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Falls Questionnaire

History of Falls Questionnaire

Last Updated

Purpose

The History of Falls Questionnaire assesses the circumstances surrounding a fall including: activities prior to falling, perceived cause, environmental factors, and a description of injuries.

Link to Instrument

Instrument Details

Area of Assessment

Balance – Vestibular
Balance – Non-vestibular
Functional Mobility
Gait

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

Diagnosis/Conditions

  • Brain Injury Recovery
  • Cerebral Palsy
  • Multiple Sclerosis
  • Pain Management
  • Parkinson's Disease & Neurologic Rehabilitation
  • Pulmonary Disorders
  • Spinal Cord Injury
  • Stroke Recovery
  • Vestibular Disorders

Key Descriptions

  • 17-item survey with four sub-categories (Talbot et al., 2005)
  • Activities prior to falling:
    1) Ambulation
    2) Transferring
    3) Running
    4) Sports
    5) Stairs/Curb
    6) Other
  • Perceived causes - Accident/environmental-related:
    1) Collapse episode
    2) Dizziness/vertigo
    3) Balance/gait impairment
    4) Other
  • Perceived causes - Environmental factors:
    1) Wet surface
    2) Uneven surface/steps
    3) Objects on surface/rugs
    4) External forces
    5) Icy surfaces
    6) Other
  • Injuries sustained from fall:
    1) Fractures
    2) Treated injury
    3) Untreated injury
    4) No injury

Number of Items

17

Equipment Required

  • None (non-instrumented) or video goggles (vHIT)

Time to Administer

5-10 minutes

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Initially reviewed by Suzanne O’Neal, PT, DPT, NCS & the PD EDGE task Force of the Neurology Section of the APTA.

ICF Domain

Body Function
Activity
Environment

Measurement Domain

Activities of Daily Living
Motor

Professional Association Recommendation

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

For detailed information about how recommendations were made, please visit:  http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

Abbreviations:

 

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

Recommendations Based on Parkinson Disease Hoehn and Yahr stage: 

 

I

II

III

IV

V

PD EDGE

NR

NR

NR

NR

NR

Recommendations for entry-level physical therapy education and use in research:

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

PD EDGE

No

No

No

Not reported

Considerations

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Bibliography

Talbot, L. A., Musiol, R. J., et al. (2005). "Falls in young, middle-aged and older community dwelling adults: perceived cause, environmental factors and injury." BMC Public Health 5(1): 86.