Reduce Fall Risk Research Articles

Investigating the impact of oral healthstatus on the prevalence of falls among caregivers and non-caregivers in the United States: A retrospective study.

Examining the association between oral health and the prevalence of falls among US caregivers. There is a scarcity of research on the association between oral health status and the prevalence of falls among older adults and caregivers. Data from the Behavioral Risk Factor Surveillance System (BRFSS) surveys from 2016 to 2020 were analyzed. The analysis was limited to individuals aged 45 years and older (n=97 550). The outcome variable was if a person had fallen at least once during the past 12 months. The main predictor variables were the number of teeth removed, the last dentist visit, and caregiver status. Data were analyzed using bivariate descriptive statistics, chi-square tests, and logistic regression to estimate adjusted odds ratios (AORs). Having one to five teeth removed was linked to an increased prevalence of falls [AOR: 1.13, 95% confidence interval (95% CI): 1.02-1.25, p=.017] and was highest for complete tooth loss (AOR: 1.35, 95% CI: 1.15-1.58, p<.001). Caregivers had increased fall odds (AOR: 1.23, 95% CI: 1.10-1.38, p<.001). Caregivers' prevalence of fall increases with six or more teeth removed (AOR: 1.41, 95% CI: 1.02-1.94, p=.038) and all teeth removed (AOR: 1.47, 95% CI: 1.03-2.09, p=.030). Dental visits in the past year were associated with a 21% reduced fall risk for caregivers (AOR=0.79, 95% CI: 0.64-0.98, p=.035). The study showed that maintaining good oral health and utilizing dental services may be associated with lower fall risks, particularly among caregivers, suggesting the need for integrating oral health into fall prevention strategies.

2821 The feasibility of delivering evidence-based fall prevention exercise in the voluntary sector—a mixed methods study

Abstract Introduction Highly challenging, regular strength and balance exercise classes (SBE) reduces fall risk but there are few options for long-term continuation. SBE could be delivered by the voluntary sector, but care is needed to ensure good fidelity. The feasibility of delivering evidence-based SBE outside the governance of health services is unclear. A voluntary sector-led weekly SBE class ‘Strong and Steady (S&amp;S)’, led by a level 4 qualified postural stability and funded via grants and fees, was set up in December 2022 alongside an existing community coffee morning. Methods Baseline measures and adherence were collected for all who commenced S&amp;S. Two classes were observed using a standardised fidelity checklist. Interviews and focus groups were undertaken with class participants, a previous participant, the exercise instructor and lead volunteer. Results Since December 2022, 24 participants aged 59–95 (63% female) self-referred to S&amp;S. Baseline measures, collected in 100% of assessments, (timed up and go, four-step balance scale and 60-second sit-to-stand) indicated performance slightly below age-matched norms with the exception of falls efficacy (FES-I). Three participants dropped out (1 died) and adherence was 67%. Fidelity in both observed classes was good (mean score 21/24). Four themes emerged from thematic analysis of all the interviews and focus groups: Conclusion Delivering SBE via the voluntary sector is feasible and can be delivered with good fidelity. The provision tends to attract people who have high levels of self-efficacy and motivation to exercise.

Effects of Different Exercise Interventions on Fall Risk and Gait Parameters in Frail Patients After Open Heart Surgery: A Pilot Study

Background and Objectives: Research on the effectiveness of different exercise programs on reducing fall risk and improving gait parameters among frail patients after open heart surgery is scarce. Therefore, the aim of this study was to evaluate and compare the effects of different exercise interventions on fall risk and gait parameters in frail patients after open heart surgery during inpatient rehabilitation. Materials and Methods: A prospective randomized study was conducted at Kulautuva Hospital of Rehabilitation, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, from July 2021 to November 2023. A total of 105 pre-frail and frail patients were randomized into three groups: control (CG, n = 35), intervention 1 (IG-1, n = 35), and intervention 2 (IG-2, n = 35). All three groups completed a conventional rehabilitation program that included aerobic training tailored based on each person’s health status six times/week. The IG-1 additionally received multicomponent dynamic aerobic balance and strength training three times/week, and the IG-2 received a combined computer-based interactive program three times/week. The overall stability index, as an outcome of fall risk, Short Physical Performance Battery (SPPB) score, and gait parameters (geometry, stance, and timing) were assessed before and after rehabilitation. Results: Of the 105 patients, 87 completed the study. The median age of the patients was 71 years (range: 65–88); 64.76% were male. After rehabilitation, within-group comparisons showed a significant improvement in the overall stability index, SPPB, and all phase gait parameters in all groups. Of all geometry gait parameters, none of the groups showed a significant improvement in step width, and foot rotation was significantly reduced only in the IG-2. All timing gait parameters improved in the CG and IG-2 after rehabilitation, while in the IG-1, only gait speed was significantly improved. Between-group comparisons after rehabilitation revealed significant differences in the overall stability index among the groups and in all phase gait parameters except for stance phase between the IG-1 and the IG-2. The greatest significant difference was documented for the double stance phase between the IG-1 and the IG-2, and the smallest was recorded for the single limb support phase. Significantly greater differences in step time and stride time were found in the IG-1 and the IG-2 than in the CG. Conclusions: All applied interventions were effective in reducing fall risk based on the overall stability index. However, interactive exercise interventions decreased fall risk based on the overall stability index by one-fifth as compared to the conventional rehabilitation program. The incorporation of interactive exercise interventions in rehabilitation resulted in improved double stance phase, stride time, and step time parameters, but did not have any effect on gait speed as compared to other exercise interventions.

Instruments for assessing healthcare professionals’ knowledge, attitudes and practices regarding deprescribing: a scoping review protocol

ObjectiveTo map instruments for assessing healthcare professionals’ knowledge, attitudes and practices regarding deprescribing.IntroductionDeprescribing is essential for improving patient outcomes by managing polypharmacy, reducing fall risks and decreasing medication costs. However,...

Impact of Unilateral Knee Osteoarthritis on Postural Stability and Gait Initiation in Older Adults

This study investigated postural stability in older adults with and without unilateral knee osteoarthritis, focusing on static balance and gait initiation. Forty older adults participated, divided into two groups: one diagnosed with osteoarthritis and the other without the condition. Center of Pressure (COP) variables were evaluated under open and closed-eye conditions, as well as during the gait initiation phase. The results indicated that osteoarthritis significantly impacts postural control, especially during the anticipatory phase of gait and in conditions without visual feedback, demonstrating a greater reliance on proprioception. The osteoarthritis group showed higher amplitudes and velocities of COP displacement, highlighting the need for targeted interventions to improve stability and reduce fall risk.

Step Width Haptic Feedback for Gait Stability in Spinocerebellar Ataxia: Preliminary Results.

Wider step width and lower step-to-step variability are linked to improved gait stability and reduced fall risk. It is unclear if patients with spinocerebellar ataxia (SCA) can learn to adjust these aspects of gait to reduce fall risk. The aims were to examine the possibility of using wearable step width haptic biofeedback to enhance gait stability and reduce fall risk in individuals with SCA. Thirteen people with SCA type 3 performed step width training (single session) using real-time feedback. Step width increased post-training (19.3 cm, interquartile range [IQR] 16.3-20.2 cm) and at retention (16.6 cm, IQR 16.2-21.1 cm), compared to baseline (11.0 cm, IQR 5.2-15.2 cm; P < 0.001). Step width variability decreased during post-training (19.7%, IQR 17.4%-26.2%) and at retention (22.3%, IQR 18.6%-30.2%), compared to baseline (44.5%, IQR 28.5%-71.2%; P < 0.001). Crossover steps, another mark of instability, decreased after training (P < 0.031). These pilot results suggest that patients with SCA can use a novel, wearable biofeedback system to improve their gait stability. © 2025 International Parkinson and Movement Disorder Society.

Association Between Lower Limb Strength Asymmetry and Gait Asymmetry: Implications for Gait Variability in Stroke Survivors.

Background: Gait disturbances characterized by asymmetries in lower limb strength and gait patterns are frequently observed in stroke patients, which increases gait variability and fall risk. However, the extent to which lower limb strength asymmetry influences gait asymmetry and variability in this population remains unclear. Methods: This cross-sectional study included 84 participants, comprising stroke survivors and age- and sex-matched healthy older adults. A portable dynamometer was used to assess lower limb strength, and inertial measurement units to analyze gait parameters. Asymmetry indices were used to quantify strength and gait asymmetries. Statistical analyses included Pearson correlations and stepwise regression to examine the relationships among lower limb strength asymmetry, gait asymmetry, and gait variability. Results: Stroke survivors exhibited significantly greater lower limb strength and gait asymmetries than healthy older adults (p < 0.001). Knee extension (KE) strength asymmetry was a significant predictor of increased gait variability in stroke survivors (R2 = 0.448, p < 0.001) but not in healthy controls. Moreover, longer poststroke duration was associated with greater asymmetry in KE strength (r = 0.42, p < 0.05) and double support time (r = 0.45, p < 0.05). Conclusions: Lower limb strength asymmetry, specifically in knee extensors, is a critical determinant of gait asymmetry and variability in stroke survivors. The association between poststroke duration and increased asymmetry indicates the progressive nature of these impairments. These findings emphasize the importance of targeted interventions to reduce strength asymmetry and address chronic impairments in poststroke rehabilitation to improve gait stability and reduce fall risk.

Peripheral and Central Contributions to Age-Related Proprioceptive Decline, Clinical Implications and Management

Introduction: Proprioception is the body’s ability to perceive its position and movement in space, crucial for maintaining balance and coordination, especially in older adults. As individuals age, both peripheral and central mechanisms of proprioception decline. Peripheral contributions include sensory mechanisms in muscle spindles and cutaneous mechanoreceptors, vital for joint position sense. This decline can lead to balance disturbances and increased fall risk. Central contributions involve neuroanatomical changes, neurochemical alterations, and cognitive factors such as decreased memory, obstructing effective proprioceptive integration. Methods: The search utilised key databases such as PubMed, PubMed Central (PMC) BioMed Central (BMC) along with various grey literature sources, to gather a comprehensive range of information. Clinical implications: Impaired proprioception can decrease postural control and balance, increasing fall risk and associated chronic pain conditions. Interventions: Evidence highlights the effectiveness of technological advancements, personalised physical activity programmes, and proprioceptive training strategies. Collaborative efforts among healthcare professionals are vital for creating comprehensive care plans. Conclusion: Age-related proprioceptive decline significantly impacts balance and functional independence in older adults. Effective interventions to preserve proprioceptive function and reduce fall risk are crucial. A multifaceted approach that includes targeted training and interdisciplinary collaboration can enhance outcomes and support a more active life for older individuals. Future research should address literature gaps through longitudinal studies and randomised controlled trials to evaluate intervention effectiveness and advancements in technologies like virtual reality. A holistic approach involving interdisciplinary collaboration among healthcare professionals is essential. Keywords: Proprioception, ageing, balance, risk of falls, proprioception interventions

Osteoporosis in Older Men: Informing Patient Management and Improving Health-Related Outcomes.

Osteoporosis has been usually considered a female disease, generally causing more fracture risk and complications in adult and older women compared to older men. While vertebral fractures occur in a small proportion of men during middle age, men generally fracture about 10years later than women, with significant increases in fracture risk after about age 75. Independent of age, men experiencing fragility fractures have a higher risk of life-threatening events compared to women, but the risk of secondary fragility fracture overlaps between men and women. Often, male osteoporosis recognizes the overlap between secondary causes and primary osteoporosis risk factors. Assessment through physical examination, history, and laboratory tests is recommended, with dual-energy X-ray absorptiometry of bone density being the preferred diagnostic test for osteoporosis in men. A treatment program should include awareness of diet and vitamin D status, fall risk reduction, and pharmaceutical therapy. Medications that are fracture-reducing in older women should also achieve fewer fractures in older men; however, there is a paucity of studies in men with the primary outcome of fracture risk reduction. Most older men with osteoporosis should be treated with oral or intravenous bisphosphonates, denosumab especially when on androgen deprivation therapy, and initial anabolic treatment should be considered for men at very high risk of fracture. This review summarizes the main features of osteoporosis and fragility fractures in men and reports findings from the available pharmacological and non-pharmacological studies conducted in men.

Impact of a Long-Term Home-Based Rehabilitation Program on Quality of Life, Balance, and Autonomy in Adults with Disabilities.

Rehabilitation is a critical process for enhancing functionality, independence, and quality of life in individuals with disabilities. Grounded in the biopsychosocial model, it addresses physical, emotional, and social dimensions through personalized, evidence-based interventions. By integrating standardized assessments and continuous evaluation, rehabilitation has the potential to promote recovery and support active participation in society. This study evaluated the impact of a long-term, multidisciplinary, home-based rehabilitation program on quality of life, balance, and functional autonomy in adults with neuromusculoskeletal disabilities. A total of 559 participants received individualized interventions from a team of physical therapists, occupational therapists, psychologists, and other health professionals. Functional independence, balance, depressive symptoms, and quality of life were assessed using the Barthel Index, Berg Balance Scale, Beck Depression Inventory, and SF-36 questionnaire, respectively. A longitudinal analysis comparing pre- and post-intervention outcomes revealed statistically significant improvements (p < 0.001) across all metrics. The Barthel Index median increased from 85 to 90 points, indicating greater functional independence, while the Berg Balance Scale improved from 39 to 47 points, reflecting reduced fall risk. Depressive symptoms decreased, with Beck Depression Inventory scores dropping from 12 to 9, and both physical and mental health components of the SF-36 showed marked enhancements. These findings demonstrate the program's effectiveness in addressing both physical and emotional needs, emphasizing the value of extended, personalized, home-based care in improving health, autonomy, and overall quality of life for individuals with disabilities. This study underscores the potential of multidisciplinary approaches to support long-term rehabilitation in diverse populations.

ChatGPT-4o can serve as the second rater for data extraction in systematic reviews.

Systematic reviews provide clarity of a bulk of evidence and support the transfer of knowledge from clinical trials to guidelines. Yet, they are time-consuming. Artificial intelligence (AI), like ChatGPT-4o, may streamline processes of data extraction, but its efficacy requires validation. This study aims to (1) evaluate the validity of ChatGPT-4o for data extraction compared to human reviewers, and (2) test the reproducibility of ChatGPT-4o's data extraction. We conducted a comparative study using papers from an ongoing systematic review on exercise to reduce fall risk. Data extracted by ChatGPT-4o were compared to a reference standard: data extracted by two independent human reviewers. The validity was assessed by categorizing the extracted data into five categories ranging from completely correct to false data. Reproducibility was evaluated by comparing data extracted in two separate sessions using different ChatGPT-4o accounts. ChatGPT-4o extracted a total of 484 data points across 11 papers. The AI's data extraction was 92.4% accurate (95% CI: 89.5% to 94.5%) and produced false data in 5.2% of cases (95% CI: 3.4% to 7.4%). The reproducibility between the two sessions was high, with an overall agreement of 94.1%. Reproducibility decreased when information was not reported in the papers, with an agreement of 77.2%. Validity and reproducibility of ChatGPT-4o was high for data extraction for systematic reviews. ChatGPT-4o was qualified as a second reviewer for systematic reviews and showed potential for future advancements when summarizing data.

Low-Intensity Resistance Exercise with Blood Flow Restriction Improves Balance in Elderly Women: A Comparative Study on the Lower Quarter Y-Balance Test

Introduction: Enhancing leg muscle strength in elderly could play a crucial role in reducing fall risk. A novel approach to enhance muscular strength involves the use of low-intensity resistance exercises in conjunction with blood flow restriction (BFR), as an alternative to high-intensity exercise. This study aimed to evaluate the effects of low-intensity strength exercise with BFR on lower quarter Y-balance test (LQ-YBT) performance, compare to moderate-intensity strength exercise in elderly female.Methods: The study employed a true experimental randomized design, assessing balance using the LQ-YBT in 26 elderly women over a six-week exercise period. Subjects were divided into two groups: one performing medium-intensity strengthening exercises (≥40-60% 1 RM (Repetition Maximum)) and another engaging in low-intensity strengthening exercises (20-30%1RM) with BFR. The BFR technique involved applying a cuff to the upper third of the thigh with a restrictive pressure of 50 mmHg or 40% Artery Occlusion Pressure, which was released during rest periods.Results: The moderate and BFR groups exhibited notable distinctions in all directions (anterior, posterolateral, posteromedial and composite) for both left and right legs (p&lt;0.001). The disparity in LQ-YBT values between groups was notable in the right anterior (p=0.017), right posterolateral (p&lt;0.001), right composite (p&lt;0.001), left anterior (p=0.007), and left composite (p=0.050) directions.Conclusions: This study showed that low-intensity resistance exercise with BFR for six weeks may yield superior improvements in the LQ-YBT for elderly women compared to moderate-intensity strengthening exercises

Postural stability and risk of slips in lifting tasks: Effects of load weight and load knowledge

Load transfer during lifting leads to increased postural perturbations that may compromise postural stability, so lifting is an occupational task associated with high fall risk. This study aimed to gain improved knowledge about fall risk in lifting tasks. The effects of both load weight and load knowledge were examined. Load weight was set at three levels according to individuals’ maximum acceptable lifting capacity. Unlike previous studies, load knowledge was set by considering load material fragility. Twenty-four male participants were involved in the experimental study, in which they were instructed to perform both symmetric and asymmetric lifting tasks under conditions defined by various combinations of load weight and load knowledge. Fall risk was assessed by using measures accounting for postural stability and risk of slips. The results showed that when being defined near individuals’ maximum acceptable lifting capacity, increased lifting load weight not only improved postural stability in the rising phase of lifting, but also increased the risk of slips. These findings suggest that improved postural stability due to increased load weight in the rising phase could be a compensatory postural control strategy for the increased risk of slips so as to maintain balance and avoid the occurrence of a potential fall. We also found that load knowledge of fragility and weight may not contribute to fall risk reduction during lifting. The findings obtained from the present study are useful for practitioners to design safe lifting tasks.

Effects of PERMA-Based Psychological Intervention Combined with Otago Exercise Training on Fall Risk Reduction in Stroke Patients

Effects of PERMA-Based Psychological Intervention Combined with Otago Exercise Training on Fall Risk Reduction in Stroke Patients

Effects of PERMA-Based Psychological Intervention Combined with Otago Exercise Training on Fall Risk Reduction in Stroke Patients

Effects of PERMA-Based Psychological Intervention Combined with Otago Exercise Training on Fall Risk Reduction in Stroke Patients

IMPLEMENTATION OF A VIRTUAL FALL PREVENTION PROGRAM IN OLDER VETERANS

Abstract Though virtual platforms have increased in popularity few studies have explored the implementation and benefit of a virtually-based fall prevention program. MOVing FREEly (Multicomponent Otago Virtual Falls Reduction Exercise and Education program) is a VA-based fall prevention program delivered entirely over a virtual care platform. The MOVing FREEly program is six-weeks long and includes both education in fall-risk reduction and evidence-based fall prevention exercises. Process measures captured implementation considerations, feasibility and effectiveness of the program. 27 participants who were older (mean 75 years), mostly male (89.0%), white (85.2%) and moderate or high risk of falling completed the program. 70% were new to the virtual platform. Attendance for education and exercise classes was &amp;gt; 80% with little attrition. There was improvement in the Falls Efficacy Scale-International short form and statistically significant improvement in 30 second sit-to-stand and single leg balance tests. Process measures indicated that 40% of participants needed extra help at the start of each class to sign-on to the virtual visit, which was provided by program facilitators. By the fourth class, all participants were self-sufficient in their ability to navigate the virtual platform. Additional considerations such as electronic health record documentation and coding; clinic setup, referral management and virtual appointment scheduling; patient privacy and health emergency planning were necessary for the start-up and sustainability of the program. Virtual fall prevention programs are feasible and effective but require careful logistical planning and considerations. Implementation considerations from this program can guide future telerehabilitation research and clinical efforts.

도수치료와 저항밴드 운동이 65세 이상 노인의 근감소증 및 관절 기능에 미치는 효과: 무작위 대조 연구

Objective : This study aimed to evaluate the effects of combined manual therapy and resistance band exercises on sarcopenia and joint function in elderly individuals aged 65 years or older, providing scientific evidence for effective intervention programs to improve physical function. Methods : A randomized controlled trial was conducted with 32 older adults aged 65 and above, recruited from the G Welfare Center in Gwangju. Participants were randomly assigned to either the experimental group (manual therapy combined with exercise therapy) or the control group (manual therapy only), with 16 participants in each group. During the study, 12 participants dropped out, leaving 10 participants in each group for the final analysis. The intervention was conducted over six weeks, with a total of 12 sessions. The intervention effects were analyzed through various physical function assessments, including balance ability, gait speed, sit-to-stand performance, shoulder and pelvic height, and grip strength. Results : Following the combined intervention of manual therapy and resistance band exercises, the experimental group showed significant improvements in balance ability and ROM (p&lt;0.05), as well as greater changes in sit-to-stand performance (p=0.003). Gait speed significantly increased only in the experimental group (p=0.046), while grip strength showed no significant changes in either group (p&gt;0.05). Conclusion : The combined intervention of manual therapy and resistance band exercises demonstrated significant improvements in balance ability and lower limb function in older adults (p&lt;0.05). This suggests a synergistic effect of manual therapy and resistance exercises, highlighting their potential as a rehabilitation protocol for reducing fall risk and enhancing physical function.

Colour Psychology in Interior Design for Geriatric Spaces

The psychological impact of colour significantly influences the design of therapeutic and functional spaces for the geriatric population. As aging brings sensory and cognitive changes, carefully curated interior design can enhance emotional comfort, cognitive function, and overall well-being. This concept note delves into the application of colour psychology to create aging-friendly environments that promote mental health and safety. Warm, soothing colours can reduce stress and create a sense of familiarity, while brighter hues aid in improving mood and cognitive alertness. Conversely, muted tones may mitigate overstimulation, particularly in individuals with dementia or sensory sensitivities. Proper contrast and colour differentiation can also improve spatial orientation, reducing fall risks and enhancing safety. The paper underscores the need for evidence-based design principles tailored to the unique needs of the elderly. It highlights actionable strategies for interior designers, including the mindful selection of colour palettes, the integration of natural lighting, and the use of texture and contrast to improve navigation and engagement. By prioritizing the psychological and functional aspects of colour, designers can create spaces that foster comfort, safety, and emotional well-being for older adults. This exploration emphasizes how thoughtful design can contribute to a supportive and enriching environment for the aging population.

Impacts of osteosarcopenia on musculoskeletal health, risks of falls and fractures, and activities of daily living among population aged 50 and above: an age- and sex-matched cross-sectional analysis

AimsWe conducted this study to investigate the impact of muscle loss on musculoskeletal health, fall and fracture risks, and activities of daily living (ADL) in elderly patients with osteoporosis.Materials and methodsThis age- and sex-matched cross-sectional study analyzed data from a medical center involving patients aged ≥ 50 from 2020 to 2022. The included participants were formed into three groups: 100 with osteoporosis only, 100 with osteosarcopenia, and 50 control individuals without osteoporosis and sarcopenia. We compared groups based on their baseline characteristics, bone and muscle health measurements, and the risks of falls and fractures using the STRATIFY scale and FRAX, respectively. Additionally, ADL was assessed using the Barthel Index. A multivariate analysis was performed to identify factors associated with declined ADL in osteosarcopenic patients.ResultsThe mean age was 76.17 years, and 82% were female. The osteosarcopenic group demonstrated poorer bone and muscle quality and quantity, with greater risks of major osteoporotic-related fractures, hip fractures, and falls, as well as significantly decreased ADL than other groups. When comparing sexes, females exhibited worse performance than males across groups. Slow gait speed and high STRATIFY score are independent predictors of declined ADL in osteosarcopenic patients.ConclusionSarcopenia exacerbates osteoporotic patients, particularly women, worsening bone deterioration, increasing fall and fracture risks, and significantly impairing daily activities. Enhancing walking speed and reducing fall risk can boost independence in individuals with osteosarcopenia. Early detection, proper management, and preventive measures are essential for mitigating these adverse outcomes in high-risk individuals.

Developing a systematic fall risk assessment tool for outpatient clinics

Background In healthcare settings, fall incidents represent a significant public health issue and often result in severe injuries, prolonged hospital admissions, and substantial healthcare costs. Despite current fall risk reduction strategies, falls continue to be among the leading causes of sentinel events. Objective This study aims to identify fall risk factors present in an outpatient clinic work system and develop tools to support proactive risk mitigation. Research Design We introduced a systematic fall risk assessment (SFRA) tool where front-line staff can evaluate their work systems for fall risks. The tool was developed using literature review, observations, and interviews with focus groups. The tool includes step-by-step instructions for an outpatient clinic fall risk assessment, factors to consider in various settings of patient care, and guiding principles to address fall risks in an outpatient work system. Results This tool underwent user testing, which validated its learnability, usability, and usefulness, and was rated positively by a diverse range of clinics and roles. Our preliminary results suggested that the tool was effective in identifying potential fall risk factors of outpatient clinics, even when used by non-experts. Conclusion We demonstrated the effective use of human factors methods to equip front-line staff with tools to proactively evaluate outpatient clinic work systems for fall risks and develop mitigation strategies.