Low stiffness floors can attenuate fall-related femoral impact forces by up to 50% without substantially impairing balance in older women

Laing, Andrew C.; Robinovitch, Stephen N.

doi:10.1016/j.aap.2009.03.001

Cited by 68 publications

(78 citation statements)

References 53 publications

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“…In previous studies, appropriately tuned compliant flooring attenuated impact forces to the head by 80% (and to the hip by 40%), without impairing the mobility and balance of older women. 33,34 Our results support the need for ongoing efforts to examine the clinical efficacy and cost-effectiveness of this intervention. 35,36 …”

Section: Resultssupporting

confidence: 64%

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

Schonnop

Yang

Feldman

et al. 2013

CMAJ

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Research CMAJBackground: Falls cause more than 60% of head injuries in older adults. Lack of objective evidence on the circumstances of these events is a barrier to prevention. We analyzed video footage to determine the frequency of and risk factors for head impact during falls in older adults in 2 long-term care facilities. Methods:Over 39 months, we captured on video 227 falls involving 133 residents. We used a validated questionnaire to analyze the mechanisms of each fall. We then examined whether the probability for head impact was associated with upper-limb protective responses (hand impact) and fall direction.Results: Head impact occurred in 37% of falls, usually onto a vinyl or linoleum floor. Hand impact occurred in 74% of falls but had no significant effect on the probability of head impact (p = 0.3). An increased probability of head impact was associated with a forward initial fall direction, compared with backward falls (odds ratio [OR] 2.7, 95% confidence interval [CI] 1.3-5.9) or sideways falls (OR 2.8, 95% CI 1.2-6.3). In 36% of sideways falls, residents rotated to land backwards, which reduced the probability of head impact (OR 0.2, 95% CI 0.04-0.8).Interpretation: Head impact was common in observed falls in older adults living in longterm care facilities, particularly in forward falls. Backward rotation during descent appeared to be protective, but hand impact was not. Attention to upper-limb strength and teaching rotational falling techniques (as in martial arts training) may reduce fall-related head injuries in older adults. Abstract

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Section: Resultssupporting

confidence: 64%

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

Schonnop

Yang

Feldman

et al. 2013

CMAJ

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“…Five different flooring conditions were tested (Table 1) and have been described in detail previously (Laing and Robinovitch, 2009). Briefly, the 'Rigid' floor (used as a control condition) was a thin layer of dense engineered rubber appropriate for installation over concrete or wooden subfloors in institutional settings (Noraplan Classic, Nora Systems Inc, Lawrence, MA, USA).…”

Section: Floor Conditionsmentioning

confidence: 99%

“…Such products have been shown to attenuate the peak force applied to the proximal femur by 25-50% during simulated sideways falls, in addition to having minimal effects on successful completion of static (quiet stance) and dynamic balance and mobility tasks (Timed Up and Go test, backwards floor translation) in older community-dwelling women (Laing and Robinovitch, 2009). However, no information currently exists on the influence of novel compliant floors on biomechanical variables associated with balance control responses following externally induced perturbations (i.e.…”

Section: Introductionmentioning

confidence: 98%

“…A promising intervention approach that is particularly relevant for high-risk settings is to decrease the stiffness of the floor to attenuate impact forces in the event of a fall (Casalena et al, 1998;Maki and Fernie, 1990;Laing et al, 2006;Laing and Robinovitch, 2009;Laforest et al, 2000;Nevitt and Cummings, 1993;Simpson et al, 2004;Healey, 1994). While the clinical effectiveness of intervention strategies such as exercise, pharmacological agents, and wearable hip protectors depend on active user compliance and adherence, novel compliant floors are a passive intervention approach that may protect against multiple types of fall-related injuries.…”

Section: Introductionmentioning

confidence: 98%

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The influence of novel compliant floors on balance control in elderly women—A biomechanical study

Wright

Laing

2011

Accident Analysis & Prevention

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Novel compliant floors aim to decrease the risk for fall-related injury by providing substantial force attenuation during the impact phase of falls. Certain models of compliant flooring have been shown to have limited influence on postural sway and successful completion of dynamic balance tasks. However, the effects of these products on balance recovery mechanisms following an externally induced perturbation have yet to be quantified. We used a floor translation paradigm to induce a balance perturbation to thirteen elderly community-dwelling women. Outcome measures included the displacement rates and margins of safety for both the underfoot centre-of-pressure and whole-body centre-of-mass across two novel compliant floors (SmartCell, SofTile), two basic foam surfaces (Firm-Foam, Soft-Foam) and a standard 'Rigid' floor as a control condition. The centre-of-mass and centre-of-pressure margins of safety, and all centre-of-mass displacement rates, were not significantly lower for the two novel compliant flooring systems compared to the control floor. The centre-of-pressure displacement rates were similar to the control floor for the SmartCell floor condition. The majority of the margin of safety and displacement rate variables for the foam floors were significantly lower than the control condition. This study illustrates that the SmartCell and SofTile novel compliant floors have minimal influences on balance and balance control responses following externally induced perturbations in older community-dwelling women, and supports pilot installations of these floors to inform decisions regarding the development of clinical trials.

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“…Elimination of home hazards, such as slippery floors, uneven surface, and inadequate lighting, can decrease the risk of geriatric falls 16 . Low stiffness floors reduce the fall-related femoral impact by up to 50% without impairing the balance 33 . Vitamin D supplementation decrease the long term rate of fall related injuries 34 .…”

Section: Many Elderly Whomentioning

confidence: 99%

Geriatric fall-related injuries

Hefny¹,

Abbas²,

Abu‐Zidan³

2016

Afr H. Sci.

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Background: Falls are the leading cause of geriatric injury. Objectives: We aimed to study the anatomical distribution, severity, and outcome of geriatric fall-related injuries in order to give recommendations regarding their prevention. Methods: All injured patients with an age ≥ 60 years who were admitted to Al-Ain Hospital or died in the Emergency Department due to falls were prospectively studied over a four year period. Results: We studied 92 patients. Fifty six of them (60.9%) were females. The mean (standard deviation) of age was 72.2 (9.6) years. Seventy three (89%) of all incidents occurred at home. Eighty three patients (90.2%) fell on the same level. The median (range) ISS was 4 (1-16) and the median GCS (range) was 15 (12-15). The lower limb was the most common injured body region (63%). There were no statistical significant differences between males and females regarding age, ISS, and hospital stay (p = 0.85, p = 0.57, and p = 0.35 respectively). Conclusion:The majority of geriatric fall-related injuries were due to fall from the same level at home. Assessment of risk factors for falls including home hazards is essential for prevention of geriatric fall-related injuries.

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Low stiffness floors can attenuate fall-related femoral impact forces by up to 50% without substantially impairing balance in older women

Cited by 68 publications

References 53 publications

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

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

The influence of novel compliant floors on balance control in elderly women—A biomechanical study

Geriatric fall-related injuries

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