Choice Step Reaction Time (CSRT) Test

http://www.ncbi.nlm.nih.gov/pubmed/11584035

Stops walking when talking?

http://scholar.google.com/scholar?q=stops+walking+when+talking

Time up and go and stops walking when talking

Get-up-and-go test

 Get  up  and Go is the best.

Get up and go is a useful and valid test to our brazilian seniors, but there are others good options, such as downton.

Dear Juan -Diego ,  the question  was " the best test to prevent " falls  not to  predict falls .

Timed Up and Go (TUG) and Short Physical Performance Battery (SPPB)

The Spring Scale Test protocol (DePasquale L, Tosacno L, Jl Geraitr Phys Ther, 2009), employs repeated incremental predictable perturbations (RIPPS), captures forward and rear stepping limit performance expressed as percent of total body weight.. 10% total body weight highly discriminant to fall history. Research indicates the ability to withstand perturbations and adaptation to perturbations is associated with fall risk.  TUGT not discriminant in active older adults. 

there is no test to prevent falls. there are plenty to differentiate fallers from non fallers. but you have exercises and rehab technics to reduce the risk of falling. and finally the best one is still to exercise regularly for general population. Falls according to some specific condition is a different situation which needs some disease driven therapy by physiotherapist.

Prevention of falls begins by identifying those in risk of falls ' ( by ascreening test  like

Timed Get up and Go ) followed by an evaluation of those in risk in order to find out some medical problem. A program of care ' eventualy including physiotherapy is issued based on the findings. People in fisk should also have their home environment evaluated. To summ up - any fall prevention program should start with a screening test for the risk of falling. The most suitable is Timed get up and go - due to its doability .

Global assesment is needed. Dementia (patients are not able to  analyse what they see) and absence of regular walking (sarcopenia and loss of equilibrium)  are the first factors in frail elderly.

In fit persons we must think to bi-focus  or progressive glasses.

TGUT is very do-able but possesses ceiling effects and is not very discriminating nor responsive or sensitive to change at high performance levels. Pardassaney et al, Pai et al, Schoene, Arnold and other recent studies have ID limitations of TGUT in active older adults in particular.  Because a test is "do-able" doe not translate into useful. Perturbation assessment, stepping responses,reactive postural responses need assessment. Developing effective stepping responses at body weight forces of the magnitude of at least 10 % TBW will provide protection against falls.  Individuals 65 years and older should be tested for reactive stepping annually to determine % TBW effective stepping limits in AP directions. In my 40 year experience, RIPPS % TBW measure best ID fall risk and provides  quantitative, serial clinical decision making for older adults. TUGT, Gait Speed,Single limb stand time, Tandem stand time are ineffective measures of fall risk alone or in combination. Add  four square step test Tinetti to that list as well for active older adults.

I n separate studies, Pai, Martinez, Mille, Carty, Mansfield and DePasquale provide orientation to stepping and perturbation assessment.

Dear Louis - Personal experience is indeed highly valuable. However when answering such a question the benefit of public health care should be accorded

most attention. This is why TGUT  is considered the most recomended by the

falls literature. It is duable or  " du-able " because it is easy to teach medical personal how to do it ' easy to administer and  it provides a lot of  info .

Understand and appreciate your response Arthur, but evidence suggests otherwise. Recall TUGT was validated on frail population. FRAST tool (Renfro) employs TUG 7 second cut off for first tier fall ID. 7 seconds is nearly running. My clinical quest has been discerning difference between a 7 second and 9 second TUG fall risk or a Tinetti 24 vs 25 score !  respectfully submitted.

Realizing that the original question pertains "large populations", please let me posit that TUGT has been "du-able" in persons with dementia [Alzheimer's Disease (different stages)], with Minimal Detectable Change in such subjects of 4,09 "

best wishes for a Merry Christmas & Happy New Year, Mauro Colombo

I'm confused by your question. Are you interested in a test or a protocol? What are you trying to do?

Following Mauro Colombo's answer - I tested 150 elderly individuals diagnosed with knee OA using TUG - 10 had to be excluded because dementia. 6MWT is also an important test - even though it does not require too much understanding, it does take longer and may generate more fatigue. In a recent published study, I observed that obesity may be another issue, if you are generalizing your population. Happy New Year, Kamary Coriolano

Article Changes in self-reported disability after performance-based ...

kind Kamary, nice paper [just bookmarked], Mauro

Thank you Mauro, it is a pleasure to help and exchange info. Best regards,

Kamary

I don´t know the best test of the prevalent fall, but I think the preventive measure is to the pharmaceutical reviewers is the first step to the prevent fall risk. 

I don´t know the best test to the prevent fall, but I think a preventive measure to the pharmaceutical reviewers are the first step to the prevent fall risk.

Hello, I would suggest you utilize the Berg Balance Scale to identify clients at risk for falls and Functional Reach and perturbation for physical aspect; however, you will want to consider the client's visual and cognitive skills as well. Sometimes,a client's visual and cognitive capacity can be so compromised that it presents as a physical deficit. The Snellen chart is a quick assessment for acuity along with the need to complete visual fields and other areas. A thorough vision test can be done in 5 minutes. For cognition, you could utilize the Montreal Cognitive Assessment (MoCA) located on www.mocatest.org for free in various languages.

BBS and FR not discriminant in active older adult population. FR very weak and non-challenging. BBS limitations addressed by Pardassaney et al in PT 2012.

Spring Scale Test is only clinical test available capable of assessing and quantifying reactive protective stepping responses.

Hello, I offer you to consider these instruments:

Morse Fall Scale, Falls Risk Assessment Tool (FRAT)Add your answer

Best regards.

dear all, as far as I know Morse can help identify fallers among wheel-chair seated people; best regards, Mauro Colombo

Tests do not "prevent falls"  They identify the potential risk of falls and then there is a need to use a multi-system approach to address many of the complex factors that are involved.

Explore the Six pack study in Australia: http://www.med.monash.edu.au/assets/docs/sphpm/6-pack-project.pdf  In-hospital falls and fall-related injuries: A protocol for a cost of fall study (Article)

Morello, R.T.a ,

Barker, A.L.a,

Haines, T.b,

Zavarsek, S.c,

Watts, J.J.c,

Hill, K.d,

Brand, C.a,

Sherrington, C.e,

Wolfe, R.f,

Bohensky, M.a,

Stoelwinder, J.a 

And the RESPOND study

RESPOND—a patient-centred programme to prevent secondary falls in older people presenting to the emergency department with a fall: Protocol for a multicentre randomised controlled trial  (Article)

Barker, A.L.a  , 

Cameron, P.A.a, 

Hill, K.D.b, 

Flicker, L.cde, 

Haines, T.P.f, 

Lowthian, J.A.a, 

Waldron, N.g, 

Arendts, G.ce, 

Redfern, J.h, 

Forbes, A.i, 

Brand, C.A.aj, 

Etherton-Beer, C.D.cde, 

Hill, A.M.k, 

Hunter, P.l, 

Nyman, S.R.m, 

Smit, D.l

Good morning,

I agree with the last comment - there is no test that will prevent falls.  A test merely identifies a risk of falls.  Falls are caused by a multitude of reasons; these can be classified as medical conditions (e.g. Parkinson's, postural hypotension), pharmacological (e.g. polypharmacy, anti-psychotics), impaired cognition (e.g. early onset dementia), strength and balance.  These all intertwine and interact on one another.  The UK's National Institute of health and Care Excellence (NICE) provide an excellent review of causes, interventions, and make recommendations for successful and effective interventions:  https://www.nice.org.uk/guidance/cg161

As a research Physiotherapist, I will address all of the above within a multi-disciplinary team.  I will examine gait and balance deficits, one of which might be impaired vestibular function.  There is very clear evidence that strength and balance training is effective in the reduction of falls.  Programmes should have a dosage which exceeds 50hours taken at regular intervals.  There is no single test that reduces falls, for gait and balance deficits, you might consider several tests - Timed Up & Go, Berg Balance, Tinetti, Sharpened Romberg for example.

Hope this helps 

Perturbation Spring Scale Test described by DePasquale  and Toscano JGPT 2009. SST was most discriminant to fall history in active older adults compared to gait speed, TUGT, single limb stand and sharpened rhomberg.

Acupuncture treatment. It makes elderly without repeated falls, poor balance, and bone fracture that will solve the elderly falling problem. Moreover, it brings many advantages.

https://universaltcm.com/acupuncture-treats-elderly-falling/

Tests do not prevent falls. Tests can only detect  with varying accuracy what is the risk

of a certain person to fall. Following  a positive such test, an evaluation should be made as to possible treatable conditions in hope to prevent or minimize falls.

The Spring Scale Test  (DePasquale L, Toscano L, JGPT 2009 ) which is a waist pull perturbation assessment and intervention method predicated on repeated incremental "predictable" perturbations validated on ACTIVE older adults n=58 (n=30 80-89 yrs old). Percent of total body weight is performance measure, 10 % TBW discriminant for fall status, This test superior to TUGT, gait speed, OLST and tandem stand. Many current studies concluding the limit and weakness of TUGT and BBS.

Quick tests not very usefull .  Might consider the MiniBestest . 

study attached