There are several outcome measures used clinically to determine if an individual is at high risk for falls. These objectively measureable tests can be helpful to assess risk for falls, need for use of assistive walking device and/or possible need for skilled care intervention (i.e. physical or occupational therapy). Often times a baseline test score is established upon evaluation of a patient and goals are set to achieve the normal scores. A high percentage of falls in the elderly involve hip fractures that may require surgery and/or compression fractures of the spine. Early assessment can lead to prevention of these types of problems that are often painful and require a lengthy recovery time.
Five-Times-Sit-to-Stand-Test (FTSST): This test is easy to administer and can quantify the ability of an individual to perform a transitional movement, assess leg strength/balance and can be linked to risk for falls. Subject is asked to sit to stand from a 43 cm height chair as quickly as possible with their arms crossed on the chest, five times. Timing begins at start of first sit to stand transfer and ends when hips touch the chair on the 5th repetition. Timer should provide close supervision (standing within arms length distance of individual) for safety should patient lose their balance. Research has shown that slower sit to stand times are linked to greater deficits with activities of daily living and to balance disorders in the elderly. Normal score for patients <60 years of age = 10 sec, >60 years of age = 14.2 sec
Timed Up and Go Test: A timed walking test including sit to stand transfer use to assess balance with transitional movements, speed of walking and risk for falls. Individual is timed as he/she stands from sitting in a standard chair with arm rests, walks 3 meters, turns 180 degrees and walks back to the chair to sit. Timing begins as patient stands from the chair and ends when hips touch the chair upon sitting after walking 3 meters. Timer should walk with the patient to provide supervision if safety is an issue. Normal score is <12 seconds. Timed Up and Go scores of >16 seconds has been showen to be predictive of increased fall risk in community dwelling elderly adults.
Berg Balance Scale Score: This 14 item performance instrument can be found online. Some training may be necessary for proper administration for reliability and validity. A physical therapist may administer this test with patients who have balance disorders or difficulty walking under the prescription of a medical doctor. Each of the 14 items are scored from 0-4 points. A score of <45/56 total suggests an individual is at high risk for falls.
These are just a few examples of ways to objectively measure risk for falls. They can also be used as screening tool to assess need for use of an assistive walking aid or need for skilled care intervention (i.e. physical and/or occupational therapy).
