title: The 'Aachen Falls Prevention Scale' - development of a tool for self-assessment of elderly patients at risk for ground level falls.
abstract: BACKGROUND
  The incidence of falls in the elderly population is difficult to determine and therefore potentially underestimated. Screening algorithms usually have in common that the evaluation is undertaken by trained individuals in a hospital setting. This leads to the inclusion of a high proportion of low-risk people and a waste of resources. It would be advantageous to pretest the individuals at risk in their own environment using a simple self-assessment approach.
  
  
  METHODS
  The consensus process of our group of clinicians and physical therapists included: 1. a preparative literature review about risk profiles and assessment tools for ground level falls; 2. a selection of appropriate questions that cover all health aspects involved in an increased risk for falling; and 3. a selection of a simple physical test that can be used at home without the need of a health care professional. We thus searched to develop a scale that can be used by older citizen at higher risk of falling. The current manuscript summarizes the results of this review, consensus and selection process.
  
  
  RESULTS
  The literature search was undertaken between March and August 1, 2013. The selection process for the questions used (Part I) lasted between March 2013 and January 2014. Among all tests evaluated the 20 second standing test (Part II) was deemed to be safe to be performed even by an individual at risk for a fall, as it closely resembles activities of daily living. The `Aachen Falls Prevention Scale` finally uses a self-assessment tool grading falls risk on a scale of 1 to 10 by the individual itself after completion of Part I and Part II. In summary, we present a scale that might offer a self-assessment option to improve the measures of falls prevention pass for elderly citizens.
  
  
  CONCLUSIONS
  The introduction of the `Aachen Falls Prevention Scale` which combines a simple questionnaire with a safe and quick balance tool, meets the criteria to identify whether or not a balance problem exists - the first step in evaluation of falls risk. Further studies will have to assess the ability of an individual to estimate his or her individual falls risk on a longitudinal basis and possibly trigger the necessity for the assessment by a physician.
authors: Department of Orthopaedic Trauma, University of Aachen Medical Center, 30 Pauwelsstreet, 52074 Aachen, Germany.
authors: Hans-Christoph
authors: HC
authors: Pape
authors: Division of Physical Therapy at University of Aachen Medical Center, Aachen, Germany ; Harald Tscherne Lab for Orthopaedic Trauma, University of Aachen Medical Center, Aachen, Germany.
authors: Ulrike
authors: U
authors: Schemmann
authors: Division of Physical Therapy at University of Aachen Medical Center, Aachen, Germany.
authors: Juergen
authors: J
authors: Foerster
authors: Department of Orthopaedic Trauma, University of Aachen Medical Center, 30 Pauwelsstreet, 52074 Aachen, Germany ; Harald Tscherne Lab for Orthopaedic Trauma, University of Aachen Medical Center, Aachen, Germany.
authors: Matthias
authors: M
authors: Knobe
keywords: Balance assessment; Co-managed care; Fall prevention; Fractures in the elderly; Geriatric trauma center; Orthogeriatrics