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

Lingjun Chen1, Tobia Zanotto2,3, Joo Hyun Lee1

  • 1Department of Physical Therapy, Rehabilitation Science, and Athletic Training, School of Health Professions, University of Kansas Medical Center, KS, United States.

Medrxiv : the Preprint Server for Health Sciences
|August 8, 2025
PubMed
Summary
This summary is machine-generated.

The Fall Injury Avoidance Scale (FIAS) reliably assesses protective movements in older adults, helping to predict and prevent fall-related injuries. A score of 6 or higher effectively rules out head impacts.

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Area of Science:

  • Gerontology
  • Biomechanics
  • Injury Prevention

Background:

  • Falls are a major cause of injury in older adults.
  • Assessing protective movements during falls is crucial for injury risk evaluation.
  • Existing tools for fall risk assessment lack focus on protective movement analysis.

Purpose of the Study:

  • 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 in older adults.
  • To establish the reliability, validity, and diagnostic utility of the FIAS.

Main Methods:

  • Secondary analysis of 274 video-recorded experimental falls from 23 older adults (aged 66-84).
  • Motion capture and commercial cameras recorded fall movements.
  • FIAS scores (0-8) were determined by two independent raters based on 4 protective movements; head impact occurrence was also noted.

Main Results:

  • FIAS demonstrated excellent inter-rater reliability (ICC=0.85).
  • Higher FIAS scores correlated with lower peak acceleration (hip and head) and reduced odds of head impact (OR=0.20).
  • FIAS showed significant responsiveness to training and high specificity (95.5%) for ruling out head impact falls with a score ≥ 6.

Conclusions:

  • The Fall Injury Avoidance Scale (FIAS) is a reliable, valid, and responsive tool.
  • FIAS effectively assesses protective fall movements and injury risk in older adults.
  • FIAS has potential utility in screening and preventing fall-related injuries.