Falls often have severe financial and environmental consequences, not only for those who fall, but also for their families and society at large. Identifying fall risk in older adults can be of great use in preventing or reducing falls and fall risk, and preventative measures that are then introduced can help reduce the incidence and severity of falls in older adults. The overall aim of our systematic review was to provide an analysis of existing mechanisms and measures for evaluating fall risk in older adults. The 43 included FRATs produced a total of 493 FRAT items which, when linked to the ICF, resulted in a total of 952 ICF codes. The ICF domain with the most used codes was body function, with 381 of the 952 codes used (40%), followed by activities and participation with 273 codes (28%), body structure with 238 codes (25%) and, lastly, environmental and personal factors with only 60 codes (7%). This review highlights the fact that current FRATs focus on the body, neglecting environmental and personal factors and, to a lesser extent, activities and participation. This over-reliance on the body as the point of failure in fall risk assessment clearly highlights the need for gathering qualitative data, such as from focus group discussions with older adults, to capture the perspectives and views of the older adults themselves about the factors that increase their risk of falling and comparing these perspectives to the data gathered from published FRATs as described in this review.

Background. Traumatic brain injury (TBI) is a health and socioeconomic concern worldwide. In patients with TBI, post-traumatic balance problems are often the result of damage to the vestibular system. Nystagmus is common in these patients, and can provide insight into the damage that has resulted from the trauma. Objective. To present a systematic overview of published literature regarding nystagmus in patients with TBI. Methods. Nine databases and platforms were searched during October 2016 for articles published between 1996 and 2016. Studies of any research design and published in English that focused on nystagmus in patients with TBI were considered for inclusion. A total of 110 articles were screened once duplicates had been removed, and 29 full-text articles were assessed. Eleven articles were included in the quality appraisal phase (using the McMaster tool), after which 10 articles were included in this review. Results. This review describes nystagmus in 713 patients, and all articles reviewed described the type of assessment method that was used. However, the results lacked comprehensive data regarding the assessment, measurement and description of nystagmus in TBI patients, or the possible link and relationship between nystagmus and TBI. Conclusions. This systematic review indicated that: (i) there is a growing body of evidence that benign paroxysmal positional vertigo should be considered during the medical examination of all patients suffering from head trauma; (ii) all patients with TBI should undergo visual (eye movement) and vestibular examination; and (iii) future studies should include quantitative measurements of eye movements and nystagmus.

The aim of this study is to establish the perceptions of older adults in the South African context regarding falls and to link these perceptions to the International Classification of Functioning, Disability and Health (ICF). Data were analyzed by a summative, conventional, and deductive approach. The analysis indicated that the Body Function and Structure codes were most frequently used during the discussions, but the contextual analysis of the most frequently used categories indicated that Activities and Participation were the participants’ main focus. The main focus of fall assessment in older adults should therefore be on Activities and Participation, as this can assist them in decreasing their fall risk, irrespective of whether they had a previous fall. Contrary to the majority of current literature on falls, this study included both participants who had fallen and those who hadn’t, resulting in richer data and themes gathered from the focus groups.

Background: Accidental falls could have severe and far-reaching consequences for older adults, their families and society at large. Healthcare practitioners’ (HCPs) perspectives on fall risk factors in older adults could assist in reducing and even preventing falls. Currently, no universal tool exists for this purpose. The World Health Organization’s globally accepted International Classification of Functioning, Disability and Health (ICF) was used.Aim: This study aimed to (1) describe the perspectives of HCPs on fall risk factors in older adults in South Africa and (2) link these factors to the ICF.Setting: Eighteen HCPs participated in two focus groups.Methods: Using a qualitative research design, an inductive thematic analysis allowed for the identification of important themes, which were linked to the ICF.Results: The factors mentioned by participants were categorised into 38 themes, which were linked to 142 ICF codes, of which 43% (n = 61) were linked to the Body Function category, 23% (n = 32) to the Environmental Factors category, 18% (n = 26) to the Body Structure category and 16% (n = 23) to the Activities and Participation category. HCPs revealed two relevant factors that were not captured in existing fall risk assessment tools (FRATs), namely ‘muscle-power functions’ and ‘mobility-of-joint functions’, which directly relate to the ability to execute mobility activities. Combining HCPs’ perspectives with other stakeholders and with literature provides a holistic picture of fall risk factors in older adults.

Purpose: Falling is a multifactorial condition that can cause severe injury and even death in older adults. Early identification of fall risk factors, as the first step of preventive health care, can assist in reducing the negative and often debilitating effects of falls in older adults. By using the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework to develop an ICF code set to identify fall risk factors in older adults, health care practitioners could obtain health information in a multidimensional way. Method: This study describes the final phase of a comprehensive, three-phase, mixed-methods sequential study. For this third phase, a pre–post group design that focused on the audiologist's perceptions of the clinical utility of a newly developed ICF code set was employed. The questionnaire that was used for this purpose consisted of two distinct sections: clinical application and clinical utility (viz., appropriateness, accessibility, practicability, acceptability, and professional utility). Thirty practicing audiologists participated in the study. Data were analyzed for each of the two sections of the questionnaire. Results: Results related to clinical application indicated that regardless of the audiologists' experience in routine fall risk assessment or fall risk factor identification, the use of the developed ICF code set increased their ability to correctly identify relevant clinical aspects. Results related to clinical utility showed high scores across all five measure components, with the highest clinical utility component being acceptability, closely followed by appropriateness and professional utility, and the lowest being accessibility. Conclusion: Several clinical implications have emerged from this study, including the usefulness of the ICF code set to identify and document fall risk factors in older adults, the code set's ability to guide audiologists to determine individualized assessment needs either by themselves or by other health care disciplines, and that the code set could be used by audiologists regardless of their experience in vestibular assessments.