Falls are a leading cause of disability and death in older adults. Each year, approximately 25% of U.S. adults 65 and older report falling, according to the CDC. And, while not all falls are fatal, many are: The Global Burden of Disease Study 2021 found that falls are the “second leading cause of unintentional injury-related deaths,” and account for around 684,000 deaths each year globally.
Even if a fall isn’t fatal, it can be debilitating – both physically and mentally. Falls can result in brain injuries, fractures, and other chronic, life-altering complications. They can also leave psychological scars that decrease independence and quality of life. One study found that up to 70% of individuals recovering from a recent fall report “fears of falling” and 50% “may limit or exclude physical or social activity because of this fear.”
The good news is this: Falls are preventable.
To help healthcare providers and caregivers prevent falls in older adults, the CDC launched the STEADI (Stopping Elderly Accidents, Deaths, and Injuries) Initiative in 2012. The initiative, which includes clinical and practical resources, outlines how healthcare providers can screen their patients for risk factors. Many of the screening tests the CDC recommends can be augmented by the objective data that biofeedback tools – like force plates – generate.
Risk Factors of Falling
Falls can be caused by intrinsic or extrinsic factors. Healthcare providers can provide education, but not screening, for extrinsic causes of falls, like ill-fitting footwear, slippery surfaces, and poor lighting. They can, however, screen for intrinsic factors, including:
- Previous falls
- Advanced age
- Impaired gait and mobility
- Poor balance
- Chronic medical conditions, including vascular diseases, arthritis, diabetes, and vertigo
- Cognitive disorders, like dementia and Parkinson’s
- Impaired vision
- Poor nutrition and vitamin deficiencies
- Postural hypotension
How to Assess an Older Adult’s Fall Risk
If a healthcare provider suspects a patient may be at risk of falling, they should assess their gait, strength, and balance using the tests below, per STEADI guidelines.
Timed Up & Go (TUG) Test
The patient begins the exercise sitting in a chair. They are directed to stand, walk in a line 10 feet away, return to the chair, and then sit down. Older adults who take twelve or more seconds to complete the test are at higher risk of falling.
30-Second Chair Stand Test
The patient is instructed to sit and come to a full standing position as many times as possible in a 30-second window. Below-average scores (see the chart to the right) are associated with an increased risk of falling.
4-Stage Balance Test
The patient is led through a series of four balance tests that get progressively harder:
- Test 1: Feet are placed side-by-side
- Test 2: The instep of one foot touches the big toe of the other foot
- Test 3: One foot is placed in front of the other, heel touching toe
- Test 4: The patient stands on one foot
Older adults who struggle to hold any of the four stances for at least 10 seconds may be at increased risk of falling.
While the three tests outlined above are recommended by the CDC, other assessments can also be used to evaluate a patient’s fall risk, including:
- Tinetti Test: Measures gait and balance on a 28-point scale; scores under 19 indicate a high risk of falling
- Unipedal Balance Test: Evaluates the patient’s ability to stand on one leg with eyes closed; inability to hold the position for a minimum of 5 seconds indicates high fall risk
- Heel Rise/Calf Strength Test: Measures triceps surae strength; inability to perform multiple repetitions may indicate weaknesses that make the patient more susceptible to falling
How Force Places Augment Fall Prevention Initiatives
Most healthcare providers rely on analog tools (e.g., a stopwatch and a chair) and eyeballing to run tests and draw conclusions about a patient’s risk of falling. While these methods are sound, there are limitations: scoring can be subjective, and evaluations vary from provider to provider.
To make assessments more objective, forward-thinking healthcare providers have started to adopt digital biofeedback tools and connected ecosystems, like Kinvent. These tools – and force plates, in particular – generate accurate, quantitative data that can enhance traditional testing methods and, ultimately, help prevent falls.
Force plates measure the ground reaction force (GRF) of a body or limb that is stationary or in motion. Healthcare providers can use force plates to measure steadiness, stability, and right-left symmetry, and assess gait and balance using center of pressure (COP) and center of gravity (COG) metrics. That data can be used to closely monitor a patient’s fall risk over time.
The efficacy of force plates in fall prevention programs isn’t just anecdotal: One systematic review found that “certain aspects of force platform data may have predictive value for subsequent falls, especially various indicators of the lateral control of posture.”
Case Study: Force Plates Used to Reduce Medio-Lateral Sway
Who: An 80-year-old with severe spinal stenosis and a history of vertigo
The problem: The patient experienced severe pain in his left leg while walking and was at risk of falling.
The diagnostic procedure: Dr. Adam Ruszkowski, a physical therapist, orthopedic clinical specialist, performance consultant, and the founder of AR Physical Therapy, had the patient perform 30-second sit-to-stand tests on Kinvent’s K-Deltas with the K-Move strapped to his right thigh to collect additional data. He also ran single-leg balance and Romberg tests to predict the patient’s fall risk. All data generated by the sensors was sent to the Kinvent App and organized into clear, user-friendly reports.
What the data showed: The initial assessment showed the patient had 18.5% asymmetry between his right and left sides, distributed his weight to his heels, and had significant medio-lateral sway.
The outcome: After two months of rehab, the patient reduced his right/left asymmetry to 4.6%. Dr. Ruszkowski submitted the data to Medicare to get the patient additional sessions, which were easily approved because he proved clinical rationale, thanks to Kinvent.
Prevent Falls with Force Plates Today
Force plates generate the objective data healthcare providers need to build personalized fall prevention programs for their clients. When used in conjunction with traditional tests – like TUG, sit-to-stand, and balance tests – force plates can help identify and monitor deficiencies that increase a patient’s fall risk.
For more information about force plates, read our comparison guides:
To learn more, contact JLW Instruments to speak with a force plate expert. We stock and calibrate the entire suite of Kinvent Bluetooth-enabled digital devices, including the K-Force Plates, K-Deltas, K-Deltas XL, and K-Deltas 3D.
