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What is QuickScreen©?

Since there are many risk factors for falls which vary from person to person, individualised risk factor assessment should be the first step in developing effective intervention strategies for the prevention of falls in older people.

The NeuRA QuickScreen © Clinical Falls Risk Assessment (or QuickScreen © for short) was developed by researchers at Neuroscience Research Australia (NeuRA) and is a multifactorial assessment tool which was designed specifically for use in clinical settings. It has been rigorously tested in a large sample of community-dwelling older people in which it was found that performance in the QuickScreen © was able to accurately predict faller status. In a sub-group of these people, the QuickScreen © measures exhibited good reliability, demonstrating low measurement error and a high ability to detect change in physical status over time.

The QuickScreen © assessment has been trialled in several clinical settings with general practitioners, practice nurses and physiotherapists, where it was found to be quick and easy to administer, taking an average of 10 minutes to complete. The clinicians reported that the assessment provided useful information about risk factors and guided the implementation of intervention strategies. The QuickScreen © consists of the following measures: previous falls, medication usage, vision, peripheral sensation, lower limb strength, balance and co-ordination and requires the use of minimal equipment. This makes it a portable, easy to use assessment which has a low cost yet high accuracy in determining who is at risk of falling and which particular factors contribute to that risk.

The assessment also allows the user to calculate the combined risk increase that the identified risk factors present for future falls. The inclusion of this scoring system in the QuickScreen © allows for the identification of people who are at a high risk of falling, in addition to its ability to determine which specific factors contribute to that risk. This information can then be used to determine which intervention strategies are likely to be most beneficial in reducing the risk of future falls.

Reference: Tiedemann A. The development of a validated falls risk assessment for use in clinical practice [PhD Thesis]. Sydney (NSW): University of New South Wales; 2006

FAQs for QuickScreen©

1. What is the difference between QuickScreen© and FallScreen
Answer: both are multifactorial falls risk assessment tools, which are designed to identify people at risk of falls, to identify which specific risk factors are placing the person at risk and to guide interventions for the prevention of future falls. The differences lie in a) the time taken to administer the assessments- Fallscreen takes 15-20mins, QuickScreen© takes 5-10 minutes, b) the need for specialized testing equipment- Fallscreen requires the use of several pieces of specialized equipment which is less portable than the QuickScreen©, which requires minimal equipment and fits into a small satchel, c) the interpretation of test results- Fallscreen requires the use of computer software to interpret the assessment results, QuickScreen© involves a simple scoring procedure which does not require computer processing, d) quantitative versus qualitative scoring- Fallscreen has a quantitative scoring method, allowing for the change in individual test scores to be compared over time, QuickScreen© uses a pass/fail tick box method of scoring, making it less accurate for comparison over time, e) cost- Fallscreen is a more comprehensive assessment with specialized equipment and costs $4,000(excl. GST) for the short version and $8000(excl GST) for the long version, QuickScreen© costs $300.00 (excl. GST). Delivery cost upon request.

2. What is the most appropriate way to use the visual acuity chart?
Answer: the protective sheet should be moved when doing the vision test. Tilt the chart to remove glare or change the light source.

3. Can the visual acuity chart be used with NESB (Non English speaking Background) clients?
Answer: the vision chart has not been used with NESB clients and is not validated with them. There are vision charts available for NESB clients which test the patients ability to identify the orientation of a shape (we have one here with E’s) but they have not been validated for predicting falls as yet.

4. Most of my clients are failing the peripheral sensation test, what is the problem?
Answer: users need to consider whether they are applying the monofilament correctly. It must bend and be applied for approx one second to the lateral malleolus.

5. If someone has 2 or more risk factors in the same area, do they count as 1 or 2 risks in the risk calculation?
Answer: each risk factor counts separately for the risk score calculation even if they are from the same risk area- this is because they have all been shown to be predictors of risk independently.

6. Can I buy additional equipment once I have purchased a compete QuickScreen© kit?
Answer: the components of the kit are available for purchase once a complete kit has been bought. The visual acuity chart and the touch rod (aesthesiometer) can be purchased for $75 each, plus postage. The stopwatch, foot placement squares and 3m string, all in a storage case can be purchased for $20 plus postage.

7. Do I need to use the square template when carrying out the near tandem stand test?
Answer: yes, the template ensures correct positioning of the feet for the test and should be used.

8. Does the patient need to remove socks/ stockings for the touch sensation test?
Answer: Yes, the touch sensation test must be conducted on bare skin.

If you have any further questions regarding QuickScreen please contact the Falls and Balance team at fallscreen@neura.edu.au. To order a kit please use the order form at the top of this page.

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Abdominal Functional Electrical Stimulation for Orthostatic Hypotension in Spinal Cord Injury

Spinal cord injury (SCI) results in the loss of function to not only voluntary motor control, but also to the regulatory systems that control bodily processes. Orthostatic (postural) hypotension (OH) is a common clinical feature in SCI patients, affecting up to 73% of patients with cervical spine and upper thoracic spine injuries during mobilisation and postural changes. This often results in symptoms of dizziness, light-headedness, fatigue and confusion, in turn limiting individual participation in physical rehabilitation and restricting progress towards regaining function and independence. Therapeutic interventions are centred around ameliorating symptoms of OH; however, options for patients remain limited. Non-pharmacological treatments have had little success at treating hypotension in the long-term, while pharmacological interventions are used only when necessary as they may contribute to hypertension and even worsen episodes of autonomic dysreflexia, a life-threatening condition. Functional Electrical Stimulation (FES) is one of the only interventions that has been shown to display some benefit in improving OH. Recently, stimulation of the lower limbs has been shown to acutely increase blood pressure in patients with SCI. Our recent projects have involved the use of FES applied over the abdominal muscles, termed abdominal FES, for SCI patients at risk of respiratory complications with promising results. As this same population is at risk of orthostatic hypotension, this study aims to determine whether abdominal stimulation can also be used to help this condition. Based on our previous research, we believe that abdominal FES will increase blood pressure acutely during an orthostatic challenge in individuals with acute spinal cord injury, allowing for a longer time spent in a standing position. This will facilitate more effective rehabilitation, therefore improving quality of life and decreasing associated medical complications.