Fraunhofer Center for Assistive Information and Communication Solutions – AICOS12.1.2017
Fraunhofer Portugal AICOS has been developing a solution for the evaluation of fall risk factors on a daily basis: the Fall Risk App. The application allows to continuously assess the mobility of the users while they are performing their usual daily activities. The validation of the application was developed in partnership with the Dutch company Gociety and carried on by the Faculty of Health Care of Zuyd University.
Falls are one of the most common health related problems in the elderly population, representing more than 50% of the hospitalizations due to injuries. The majority of falls can be anticipated by tracking the evolution of a set of fall risk factors. The knowledge about the most relevant fall risk factors for a given person is also key for the implementation of targeted prevention strategies. The main risk factors associated with falls include muscle weakness, gait and balance problems, visual or cognitive impairment, functional decline, or the use of certain medications.
With the Fall Risk App, the movements performed during daily activities are characterized, allowing to extract metrics, which are associated with personal information, medical conditions, medication plans and answers to questionnaires, allowing to obtain a continuous estimate of the risk of falling.
There are a variety of tests and scoring systems for the evaluation of fall risk factors that aim to differentiate between fallers and non-fallers. Standard assessment procedures are based on questionnaires or functional evaluations that are applied by a specialized professional in a dedicated setting, as a clinic, hospital or nursing home. The main drawbacks of these procedures are the subjective nature of the evaluation, not only regarding the answers to the questionnaires but also the observational scoring scales that are used in most of the tests. Moreover, few tests rely on multifactorial analysis of risk factors and the evaluation is only performed at a given moment in time.
The aim of the validation study was to compare the evaluation of fall risk made by the developed application and three standard fall risk assessment tests: Tinetti Performance Oriented Mobility Assessment (POMA), Timed Up and Go (TUG) and Functional Reach (FR). The Faculty of Health Care of Zuyd University conducted the validation of the project, with a total of 65 subjects (mean age was 65.7 ± 6.5 years old). In a group of 29 males and 36 females, 31 used walking aid and 24 have fallen last year. All the participants carried, during two weeks, a smartphone inside the pocket or fixed in the belt. The mean fall risk score calculated by the application during that time showed good correlation with the standard tests: the correlation with POMA and FR tests is moderate and with the TUG test is strong.