PP1413 - Remote Falls Risk Assessment: Validating a Novel Mobile Application for Home-Based Screening and Functional Testing

Abstract:
A mobile application was developed to deliver question-based falls risk screening and functional gait, strength, and balance testing following the CDC’s STEADI Initiative. This field validation study examined differences in participant performance between supervised lab assessments and unsupervised home use, as well as the effect of level of initial clinician involvement. Results confirmed the application’s reliability across both environments, with no significant safety concerns. While most users performed well, some experienced challenges with independent use, suggesting that clinician guidance may improve outcomes. Overall, the application proved effective for remote balance screening and assessment based on the STEADI framework.

Summary:
A mobile application was developed to deliver question-based falls risk screening and functional assessments of gait, strength, and balance using hearing aid motion sensor data, in line with the CDC's STEADI Initiative. While the accuracy of the algorithms analyzing this motion sensor data had previously been established, further research was needed to evaluate the application's suitability for unsupervised trials in at-home environments and the impacts of clinical instruction prior to user attempts.

This field validation study aimed to investigate performance differences between supervised laboratory assessments and unsupervised home evaluations, specifically examining the influence of clinician demonstrations on user performance within the STEADI framework. A cohort of older adults underwent evaluations designed to assess the mobile application’s usability across both settings. The primary objective was to determine the reliability and consistency of the results generated by the application, and the role clinician-led demonstrations played in improving usability and performance.

The findings underscore the robustness of the mobile application and its algorithms across supervised and unsupervised environments, showing good reliability for remote use in all four sub-tasks. Although differences in performance were noted—particularly in unsupervised attempts among participants in the No Demonstration group—these differences did not reach statistical significance. The application consistently delivered accurate results, with no falls or safety incidents reported, demonstrating its safety for unsupervised use among the sample.

While the application demonstrated overall reliability in facilitating the users’ task performances, some participants faced challenges using the feature independently at home, indicating that additional instructional support could benefit first-time users. These findings highlight the potential advantages of clinician guidance during initial use, especially for users less familiar with digital tools, and emphasize the need for ongoing support to enhance user experience and engagement. Overall, the application proved effective for remote balance screening and functional testing based on the STEADI framework and could be used to more frequently monitor hearing aid users’ modifiable risk factors for falling.

Brief Summary of Clinical Takeaways:
The novel mobile application developed for falls risk screening and functional balance assessments using hearing aid motion sensor data was found to be a reliable tool for both supervised and unsupervised use. It offers clinicians the ability to more frequently monitor hearing aid users’ modifiable risk factors for falling.

Assumptions
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