Effect of elbow flexion on upper extremity impact forces during a fall

Chou, Pei Hsi; Chou, You-Li; Lin, Chii-Jeng; Su, Fong Chin; Lou, Shu Zon; Lin, Chyan Fei; Huang, Gwo-Feng

doi:10.1016/s0268-0033(01)00086-9

Cited by 65 publications

(48 citation statements)

References 13 publications

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“…The elbow flexion observed in this study contributed to the reduction in velocity during forward falls and is consistent with previous studies (Chou et al, 2001;Ashton-Miller, 2002, 2003;Kim and Ashton-Miller, 2003). Elbow flexion during forward falls was also shown to influence the force profile after impact and reduce fracture risk.…”

Section: Article In Presssupporting

confidence: 91%

“…Fracture risks were shown in previous studies to be influenced by parameters such as impact velocity van den Kroonenberg et al, 1996) and elbow angle (Chou et al, 2001;. Other biomechanical variables that could influence fracture risk but were not measured in the current study include (a) impact force (Chiu and Robinovitch, 1998), (b) wrist flexion/ extension and (c) forearm pronation/supination.…”

Section: Article In Pressmentioning

confidence: 67%

“…Studies on fall protective responses have focused on forward falls (Chou et al, 2001;AshtonMiller, 2002, 2003;Kim and Ashton-Miller, 2003) with fewer studies in the backward direction (Hsiao and Robinovitch, 1998;Sandler and Robinovitch, 2001). No direct comparisons between these two directions exist.…”

Section: Introductionmentioning

confidence: 99%

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Wrist impact velocities are smaller in forward falls than backward falls from standing

Tan

Eng

Robinovitch

et al. 2006

Journal of Biomechanics

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Section: Article In Presssupporting

confidence: 91%

Section: Article In Pressmentioning

confidence: 67%

See 1 more Smart Citation

Wrist impact velocities are smaller in forward falls than backward falls from standing

Tan

Eng

Robinovitch

et al. 2006

Journal of Biomechanics

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“…Cartilage material properties were assigned based on the assumption that the model would simulate an impact during which the peak force occurs approximately 30 ms after initial contact (Chou et al, 2001;Reed-Troy and Grabiner, 2005). At this rapid loading rate, cartilage appears nearly incompressible (Stolz et al, 2004), thus n ¼ 0.49 was assigned.…”

Section: Model Developmentmentioning

confidence: 99%

Off-axis loads cause failure of the distal radius at lower magnitudes than axial loads: A finite element analysis

Troy¹,

Grabiner²

2007

Journal of Biomechanics

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Distal radius (Colles') fractures are a common fall-related injury in older adults and frequently result in long-term pain and reduced ability to perform activities of daily living. Because the occurrence of a fracture during a fall depends on both the strength of the bone and upon the kinematics and kinetics of the impact itself, we sought to understand how changes in bone mineral density (BMD) and loading direction affect the fracture strength and fracture initiation location in the distal radius. A three-dimensional finite element model of the radius, scaphoid, and lunate was used to examine changes of +/-2% and +/-4% BMD, and both axial and physiologically relevant off-axis loads on the radius. Changes in BMD resulted in similar percent changes in fracture strength. However, modifying the applied load to include dorsal and lateral components (assuming a dorsal view of the wrist, rather than an anatomic view) resulted in a 47% decrease in fracture strength (axial failure load: 2752N, off-axis: 1448N). Loading direction also influenced the fracture initiation site. Axially loaded radii failed on the medial surface immediately proximal to the styloid process. In contrast, off-axis loads, containing dorsal and lateral components, caused failure on the dorsal-lateral surface. Because the radius appears to be very sensitive to loading direction, the results suggest that much of the variability in fracture strength seen in cadaver studies may be attributed to varying boundary conditions. The results further suggest that interventions focused on reducing the incidence of Colles' fractures when falls onto the upper extremities are unavoidable may benefit from increasing the extent to which the radius is loaded along its axis.

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“…6a). 20,21,26,27,61,71,73 (See Appendix B for the details of the F GR calculation.) In the case of the lumbar spine static lift model, we compared the BFxRM predictions of F GR to four experimental studies in which F GR was measured during a drop landing (Fig.…”

Section: Resultsmentioning

confidence: 99%

Development and Validation of a Predictive Bone Fracture Risk Model for Astronauts

et al. 2009

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There are still many unknowns in the physiological response of human beings to space, but compelling evidence indicates that accelerated bone loss will be a consequence of long-duration spaceflight. Lacking phenomenological data on fracture risk in space, we have developed a predictive tool based on biomechanical and bone loading models at any gravitational level of interest. The tool is a statistical model that forecasts fracture risk, bounds the associated uncertainties, and performs sensitivity analysis. In this paper, we focused on events that represent severe consequences for an exploration mission, specifically that of spinal fracture resulting from a routine task (lifting a heavy object up to 60 kg), or a spinal, femoral or wrist fracture due to an accidental fall or an intentional jump from 1 to 2 m. We validated the biomechanical and bone fracture models against terrestrial studies of ground reaction forces, skeletal loading, fracture risk, and fracture incidence. Finally, we predicted fracture risk associated with reference missions to the moon and Mars that represented crew activities on the surface. Fracture was much more likely on Mars due to compromised bone integrity. No statistically significant gender-dependent differences emerged. Wrist fracture was the most likely type of fracture, followed by spinal and hip fracture.

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Effect of elbow flexion on upper extremity impact forces during a fall

Cited by 65 publications

References 13 publications

Wrist impact velocities are smaller in forward falls than backward falls from standing

Wrist impact velocities are smaller in forward falls than backward falls from standing

Off-axis loads cause failure of the distal radius at lower magnitudes than axial loads: A finite element analysis

Development and Validation of a Predictive Bone Fracture Risk Model for Astronauts

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