Usability of Self-Guided Mixed Reality Fall Risk Assessment for Older Adults

Background: Fall risk assessments are critical to identify those at risk of falling, but they are seldom performed due to time restrictions with clinicians and the need for trained expertise. Mixed-reality headsets offer potential to overcome these limitations and provide self-guided fall risk assessments through validated, clinical tasks. However, there is limited evidence of whether older adults are willing to use and accept self-guided technology. Objective: The purpose of this study was to determine the usability of a mixed-reality fall risk application (app) for older adults. Methods: A customized application was developed and deployed on a Microsoft HoloLens display to guide users through four mobility tasks: five times sit-to-stand, timed up and go, eyes open stance, and eyes closed stance. Ten older adults used the headset and completed a self-guided assessment, thinking their thoughts aloud. Participants were interviewed to ask about their likes, dislikes, and perceived usefulness with the app. Interviews were recorded, transcribed, and coded into themes. Participants also completed the System Usability Scale. Results: Three themes were identified: comfort, learnability, and usefulness. Older adults reported that the headset was heavy to wear, they needed time to learn how to navigate through the app and found the app useful to understand their fall risk. Average SUS score was 71.9. Conclusions: A self-guided mixed reality app has the potential to offer routine, fall risk assessment to older adults. Increasing knowledge of older adults' fall risk may improve fall risk screening and provide treatment strategies to reduce fall-related injuries.