Researchers at the University of Michigan have developed a new program designed to identify an individual's risk of falling before an accident occurs. The innovative approach, called JEDII, moves beyond reactive care and focuses on proactive assessment to help people maintain their independence and prevent serious injuries.
The program, short for Judicious Early Detection of Impending Imbalance, utilizes a series of simple yet effective tests to measure three critical factors for stability: sensation, strength, and mental processing speed. By evaluating these key areas, medical professionals can create personalized prevention strategies for at-risk individuals.
Key Takeaways
- The University of Michigan has created the JEDII program to proactively assess fall risk.
- The system evaluates three core areas: foot sensation, hip and trunk strength, and brain processing speed.
- Poor performance in two of the three areas, or being average in all three, indicates a higher risk of falling.
- Based on test results, specific interventions like physical therapy, ankle braces, or medication reviews can be recommended.
A New Philosophy in Fall Prevention
Traditionally, medical intervention for falls happens after the fact. A patient suffers a fall, sustains an injury, and only then does a comprehensive risk assessment begin. This new initiative seeks to flip that script by identifying subtle signs of instability early on.
The core idea is that falls are not random events but often the result of a gradual decline in one or more physical or cognitive functions. By catching these declines before they lead to a fall, the program offers a chance to intervene and improve a person's stability.
Dr. James K. Richardson, a Professor of Physical Medicine & Rehabilitation at the University of Michigan and the mind behind the program, emphasizes this proactive stance. The goal is to move from a reactive healthcare model to a predictive one, empowering people with knowledge about their own bodies.
The Silent Epidemic
Falls represent a significant public health issue, particularly for older adults. They are a leading cause of both fatal and nonfatal injuries, often resulting in loss of independence, costly medical bills, and a diminished quality of life. Proactive screening has the potential to mitigate these widespread consequences.
The Three Pillars of Stability Assessment
The JEDII program is built upon a straightforward, three-part evaluation that can be administered quickly in a clinical setting. Each test targets a different system that contributes to a person's ability to stay upright and navigate their environment safely.
1. The Sensation Test
This initial test measures how well an individual can feel vibrations in their feet. Using a simple tuning fork, a clinician can gauge the sensitivity of the nerves in the lower extremities. Good foot sensation is crucial for detecting changes in ground surfaces and making micro-adjustments to maintain balance.
Numbness or reduced sensation, a condition often associated with diabetes or other nerve-related issues, can significantly increase fall risk because the brain isn't receiving accurate information from the feet.
2. The Strength Test
Core and hip strength are fundamental to stability. To measure this, the program uses a lateral plank position. Patients are asked to hold this position, which engages key muscle groups in the hips and trunk responsible for keeping the body stable.
The target for this test is to maintain the position for at least 20 seconds. An inability to do so indicates a potential weakness in the muscles that prevent swaying and loss of balance during movement.
3. The Brain Speed Test
The final component evaluates cognitive processing speed and reaction time. This is not just about thinking fast, but about selective attention—the ability to process multiple stimuli and react appropriately. The test uses a device called a “REAC-stick” to measure a person's reaction time in milliseconds.
This test simulates real-world scenarios, such as walking on a busy sidewalk or avoiding an unexpected obstacle, where quick mental processing is essential for preventing a fall.
It's a Balancing Act
According to the program's findings, you don't need to be perfect in all three areas. Strength in two categories can often compensate for a weakness in the third. The danger zone emerges when two or more areas are below average.
Interpreting the Results
The power of the JEDII assessment lies in its holistic view. Dr. Richardson explains that a person can perform poorly on one of the tests and still have a low fall risk, provided they excel in the other two areas.
“You can miss one [test]. So say your feet are numb. If your hips are strong and your brain’s quick, you’re fine,” Dr. Richardson stated. “Two of the three being below average, or being average on all three, and you start to get in a gray zone.”
This “gray zone” is where the risk becomes significant. An individual with average scores across the board might not have an obvious single weakness, but their combined mediocrity in sensation, strength, and processing speed makes them vulnerable.
From Assessment to Action
Once a person's risk profile is understood, the program provides clear, actionable steps to address specific weaknesses. The solutions are tailored to the test results, ensuring that interventions are targeted and effective.
These recommendations can include:
- For Reduced Sensation: Using trekking poles for stability on uneven ground, wearing supportive sport braces on the ankles, and prioritizing vision care. Simple changes, like avoiding bifocals when walking, can also make a difference.
- For Strength Deficits: A referral to a physical therapist or a certified trainer can help. A focused exercise program targeting the hips and core can rebuild essential muscle groups. Weight management may also be part of a comprehensive strength-building plan.
- For Slower Processing Speed: This can sometimes be linked to medications. A review with a doctor or pharmacist is recommended. Other factors, like improving sleep quality and addressing issues like sleep apnea, can also enhance cognitive function and reaction time.
By providing a clear path from diagnosis to solution, the JEDII program aims to empower individuals to take control of their health and actively participate in preventing falls, ensuring they can lead safer, more independent lives for longer.