跌倒伤害预防策略量表（FIAS）——一种量化与跌倒相关的保护动作的量表的开发与验证

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

作者信息

Chen Lingjun, Zanotto Tobia, Lee Joo Hyun, Fang James, Tabatabaei Abbas, Alexandar Neil, Sosnoff Jacob

机构信息

Department of Physical Therapy, Rehabilitation Science, and Athletic Training, School of Health Professions, University of Kansas Medical Center, KS, United States.

Department of Occupational Therapy Education, School of Health Professions, University of Kansas Medical Center, KS, United States.

出版信息

medRxiv. 2025 Jul 23:2025.07.22.25331998. doi: 10.1101/2025.07.22.25331998.

DOI:10.1101/2025.07.22.25331998

PMID:40778133

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12330437/

Abstract

OBJECTIVES

To develop and validate the Fall Injury Avoidance Scale (FIAS), a novel video-screening tool to assess protective movements and injury risk during standing-height falls among older adults.

DESIGN

Secondary analysis of video-recorded experimental falls.

SETTING

Laboratory setting.

PARTICIPANT

Twenty-three older adults (aged 66-84 years; 4 males, 19 females) at risk of injurious falls.

INTERVENTION

Not applicable.

MAIN OUTCOME MEASURES

Participants experienced a total of six standardized experimentally-induced (backwards, left, and right directions). Fall movements were recorded using a motion capture system and commercially-available cameras. Hip and head peak acceleration were extracted from custom MatLab scripts. FIAS score (sum of 4 evidence-based protective fall movements, range 0-8) and the occurrence of head impact were determined by two independent raters using standardized and structured questionnaire. Inter-rater reliability, construct validity, responsiveness, and diagnostic utility of FIAS score were evaluated.

RESULTS

A total of 274 experimental falls were analyzed. FIAS score indicated excellent inter-rater reliability (ICC(2,k) = 0.85 (95%CI [0.81-0.88], p<0.001). The higher FIAS scores were significantly associated with the lower hip peak acceleration (B=-1.01, 95%CI [-1.47, -0.56], p<0.001) and head peak acceleration (B=-6.08, 95%CI [-709, -5.06], p<0.001), and lower odds of head impact (Odds Ratio [OR]=0.20, 95%CI [0.12, 0.33], p<0.001). FIAS score also demonstrated significant responsiveness to the training-induced changes (F=18.74, p<0.001). Diagnostic analysis suggested that FIAS score ≥ 6 showed the high specificity (95.5%) for ruling out head impact falls.

CONCLUSIONS

FIAS is a reliable, valid, and responsive tool to assess the protective fall movements and injury risk among older adults, which has potential utility in screening and prevention of fall-related injuries.

摘要

目的

开发并验证跌倒损伤预防量表（FIAS），这是一种新型视频筛查工具，用于评估老年人站立高度跌倒时的防护动作和损伤风险。

设计

对视频记录的实验性跌倒进行二次分析。

设置

实验室环境。

参与者

23名有跌倒致伤风险的老年人（年龄66 - 84岁；男性4名，女性19名）。

干预

不适用。

主要观察指标

参与者总共经历了6次标准化的实验性诱发跌倒（向后、向左和向右方向）。使用动作捕捉系统和市售相机记录跌倒动作。从自定义的MatLab脚本中提取髋部和头部的峰值加速度。FIAS评分（基于4种循证防护跌倒动作的总和，范围0 - 8）和头部撞击的发生情况由两名独立评估者使用标准化和结构化问卷确定。评估了FIAS评分的评估者间信度、结构效度、反应度和诊断效用。

结果

共分析了274次实验性跌倒。FIAS评分显示出极好的评估者间信度（ICC(2,k)=0.85(95%CI[0.81 - 0.88],p<0.001)）。FIAS评分越高，与较低的髋部峰值加速度（B = - 1.01,95%CI[-1.47,-0.56],p<0.001）和头部峰值加速度（B = - 6.08,95%CI[-7.09,-5.06],p<0.001）以及较低的头部撞击几率（优势比[OR]=0.20,95%CI[0.12,0.33],p<0.001）显著相关。FIAS评分对训练引起的变化也显示出显著的反应度（F = 18.74,p<0.001）。诊断分析表明，FIAS评分≥6对排除头部撞击跌倒具有高特异性（95.5%）。