Recreating Fall Risk Appraisal matrix using R to support fall prevention programs

Objective This study aimed to optimize Fall Risk Appraisal (FRA) graphing for use in intervention programs tailored toward reducing the fall risk of older adults by using computing graphic functions in the R language. Materials and Methods We utilized RStudio, a free development environment for the R language, as well as the functions within the “ggplot2” and “grid” packages, to develop a code that would recreate the FRA matrix for use in data visualization and analysis, as well as feedback for older adults. Results The developed code successfully recreates the FRA matrix in R and allows researchers and clinicians to graph participant data onto the matrix itself. Discussion The use of an R code allows for a streamlined approach to manipulating the FRA matrix for use in data visualization and feedback for older adults, which improves upon the traditional paper-pencil method that has been previously used. Conclusions The code presented in this study recreates the FRA matrix instrument in the R language and gives researchers the ability to instantaneously add, remove, or change different aspects of the instrument to improve its readability for researchers and older adults. Lay Summary Intervention programs utilize visual representations of data to assist in providing feedback to study participants, as well as determining the performance of the participants throughout the course of a program. One instrument, the Fall Risk Appraisal (FRA) matrix, is a graphical grid that has been previously developed to categorize older adults based on their self-perceived fall risk and physical balance. For the matrix, self-perceived fall risk is determined using the Short Falls Efficacy Scale International (Short FES-I) questionnaire, and physical balance is determined using the BTrackS Balance System (BBS). The FRA matrix was originally designed using Microsoft Paint, which lacks the ability to accurately graph coordinate points on the matrix itself. The ability to accurately graph data points (Short FES-I and BBS intersections for an individual) on the FRA matrix allows for easier visualization of data for researchers, as well as older adults. Here, we present a code in R that accurately recreates the FRA matrix and enables a researcher to graph individual data points, as well as add supplementary information, directly onto and around the graph. The use of this code allows for a more streamlined approach to visualizing data for fall risk assessments in research and clinical