Fall Injury Avoidance Strategy Scale (FIAS)-Validation of a Scale to Quantify Fall-Related Protective Movements.

In 30 seconds

This validation study assessed the video-based Fall Injury Avoidance Strategy Scale (FIAS) in 23 older adults at risk of injurious falls, using 376 standardized experimental falls recorded at baseline, after intervention, and at 3-month follow-up. The scale showed good interrater reliability (intraclass correlation coefficient, 0.87; 95% CI, 0.84-0.89). Higher FIAS scores were associated with lower hip and head peak acceleration and lower odds of head impact. The scale also responded to training-related changes and identified head-impact risk with an area under the curve of 0.87 (95% CI, 0.84-0.91).

Key findings

• Higher FIAS scores were associated with lower odds of head impact (odds ratio, 0.22; 95% CI, 0.15-0.32; P<.001).
• Higher scores were associated with lower hip peak acceleration (B=-0.94; 95% CI, -1.33 to -0.54) and head peak acceleration (B=-5.88; 95% CI, -6.76 to -5.01).
• Interrater reliability was good (intraclass correlation coefficient (2,k), 0.87; 95% CI, 0.84-0.89; P<.001), and responsiveness to training-induced changes was significant (F=11.06; P<.001).
• For identifying head-impact risk, the area under the curve was 0.87 (95% CI, 0.84-0.91); a cut-off score of ≥5 yielded 78.03% sensitivity and 80.36% specificity.

Why it matters

Protective movements during a fall may relate to impact forces and head injury risk, but assessing them requires a consistent method. FIAS offers a structured video-based measure with reported reliability, responsiveness, and diagnostic performance in experimental falls. These findings support further consideration of protective movement assessment as one component of research and evaluation aimed at understanding fall-related injury risk.

What to keep in mind

The validation involved 23 older adults in a laboratory using standardized experimental falls, so performance in real-world falls is not established by this study.