James Richardson, M.D., watches as 72-year-old Linda Carter grips the ReacStick in Ann Arbor, her eyes locked on the small lights at the top of the device. In a split second, they flash—and she snatches it mid-fall. Moments like this, repeated across 172 patients, are quietly revolutionizing how doctors predict and prevent one of the leading causes of injury in older adults: falls. At the University of Michigan’s JEDII Fall Clinic—short for Judicious Early Detection of Impending Imbalance—Richardson is flipping the script on fall prevention. Instead of waiting for a patient to stumble, he’s catching risk before it turns into injury.
Falls are not just common—they’re deadly. Over 36 million occur annually in the U.S., leading to more than 32,000 deaths. Yet, most clinical assessments still wait until after a fall to intervene. Richardson’s method changes that by identifying risk with 67% accuracy using three simple, low-cost tests that pinpoint the root causes of imbalance. The breakthrough, published in Aging Clinical and Experimental Research, offers a roadmap for clinics nationwide to act earlier and more precisely.
The first test measures vibratory perception using a tuning fork placed on the big toe. If a patient feels the vibration for less than eight seconds, it signals declining nerve function in the feet—often an early sign of diabetic neuropathy or other conditions that dull the body’s ability to sense a misstep. The second, the ReacStick, measures reaction time. As the device drops, sensors record how fast the patient catches it, revealing deficits in central processing speed—a key factor in whether someone can correct a stumble before it becomes a fall. The third test evaluates frontal plane strength, assessing hip abductor muscles that keep us upright when walking or standing on one leg.
Together, these three tests explain about two-thirds of the variability in unipedal stance time—the gold standard for balance testing, where patients try to stand on one foot for 15 seconds. Those who can’t are at significantly higher risk of falling within the next decade. But unlike the stance test alone, Richardson’s trio reveals why—whether it’s nerve damage, slow brain processing, or weak hips—enabling targeted interventions like physical therapy, balance training, or neuropathy management.
The impact is already being felt. At the JEDII clinic, patients leave not just with a diagnosis, but with a clear understanding of their body’s vulnerabilities. For clinicians, the tools are inexpensive, quick, and scalable. And for public health, this could mean fewer hospitalizations, lower healthcare costs, and, most importantly, more people staying on their feet.
As aging populations grow, so does the urgency. Richardson’s vision isn’t just about preventing falls—it’s about preserving independence. "We’re not waiting for the fall anymore," he says. "We’re stopping it before it starts."