Limitations of Functional Capacity Assessment Like Fall Risk Assessment In Elderly – One Shot Assessments Don’t Account For Good and Bad Days.

Read Recent Article on How Fall Risk Assessments tools in elderly might lack validity because they don’t take into account how elderly will have good and bad days. Similarly, Functional Capacity Evaluations (FCE’s) do not take into account that discs have good and bad days that are not predicable and that the course of disc disease in the neck and back is unpredicable as well.

Falls risk-prediction tools for hospital inpatients. Time to put them to bed?
DAVID OLIVER
Age and Ageing 2008; 37: 248–250  free article here
Nurs Times. 2009 Feb 24-Mar 2;105(7):18-21.
Falls risk prediction tools for hospital inpatients: do they work?
Oliver D, Healy F. abstract here

  • later article states” Tools that claim to predict patients’ risk of falling as ‘high’ or ‘low’ do not work well and may provide false reassurance that ‘something is being done’. Falls prevention should focus on a wider range of actions at the level of patients and across organisations.”
  • Former article:
    “The nature of frail or acutely ill older people in hospital is that their falls risk is often variable over time as they develop and recover from inter-current illness, postural instability, delirium, hypotension etc. Yet, falls risk-assessment tools have tended to be applied as ‘one-off’ measurements, which do not reflect this reality.”

Re FCE’s – The fact one is able to lift a certain amount one day does not necessarily reflect how one will do on a day where one is under the weather, tired and distracted. – hence FCE’s might not reflect reality at all as well.
Various articles have been written questioning the validity of FCE’s and I haved documented that in previous blog notes. It is pseudoscience and reminds me of witch hunting – throw them in water and see.I have seen people hurt from this testing by people who are only doing their job…

I have been told, FCEs in pain clinics are used to plan programs not decide capacity and it should be kept that way.

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One Response to Limitations of Functional Capacity Assessment Like Fall Risk Assessment In Elderly – One Shot Assessments Don’t Account For Good and Bad Days.

  1. Noela says:

    It is kind of like trying one strategy to resolve ADHD, some things work one day but not the next. I know what you are talking about in terms of capacity and falling. Today is a day that I am likely to fall, but I’m not so old or frail not to recognize it.

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