Smulders E1,2,3, Groen B1,3,4, Weerdesteyn V1,3,4
1Radboud University Medical Centre, Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands, 2Avans+, Master Geriatric Physical Therapy, Breda, Netherlands, 3Dutch Institute of Allied Health Care, Amersfoort, Netherlands, 4Sint Maartenskliniek, Research, Nijmegen, Netherlands
Background: Exercise interventions have shown to be effective in reducing the number of falls in older people, yet not all falls can be prevented. Therefore, it is important to focus on reducing the risk of fall-related injuries as well. Training of safe-falling techniques may hold promise for achieving this. We have previously developed and evaluated the Nijmegen Falls Prevention Program (NFPP)1,2, which intervention consists of three elements: an obstacle course, walking exercises and the practice of safe-falling techniques derived from martial arts. Laboratory studies have confirmed that martial arts fall techniques reduce the severity of falls on the hip by reducing impact velocity and force.3 The studies on the efficacy of the NFPP were powered to demonstrate reductions in fall rates, but the sample sizes were too small to demonstrate significant differences between the number of fall-related fracture in the intervention (n=2) and control group (n=5). Hence, the question remains whether these safe-falling techniques may also help to prevent injurious falls in daily life. As a first step, we conducted structured interviews among the study participants on the conscious use of the trained safe-falling techniques during real-life falls.
Purpose: To evaluate the application of trained safe-falling techniques during real-life falls in community-dwelling elders.
Methods: Participants (>65 years) of the NFPP (n=144) were included in this study. After participation they registered their falls by monthly fall calendars for one year. A control group (n=27), who received no intervention, also registered their falls. Persons who reported a fall during this follow-up period were contacted by phone. During a structured interview the falls were evaluated in more detail. Questions were related to the conscious use of the learned safe-falling techniques (intervention group), head control, not landing on the outstretched arms and rolling.
Results: Seventy falls in the exercise and 21 falls in the control group were evaluated. One third of the participants in the exercise group reported that they consciously used the martial arts fall techniques. In the exercise group, 60% indicated to have controlled their head, 76% not to have landed on the outstretched arm and 16% indicated to be able to roll on after fall impact, versus 56%, 52% and 0%, respectively, of the participants in the control group. In the exercise group, the fallers had been able to apply at least one of these safe-falling elements in 86% of the falls, as compared to 57% in the control group.
Conclusion(s): Older people appear to be able to implement elements of the trained safe-falling techniques during falls in daily life, even in the short time frame of a real fall.
Implications: It seems relevant to train older people on safe-falling techniques. However, these preliminary observations call for larger controlled studies to establish the applicability of safe-falling techniques during unexpected falls in daily life, and their potential benefits for reducing fall injuries.
References:
1. Weerdesteyn et al. Gerontology 2006;52:131-41
2. Smulders et al. Arch Phys Med Rehabil 2010;91:1705-11
3. Moon et al. Arch Phys Med Rehabil 2017;98:783-94
Keywords: falls, safe-falling techniques, daily life
Funding acknowledgements: Organization for Healthcare Research in the Netherlands (ZonMW).
Purpose: To evaluate the application of trained safe-falling techniques during real-life falls in community-dwelling elders.
Methods: Participants (>65 years) of the NFPP (n=144) were included in this study. After participation they registered their falls by monthly fall calendars for one year. A control group (n=27), who received no intervention, also registered their falls. Persons who reported a fall during this follow-up period were contacted by phone. During a structured interview the falls were evaluated in more detail. Questions were related to the conscious use of the learned safe-falling techniques (intervention group), head control, not landing on the outstretched arms and rolling.
Results: Seventy falls in the exercise and 21 falls in the control group were evaluated. One third of the participants in the exercise group reported that they consciously used the martial arts fall techniques. In the exercise group, 60% indicated to have controlled their head, 76% not to have landed on the outstretched arm and 16% indicated to be able to roll on after fall impact, versus 56%, 52% and 0%, respectively, of the participants in the control group. In the exercise group, the fallers had been able to apply at least one of these safe-falling elements in 86% of the falls, as compared to 57% in the control group.
Conclusion(s): Older people appear to be able to implement elements of the trained safe-falling techniques during falls in daily life, even in the short time frame of a real fall.
Implications: It seems relevant to train older people on safe-falling techniques. However, these preliminary observations call for larger controlled studies to establish the applicability of safe-falling techniques during unexpected falls in daily life, and their potential benefits for reducing fall injuries.
References:
1. Weerdesteyn et al. Gerontology 2006;52:131-41
2. Smulders et al. Arch Phys Med Rehabil 2010;91:1705-11
3. Moon et al. Arch Phys Med Rehabil 2017;98:783-94
Keywords: falls, safe-falling techniques, daily life
Funding acknowledgements: Organization for Healthcare Research in the Netherlands (ZonMW).
Topic: Older people
Ethics approval required: Yes
Institution: RadboudUMC
Ethics committee: Medical Ethics Committee for the region Arnhem-Nijmegen
Ethics number: 2004/152
All authors, affiliations and abstracts have been published as submitted.
