Falls Efficacy Scale – International

People with vestibular disorders: (Morgan et al.,2013, n = 53; mean age = 54 (15) years)

• SEM = 3.0 points

People with vestibular disorders: (Morgan et al.,2013)

• 8.2 points

People with vestibular disorders: (Morgan et al.,2013)

• Excellent test-retest reliability (ICC = .94)

Concurrent validity:

People with vestibular disorders: (Morgan et al.,2013)

• Excellent correlations with Activity Balance Confidence (ABC) scores (r = -0.84)
• Excellent correlations with Dizziness Handicap Inventory (DHI) (r = 0.75)
• Excellent correlations with Vestibular Activities and Participation (VAP) (r = 0.78)
• Adequate correlations with gait speed (r = -0.55)
• Adequate correlations with 4 item- Dynamic Gait Index (DGI-4) (r = -0.55)

Community-dwelling older adults: (Delbaere et al., 2010; n = 500; mean age = 77.4 (6.08))

• Scores between 16 – 19 indicate low concern about falls
• Scores between 20 – 27 indicate moderate concern about falls
• Scores between 28 – 64 indicate high concern about falls

Older adults with and without cognitive impairments: (Hauer et al., 2011; n = 284; mean age in cognitively impaired = 82.5 (6.2); mean in cognitively intact = 81.6 (6.8) )

• Mean (SD) FES - I score of cognitively impaired group; 29.2 (10.3), range = 16 - 63
• Mean (SD) FES - I score of cognitively intact group; 29.6 (10.7), range = 16 - 59

Community-dwelling older adults: (Delbaere et al., 2010)

• Mean (SD) FES - I score at baseline; 22.6 (6.4), range = 16 – 57
• Mean (SD) FES - I score at 3 months; 21.7 (6.6), range = 16 – 55
• Mean (SD) FES - I score at 6 months; 22.8 (7.8), range = 16 – 64
• Mean (SD) FES - I score at 9 months; 23.6 (8.2), range = 16 – 62
• Mean (SD) FES - I score at 12 months; 23.6 (8.1), range = 16 – 64

Community-dwelling older adults: (Dewan and MacDermid, 2014)

• Excellent test-retest reliability (ICC = .96)

Geriatric rehabilitation patients with or without cognitive impairments: (Hauer et al., 2010)

• Adequate to Excellent test-retest reliability (ICC = .58 to 0.92)

Community-dwelling older adults:

• Excellent internal consistency (Cronbach’s alpha = 0.96*) (Dewan and MacDermid, 2014)
• Adequate internal consistency (Cronbach’s alpha = 0.79) (Delbaere et al., 2010)

Geriatric rehabilitation patients with or without cognitive impairments:

• Excellent internal consistency (Cronbach’s alpha = 0.925* to 0.957*) (Hauer et al., 2010)

Older adults with and without cognitive impairments:

• Excellent internal consistency (Cronbach's alpha = 0.92*), both community-dwelling older adults and geriatric rehabilitation patients with or without cognitive impairments (Hauer et al., 2011)

*Scores > 0.9 may indicate redundancy

Older adults with and without cognitive impairments:

• Adequate floor effects = 3.9% (Hauer et al., 2011, n = 11)

Older adults with and without cognitive impairments: (Hauer et al., 2011; n = 130)

• Moderately sensitive (Effect Size (ES) = 0.36)

Multiple sclerosis: (Vliet et al., 2013, n = 169, mean age = 50.6 (10.9) years)

• SEM = 0.19 points

Multiple sclerosis: (Vliet et al., 2013)

• 0.52 points

Multiple sclerosis:

• Excellent internal consistency (Cronbach’s alpha = 0.94*) (Vliet et al.,2013)

*Scores > 0.9 may indicate redundancy

Predictive validity:

Multiple sclerosis: (Vliet et al., 2013)

• Good predictive validity was established through its ability to discriminate between multiple fallers and non-multiple fallers assessed during a 12-month follow-up period, suggesting that the FES-I is likely to have an acceptable sensitivity to change in people with MS.

Convergent Validity

Multiple sclerosis: (Vliet et al., 2013)

Discriminant validity

Multiple sclerosis: (Vliet et al., 2013, n = 169, mean age = 50.6 (10.9) years )

• Poor correlations between FES-I and the duration of the disease (P = 0.138) is indicative of good discriminant validity, suggesting that high FES-I scores are not merely a reflection of disease duration.

Elderly with hip fracture: (Visschedijk et al., 2015, Group 1, n = 100, mean age = 83.1 (8.3) years, Group 2, n = 23, mean age  = 83.2 (7.2) years)

• SEM = 6.4 points

Elderly with hip fracture: (Visschedijk et al., 2015)

• 17.7 points

Elderly with hip fracture:(Visschedijk et al., 2015)

• Adequate inter-rater reliability (ICC = 0.72)

Elderly with hip fracture:

• Excellent internal consistency (Cronbach’s alpha = 0.94*), 3th or 4^th week after admission to SNF (Visschedijk et al., 2015)

*Scores > 0.9 may indicate redundancy

• The FES-I was developed through a series of meetings between members of the Prevention of Falls Network Europe (ProFaNE), an EC funded collaboration coordinating research into fall prevention.
• Members examined the existing items of the FES to identify any potential difficulties they might pose either for accurate translation or for applicability to their cultural context.
• The wording of items that posed potential problems was then revised through discussion. For example, the item ‘Reaching into cabinets or closets’ appeared ambiguous because of cross-cultural differences in the use of storage space and the terms employed to describe it; consequently, the activity this item assessed was standardised as ‘Reaching up or bending down’ (Yardley, Beyer, Hauer, Kempen, Piot-Zieglers & Todd, 2005).

• Not assessed statistically, however, the authors selected additional items with cross-cultural face validity to assess more difficult and social activities based on the literature and the professional experience of members.
• The resulting questionnaire comprised 16 items, including the 10 original items from the FES (with some rewording where necessary) and six new items assessing walking on slippery, uneven or sloping surfaces, and visiting friends or relatives, going to a social event or going to a place with crowds.
• The authors employed the revised FES instructions and response categories that assess level of concern about falling when carrying out each activity on a four point scale (1=not at all concerned, 4=very concerned) (Yardley et al., 2005).