REMOTE VS. FACE-TO-FACE FALL RISK ASSESSMENT

H. Sarig Bahat¹, A. Toledano-Shubi¹, H. Hel-Or²

¹University of Haifa, Physical Therapy, Haifa, Israel, ²University of Haifa, Computer Science, Haifa, Israel

Background: One significant contribution of the COVID-19 pandemic was the acceleration of remote healthcare. Remote fall risk assessment is essential to ensure the safety and well-being of the elderly population. Additionally, remote fall risk assessment can reach those with limited access to healthcare facilities, and enable wide screening of the elderly population at risk. Falls are a leading cause of serious injury and death in older adults, and accurate assessment of fall risk remotely can help identify those at risk and potentially prevent falls.

Purpose: The purpose of this study was to investigate the feasibility and reliability of remote fall risk assessment, as compared with face-to-face.

Methods: This study was designed as a cross-sectional inter-format and inter-tester reliability study. The study's population included community dwelling older adults, aged 65 years and over. Exclusion criteria included inability to participate in physical assessment due to musculoskeletal disorder, or unstable systemic disease. Five valid functional and balance tests were used simultaneously in a remote FTF setting: Timed up and go test (TUG), 30 Seconds Sit to Stand Test (STS), Berg Balance Scale (BBS), Mini BESTest and 4 Meter Walk Test (4MWT). Inter-rater reliability between remote and FTF assessment was analyzed using the intraclass correlation coefficient (ICC) and the Bland and Altman methods.

Results: Forty-eight adults aged 65-86 years (mean 72.5±4.7) were recruited for this study. Excellent ICCs were found in the STS, BBS, Mini BESTest and TUG (0.9-0.99), and moderate in the 4MWT (0.74). The Bland and Altman analysis showed excellent agreement between remote and FTF assessment of the STS. All other tests showed low to moderate agreement. Mini BESTest was the only test that was not feasible for remote assessment as some of its tasks require physical contact with the tester or dedicated equipment or space.

Conclusions: According to our findings, the 30 seconds sit to stand test was found to be feasible and highly reliable for remote fall risk assessment in home dwelling elderly.

Implications: Sit to stand is a short and simple test that has been established as a predictor of recurrent falls. This study showed STS sustained its reliability in a remote format and therefore is recommended for remote detection of those at risk of fall. Early detection of fall risk and referral to physical therapy may prevent horrendous falls in the elderly.

Funding acknowledgements: This research was supported by the Data Science Research Center at the University of Haifa [# 100008981, 100009419].

Keywords:
Fall risk
Remote
Elderly

Topics:
Health promotion & wellbeing/healthy ageing/physical activity
Older people
Community based rehabilitation

Did this work require ethics approval? Yes

Institution: University of Haifa

Committee: Faculty of social welfare and health sciences ethics committee

Ethics number: 264/21