Comparing Machine Learning Approaches for Fall Risk Assessment

Joana Silva, João Madureira, Cláudia Tonelo, Daniela Baltazar, Catarina Silva, Anabela Martins, Carlos Alcobia, Inês Sousa


Traditional fall risk assessment tests are based on timing certain physical tasks, such as the timed up and go test, counting the number of repetitions in a certain time-frame, as the 30-second sit-to-stand or observation such as the 4-stage balance test. A systematic comparison of multifactorial assessment tools and their instrumentation for fall risk classification based on machine learning approaches were studied for a population of 296 community-dwelling older persons aged above 50 years old. Using features from inertial sensors and a pressure platform by opposition to using solely the tests scores and personal metrics increased the F-Score of Naïve Bayes classifier from 72.85% to 92.61%. Functional abilities revealed higher association with fall level than personal conditions such as gender, age and health conditions.


  1. Agrawa, Yuri, John P. Carey, Howard J. Hoffman, Daniel A. Sklare, and Michael C. Schubert. 2011. 'The Modified Romberg Balance Test: Normative Data in U.S. Adults'. Otology & Neurotology 32 (8): 1309-11. doi:10.1097/MAO.0b013e31822e5bee.
  2. Aguiar, B., J. Silva, T. Rocha, S. Carneiro, and I Sousa. 2014. 'Monitoring Physical Activity and Energy Expenditure with Smartphones'. In 2014 IEEE-EMBS International Conference on Biomedical and Health Informatics (BHI), 664-67. doi:10.1109/BHI.2014. 6864451.
  3. Ambrose, Anne Felicia, Geet Paul, and Jeffrey M Hausdorff. 2013. 'Risk Factors for Falls among Older Adults: A Review of the Literature'. Maturitas 75 (1): 51-61. doi:10.1016/j.maturitas.2013.02.009.
  4. Beauchet, Olivier, B. Fantino, G. Allali, S. W. Muir, M. Montero-Odasso, and C. Annweiler. 2011. 'Timed up and Go Test and Risk of Falls in Older Adults: A Systematic Review'. The Journal of Nutrition, Health & Aging 15 (10): 933-38. doi:10.1007/s12603-011- 0062-0.
  5. Bergen, Gwen, Mark R. Stevens, and Elizabeth R. Burns. 2016. 'Falls and Fall Injuries Among Adults Aged =65 Years - United States, 201478. MMWR. Morbidity and Mortality Weekly Report 65 (37): 993-98. doi:10.15585/mmwr.mm6537a2.
  6. Bigelow, Kimberly Edginton, and Necip Berme. 2011. 'Development of a Protocol for Improving the Clinical Utility of Posturography as a Fall-Risk Screening Tool'. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 66 (2): 228- 33. doi:10.1093/gerona/glq202.
  7. Cho, Kang Hee, Soo Kyung Bok, Young-Jae Kim, and Seon Lyul Hwang. 2012. 'Effect of Lower Limb Strength on Falls and Balance of the Elderly'. Annals of Rehabilitation Medicine 36 (3): 386-93. doi:10.5535/arm.2012.36.3.386.
  8. Guimaraes, V., D. Ribeiro, and L. Rosado. 2013. 'A Smartphone-Based Fall Risk Assessment Tool: Measuring One Leg Standing, Sit to Stand and Falls Efficacy Scale'. In 2013 IEEE 15th International Conference on E-Health Networking, Applications Services (Healthcom), 529-33. doi:10.1109/ HealthCom.2013.6720733.
  9. Hsi, Wei-Li. 2016. 'Analysis of Medial Deviation of Center of Pressure after Initial Heel Contact in Forefoot Varus'. Journal of the Formosan Medical Association = Taiwan Yi Zhi 115 (3): 203-9. doi:10.1016/j.jfma.2015.03.004.
  10. Jones, C. Jessie, Roberta E. Rikli, and William C. Beam. 1999. 'A 30-S Chair-Stand Test as a Measure of Lower Body Strength in Community-Residing Older Adults'. Research Quarterly for Exercise and Sport 70 (2): 113-19. doi:10.1080/02701367.1999.10608028.
  11. Liu, Ying, S.J. Redmond, Ning Wang, F. Blumenkron, M.R. Narayanan, and N.H. Lovell. 2011. 'Spectral Analysis of Accelerometry Signals From a DirectedRoutine for Falls-Risk Estimation'. IEEE Transactions on Biomedical Engineering 58 (8): 2308-15. doi:10.1109/TBME.2011.2151193.
  12. Lord, Stephen R., Hylton B. Menz, and Anne Tiedemann. 2003. 'A Physiological Profile Approach to Falls Risk Assessment and Prevention'. Physical Therapy 83 (3): 237-52.
  13. Murphy, Mary A, Sharon L Olson, Elizabeth J Protas, and Averell R Overby. 2003. 'Screening for Falls in Community-Dwelling Elderly'. Journal of Aging and Physical Activity 11 (1): 66-81.
  14. Oliver, David, Fergus Daly, Finbarr C. Martin, and Marion E. T. McMurdo. 2004. 'Risk Factors and Risk Assessment Tools for Falls in Hospital in-Patients: A Systematic Review'. Age and Ageing 33 (2): 122-30. doi:10.1093/ageing/afh017.
  15. Raymakers, J. A., M. M. Samson, and H. J. J. Verhaar. 2005. 'The Assessment of Body Sway and the Choice of the Stability Parameter(s)78. Gait & Posture 21 (1): 48-58. doi:10.1016/j.gaitpost.2003.11.006.
  16. Rikli, RE, and JC Jones. 2010. 'Functional Fitness Normative Scores for Community-Residing Older Adults, Ages 60-9478. Human Kinetics Journals. April 21.
  17. Rose, Debra J, Jones, Jessie C, and Lucchese, Nicole. 2002. 'Predicting the Probability of Falls in Community-Residing Older Adults Using the 8-Foot Up-and-Go: A New Measure of Functional Mobility'. Journal of Ageing and Physical Activity 10 (4): 466- 75.
  18. Rossiter-Fornoff, J. E., S. L. Wolf, L. I. Wolfson, and D. M. Buchner. 1995. 'A Cross-Sectional Validation Study of the FICSIT Common Data Base Static Balance Measures. Frailty and Injuries: Cooperative Studies of Intervention Techniques'. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 50 (6): M291-297.
  19. Rubenstein, Laurence Z. 2006. 'Falls in Older People: Epidemiology, Risk Factors and Strategies for Prevention'. Age and Ageing 35 (suppl 2): ii37-ii41. doi:10.1093/ageing/afl084.
  20. Rubenstein, Laurence Z., and Karen R. Josephson. 2002. 'The Epidemiology of Falls and Syncope'. Clinics in Geriatric Medicine 18 (2): 141-58.
  21. Scott, Vicky, Kristine Votova, Andria Scanlan, and Jacqueline Close. 2007. 'Multifactorial and Functional Mobility Assessment Tools for Fall Risk among Older Adults in Community, Home-Support, Long-Term and Acute Care Settings'. Age and Ageing 36 (2): 130-39. doi:10.1093/ageing/afl165.
  22. Silva, Joana, and Ines Sousa. 2016. 'Instrumented Timed Up and Go: Fall Risk Assessment Based on Inertial Wearable Sensors'. In 2016 IEEE International Symposium on Medical Measurements and Applications (MeMeA) (MeMeA 2016). Benevento, Italy.
  23. Thomas, Julia C., Charles Odonkor, Laura Griffith, Nicole Holt, Sanja Percac-Lima, Suzanne Leveille, Pensheng Ni, Nancy K. Latham, Alan M. Jette, and Jonathan F. Bean. 2014. 'Reconceptualizing Balance: Attributes Associated with Balance Performance'. Experimental Gerontology 57 (September): 218-23. doi:10.1016/j.exger.2014.06.012.
  24. Tinetti, Mary E. 1986. 'Performance-Oriented Assessment of Mobility Problems in Elderly Patients'. Journal of the American Geriatrics Society 34 (2): 119-26.
  25. Zhang, Wei, G. Ruben H. Regterschot, Hana Schaabova, Heribert Baldus, and Wiebren Zijlstra. 2014. 'TestRetest Reliability of a Pendant-Worn Sensor Device in Measuring Chair Rise Performance in Older Persons'. Sensors (Basel, Switzerland) 14 (5): 8705-17. doi:10.3390/s140508705.

Paper Citation

in Harvard Style

Silva J., Madureira J., Tonelo C., Baltazar D., Silva C., Martins A., Alcobia C. and Sousa I. (2017). Comparing Machine Learning Approaches for Fall Risk Assessment . In Proceedings of the 10th International Joint Conference on Biomedical Engineering Systems and Technologies - Volume 4: BIOSIGNALS, (BIOSTEC 2017) ISBN 978-989-758-212-7, pages 223-230. DOI: 10.5220/0006227802230230

in Bibtex Style

author={Joana Silva and João Madureira and Cláudia Tonelo and Daniela Baltazar and Catarina Silva and Anabela Martins and Carlos Alcobia and Inês Sousa},
title={Comparing Machine Learning Approaches for Fall Risk Assessment},
booktitle={Proceedings of the 10th International Joint Conference on Biomedical Engineering Systems and Technologies - Volume 4: BIOSIGNALS, (BIOSTEC 2017)},

in EndNote Style

JO - Proceedings of the 10th International Joint Conference on Biomedical Engineering Systems and Technologies - Volume 4: BIOSIGNALS, (BIOSTEC 2017)
TI - Comparing Machine Learning Approaches for Fall Risk Assessment
SN - 978-989-758-212-7
AU - Silva J.
AU - Madureira J.
AU - Tonelo C.
AU - Baltazar D.
AU - Silva C.
AU - Martins A.
AU - Alcobia C.
AU - Sousa I.
PY - 2017
SP - 223
EP - 230
DO - 10.5220/0006227802230230