Fall Risk Assessment

Fall Risk Battery

Complete only the assessments performed
🔒
No patient identifiers stored or transmitted. All data remains on this device.
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Patient Info
Required for age-normed interpretations
Age Range
Fall History
Fear of Falling
Assistive Device
Timed Up & Go (TUG)
Time to rise, walk 3m, return, sit
not scored
🪑
30-Second Sit to Stand
Repetitions in 30 seconds — LE power & endurance
not scored
🔁
Five Times Sit to Stand (5XSTS)
Time to complete 5 sit-to-stand repetitions
not scored
⚖️
4-Stage Balance Test
Hold each position for 10 seconds
not scored
🧪
Mini-BESTest
14 items · 28 points total · balance systems evaluation
not scored
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Berg Balance Scale
14 items · 56 points total · gold standard
not scored
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Functional Gait Assessment (FGA)
10 items · 30 points total · dynamic gait
not scored
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Tinetti POMA
Balance (16pts) + Gait (12pts) = 28 points total
not scored
😰
ABC Scale
Activities-Specific Balance Confidence — 16 items · patient self-report
not scored
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Clinical Notes
Additional observations and context
Fall Risk Assessment

Fall Risk Report