Age Differences in Energy Absorption in the Upper Extremity During a Descent Movement: Implications for Arresting a Fall

Abstract

During a descent movement that simulates fall arrest, the energy-absorbing capacity of the upper extremities in older women is nearly half that of young women. Absorbing the full energy of a fall in the upper extremities is a challenging task even for healthy young women. Strengthening of upper extremity muscles should enhance this ability and presumably reduce the risk for injury to the hip and head during a fall.

Prevalence of and factors associated with head impact during falls in older adults in long-term care

“…Upper-limb strength (and movement speed) should be assessed carefully in the older adult who presents with a fall-related injury, and adults should be encouraged across their lifespan to engage in exercises to strengthen upper limbs to improve their ability to stop a fall. 23 As previously mentioned, future research should also examine the potential benefit for older adults of carefully designed training based on martial arts falling techniques. 31 In the long-term care setting, the high rate of cognitive and physical impairment among residents creates challenges for widespread implementation of exercise programs, and attention should focus additionally on the design of safer environments.…”

“…Although we cannot identify why hand impact was generally ineffective in halting downward movement and preventing head impact, likely causes include ineffective arm placement; nonoptimal muscle tone or muscle activation at impact; 28 and insufficient strength in upper-limb, neck and trunk muscles, 22,23 which is amenable to improvement through resistance training.…”

“…12,26 However, stopping a fall with the upper limbs is demanding in terms of speed, coordination and strength to prevent arm collapse. 22,23,27 It also depends on the intactness of neurologic systems to detect falls and to rapidly select a motor program (for hand placement and energy absorption) appropriate to a given situation. Our participants displayed a tendency to move their arms into a protective position (hand impact occurred in 74% of falls), which signals persistence in the generation and execution of upper-limb protective responses.…”

“…1,10 Falls in young adults rarely result in head impact, owing to protective responses such as use of the upper limbs to stop the fall, trunk flexion and rotation during descent. [20][21][22][23] We have limited evidence of the efficacy of protective responses to falls among older adults.…”

Bone strength and muscle properties in postmenopausal women with and without a recent distal radius fracture

“…Further, it has been shown that grip strength remains up to 12 % lower at the injured site [16]. Thus, the muscle-bone interaction in the upper extremity may play an important role in determining bone strength [15,16], while also contributing to the ability of the upper extremity to absorb impact forces from a fall impact [17,18].…”