Determining Fall Types and Fall Assessment Measures for People with Osteoarthritis

Falls are a leading cause of death and disability for older adults in the US. A commonly reported risk factor to falls is the presence of osteoarthritis (OA). People with OA fall at rates 50% higher than older adults without OA. There are currently no fall prevention programs targeting this population. The scarcity of information about the circumstances and consequences of falls experienced by people of OA could be limiting the development of effective fall prevention programs. There is currently no self-report instrument that collects information about the circumstances and consequences of falls that include factors associated with symptoms of OA. Thus, a series of 4 studies were performed to explore the fall experience from the perspectives of people with OA and to create a Fall Assessment Survey for People with Osteoarthritis (FASPO), then utilize this instrument to gather information about the circumstances and consequences of falls. Next, to organize fall information in a standardized and systematic format, a fall classification framework was created to improve the analysis and reporting of falls. Finally, the information gathered was used to determine the types of falls to examine the relationships between types of falls and the following variables: 1) demographic characteristics, 2) personal characteristics that contribute to falls, and 3) self-report measures for pain, function, activity, and balance. Types of falls were categorized based upon the mechanism of instability, e.g., the cause of the fall. Focus group discussions revealed that symptoms of pain and joint issues contributed to falls experienced by people with OA. Cognitive interviews revealed that the FASPO was clear and meaningful and required minimal modification to improve functionality. The fall classification framework was created to categorize falls into the following types: trip, slip, misplaced step, loss of support, and collision. Walking was the most reported activity, slips were the most reported types of falls, only 3 participants reported no injury after the fall, and 63% of participants reported OA symptoms contributed to their falls. Associations were found between personal characteristics and types of falls and self-report measures, but further research is needed to examine the relationships.