics, methods, assessments used, and key findings. Participants of these studies must have had mild to moderate ID, be community dwelling, ambulatory, and over the age of 18. Selection of articles for review were between 1999-2019. Data was analyzed with descriptive summaries.
Results: 12 studies were selected based upon the inclusion criteria and underwent full article analysis. In summary, the Two Minute Walk Test, (2 MWT) the Ten Meter Walk Test and the Tinetti Performance Oriented Mobility Assessment (POMA) were found to be the most valid measurements of fall risk in this population. All assessments researched were found to have good to excellent test-retest reliability.
Conclusion(s): Although some research does exist on the reliability and validity of fall risk assessments in adults with ID, further research needs to be conducted in order to ensure health care professionals are utilizing best evaluative methods and correct data to provide evidence guided care for this underserved population.
Implications: The importance of accurately assessing fall risk for adults with intellectual disabilities is critical. It is understood that the age-related changes that happen to the general population not only happen earlier in this population, but in conjunction with multiple comorbidities. The combination of risk factors creates an unfortunate opportunity for unnecessary injuries. This compilation of the current literature highlights what limited information is available regarding fall risk assessments tools and the need for further investigation. The majority of the studies conclude that there are assessments that are reliable but not all of them passed validity testing. The most valid fall risk assessments found in this review were the Tinetti Instrument, 10 meter walk test and 2MWT. By combining the reliability and validity results, clinicians can begin to use these in their practice with this population. Although this review scoped a wide variety of literature, advocacy for the expansion of research is imperative to address the disparity in healthcare for this vulnerable population of adults with ID.
Funding, acknowledgements: None
Keywords: Fall Risk, Fall Risk Assessment Tools, Underserved Population
Topic: Intellectual disability
Did this work require ethics approval? No
Institution: Northeastern University
Committee: Northeastern University Human Subject Research Protection, Institutional Review Board
Reason: Literature Review
All authors, affiliations and abstracts have been published as submitted.
