{"doi":"10.1101/2025.07.22.25331998","title":"Fall Injury Avoidance Strategy Scale (FIAS) – Development and Validation of a Scale to Quantify Fall-Related Protective Movements","abstract":"Objectives: To develop and validate the Fall Injury Avoidance Scale (FIAS), a novel video-screening tool to assess protective movements and injury risk during standing-height falls among older adults. Design: Secondary analysis of video-recorded experimental falls. Setting: Laboratory setting. Participant: Twenty-three older adults (aged 66-84 years; 4 males, 19 females) at risk of injurious falls. Intervention: Not applicable. Main Outcome measures: Participants experienced a total of six standardized experimentally-induced (backwards, left, and right directions). Fall movements were recorded using a motion capture system and commercially-available cameras. Hip and head peak acceleration were extracted from custom MatLab scripts. FIAS score (sum of 4 evidence-based protective fall movements, range 0-8) and the occurrence of head impact were determined by two independent raters using standardized and structured questionnaire. Inter-rater reliability, construct validity, responsiveness, and diagnostic utility of FIAS score were evaluated. Results: A total of 274 experimental falls were analyzed. FIAS score indicated excellent inter-rater reliability (ICC(2,k) = 0.85 (95%CI [0.81-0.88], p<0.001). The higher FIAS scores were significantly associated with the lower hip peak acceleration (B=-1.01, 95%CI [-1.47, -0.56], p<0.001) and head peak acceleration (B=-6.08, 95%CI [-709, -5.06], p<0.001), and lower odds of head impact (Odds Ratio [OR]=0.20, 95%CI [0.12, 0.33], p<0.001). FIAS score also demonstrated significant responsiveness to the training-induced changes (F=18.74, p<0.001). Diagnostic analysis suggested that FIAS score ≥ 6 showed the high specificity (95.5%) for ruling out head impact falls. Conclusions: FIAS is a reliable, valid, and responsive tool to assess the protective fall movements and injury risk among older adults, which has potential utility in screening and prevention of fall-related injuries.","journal":"medRxiv","year":2025,"id":570924,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8434,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1076038,"name":"Tobia Zanotto","orcid":"0000-0002-6571-4763","position":1,"is_corresponding":false},{"id":1476383,"name":"Joo-Hyun Lee","orcid":"0000-0003-2431-8956","position":2,"is_corresponding":false},{"id":233711,"name":"James C. Fang","orcid":"0000-0003-2427-9504","position":3,"is_corresponding":false},{"id":1390868,"name":"Abbas Tabatabaei","orcid":"0000-0003-4640-0862","position":4,"is_corresponding":false},{"id":1476792,"name":"Neil Alexandar","orcid":null,"position":5,"is_corresponding":false},{"id":689370,"name":"Jacob J. Sosnoff","orcid":"0000-0002-0286-9207","position":6,"is_corresponding":false},{"id":1287900,"name":"Lingjun Chen","orcid":"0000-0003-1649-2436","position":0,"is_corresponding":true}],"reference_count":31,"raw_metadata":null,"created_at":"2026-07-19T02:57:11.713851Z","pmid":"40778133","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}