Grab Bar Use Influences Fall Hazard During Bathtub Exit

2021 ◽  
pp. 001872082110598
Author(s):  
Iris C. Levine ◽  
Roger E. Montgomery ◽  
Alison C. Novak
Keyword(s):  
Fall Prevention ◽  
Transfer Task ◽  
Balance Recovery ◽  
Video Cameras ◽  
Injurious Falls ◽  
Self Sufficiency ◽  
Cue Use ◽  
Recovery Strategies ◽  
Balance Loss ◽  
Transfer Tasks

Objective This study evaluated the hazard (risk of unrecovered balance loss and hazardous fall) and strategies associated with grab bar use, compared to no grab bar use, during unexpected balance loss initiated whilst exiting a bathtub. Background While independent bathing is critical for maintaining self-sufficiency, injurious falls during bathing transfer tasks are common. Grab bars are recommended to support bathing tasks, but no evidence exists regarding fall prevention efficacy. Method Sixty-three adults completed a hazardous bathtub transfer task, experiencing an unpredictable external balance perturbation while stepping from a slippery bathtub to a dry surface. Thirty-two were provided a grab bar, while 31 had no grab bar available. Slips and grab bar use were recorded via four video cameras. Slip occurrence and strategy were identified by two independent video coders. Results Participants who had a grab bar were 75.8% more likely to recover their balance during the task than those who did not have a grab bar. Successful grab bar grasp was associated with balance recovery in all cases. Attempts to stabilize using other environmental elements, or using internal strategies only, were less successful balance recovery strategies. Grab bar presence appeared to cue use of the environment for stability. Proactive grasp and other strategies modified grasping success. Conclusion Grab bars appear to provide effective support for recovery from unexpected balance loss. Grab bar presence may instigate development of fall prevention strategies prior to loss of balance. Application Bathroom designs with grab bars may reduce frequency of fall-related injuries during bathing transfer tasks.

Abstract TMP88: Slipping, Tripping, and Rapid Ambulation are Key Fall Triggers for Stroke Survivors

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Tiffany M Hoke ◽  
Ruth E Taylor-Piliae
Keyword(s):  
Fall Prevention ◽  
Exercise Intervention ◽  
Balance Control ◽  
Safety Evaluation ◽  
Community Dwelling ◽  
Stroke Survivors ◽  
Balance Recovery ◽  
Post Stroke ◽  
Recovery Strategies ◽  
Near Falls

Background: Stroke survivors fall up to seven times more annually than healthy adults of a similar age. The inability to recover balance from slipping, tripping, or rapid ambulation accounts for the majority of falls, while balance control can prevent falls. An examination of the triggers for falls and balance recovery strategies for near falls is crucial for fall prevention in stroke survivors. Purpose: To examine the self-reported triggers for falls and balance recovery strategies for near falls among community-dwelling stroke survivors. Methods: Descriptive study examining fall-related data from stroke survivors (n=89) aged ≥ 50 years, at ≥ 3 months post-stroke, participating in a 12-week exercise intervention study. All subjects were interviewed weekly to ascertain fall/near fall data over the 12 weeks. Falls were defined as: “events in which subjects end up on the floor or ground when they did not expect to.” Near falls were defined as: “events in which subjects recovered their balance without falling.” Results: Subjects (46% women) were on average 70±10 years old. The majority reported an ischemic stroke (80%), were White/European-American (79%), married/partnered (60%), college-educated (79%), and retired/unemployed (93%). Over the 12-week trial, there were a total of 124 fall-related events (n=34 falls, n=90 near falls); all events happened at home. Most falls happened due to slipping or tripping (21%) or rapid ambulation (18%). Other reported fall triggers included: legs or knees giving way (12%), bathroom related incidents such as incontinence (12%), reaching or leaning (6%), and vertigo or syncope (3%). Subjects most commonly recovered their balance without falling by grabbing onto or leaning against something (62%). A total of 29 (23%) fall-related events resulted in an injury, though only 8% of those events were evaluated by a healthcare provider. Conclusion: Our data suggests that stroke survivors fall most frequently as a result of slipping, tripping or rapid ambulation. Future studies investigating the effects of fall prevention strategies on these fall triggers are recommended. Since balance recovery was aided by grabbing onto or leaning against something, post-stroke home safety evaluation is essential in preventing falls.

scholarly journals 24-Months Cluster-Randomized Intervention Trial of a Targeted Fall Prevention Program in a Primary Care Setting

2021 ◽  
Author(s):  
Christian Hentschke ◽  
Martin Halle ◽  
Barbara Geilhof ◽  
Peter Landendoerfer ◽  
Wolfgang Blank ◽  
...  
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Fall Prevention ◽  
Care Setting ◽  
Primary Care Setting ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Risk Of Falling ◽  
Injurious Falls ◽  
Cluster Randomized

Abstract Background Falls and fall-related injuries are common in community-dwelling older persons. Longitudinal data on effective fall prevention programs are rare. Objective Therefore, we evaluated a 4-months multi-component exercise fall prevention program in a primary care setting on long-term effects over 24 months on falls and concomitant injuries in older community-dwelling persons with high risk of falling. Design and Setting In the Prevention of Falls (PreFalls) study, forty general practitioners in Germany were cluster-randomized (1:1) into an intervention group (IG) or control group (CG). Three hundred seventy-eight independently living people with high risk of falling (78.1 ± 5.9 years, 75% women) were assigned to IG (n = 222) or CG (n = 156). Intervention and Measurements Patients in IG took part in a 4-months multi-component exercise program comprising strength and balance exercises (28 sessions); patients in CG received no intervention. Primary outcome measure was number of falls over 24 months, analyzed by a patient-level, linear mixed Poisson model. Secondary endpoints were number of fall-related injuries, changes in physical function, fear of falling, and mortality. Results After 24 months, the IG demonstrated significantly fewer falls (IRR = 0.63, p = 0.021), injurious falls (IRR = 0.69, p = 0.034), and less fear of falling (p = 0.005). The mortality rate was 5.0% in IG and 10.3% in CG (HR = 0.51, 95% CI: 0.24 to 1.12; p = 0.094). Conclusions In older community-dwelling persons with high risk of falling, a short-term multi-component exercise intervention reduced falls and injurious falls, as well as fear of falling over 24 months.

Impact of Varying Flight Training Criteria on Flight Task Transfer Performance

1980 ◽  
Vol 24 (1) ◽  
pp. 572-572
Author(s):  
Mark Nataupsky ◽  
Thomas M. McCloy ◽  
John M. Bermudez ◽  
Valentin W. Tirnan ◽  
Villiam G. Buchta ◽  
...  
Keyword(s):  
Transfer Of Training ◽  
Transfer Task ◽  
Dependent Measure ◽  
The Other ◽  
Flight Training ◽  
Control Group ◽  
Wind Condition ◽  
Air Force Academy ◽  
Carry Over ◽  
Transfer Tasks

Recent studies have shown that criterion levels established in training directly affect later performance of subjects on experimental tasks. Approximately 20% of variance can be explained by these criteria. The purpose of this study was to determine if a similar relationship can be found in transfer of training situations. Twenty male Air Force Academy cadets were trained to one of two multiple criteria levels on a difficult flight manuever in a GAT-1 simulator. There was a easy criterion set and a more difficult criterion set. These two sets consisted of holding prescribed performance parameters in heading, vertical velocity, and altitude. After achieving their assigned criterion, all cadets in each of the two groups were then tested on the same task in a GAT-1 simulator, but this time the maneuver had to be performed under turbulent wind conditions. This wind condition served as the transfer task. Half of the cadets in each group had the same criterion in both the training and the transfer task. The other cadets had different criteria in the training and transfer tasks. Thus there were four experimental groups: easy-easy, easy-difficult, difficult-easy, difficult-difficult. One control group had the easy criterion while the other control group had the difficult criterion. There were five cadets in each control group. The dependent measure was the Transfer Effectiveness Ratio (TER), derived from trials of this criterion data. This index is an estimate of the amount of time saved in learning a transfer task when performance is adjusted to that of a control group. Several analyses of various tasks of derived scores yielded significant results, confirming that criterion levels established in training carry over to transfer of training situations. Moreover, the data showed consistency in accounting for 20% or more of the variance.

Context, Meaning, and Transfer of Verbal Behavior

1973 ◽  
Vol 32 (3_suppl) ◽  
pp. 1151-1157
Author(s):  
Julius M. Sassenrath ◽  
George D. Yonge
Keyword(s):  
Verbal Behavior ◽  
Repeated Measures ◽  
Transfer Of Learning ◽  
Paired Associate ◽  
Transfer Task ◽  
Sentence Context ◽  
Stimulus Response ◽  
Transfer Tasks

Two experiments, with 54 and 60 college Ss, respectively, had paired-associate words varied either in or out of a sentence context in training; had stimulus, response or both S-R similarity varied in 3 lists of paired-associate words or sentences between training and transfer; and had the meaning relationships of words within the 3 lists of paired-associate words or sentences between training and transfer varied in six ways: unrelated, synonyms, antonyms, homonyms, associates, and identical. Both experiments were designed as 2 (context) by 3 (lists) by 6 (meaning) with repeated measures for meaning. In Exp. I, the paired-associate words for the transfer task were not in a sentence context and in Exp. II the same paired-associate words were in a sentence context. The results indicated that there was reliably greater transfer for words that had homonym, associate or identical than unrelated, synonym, or antonym meaning relationships between training and transfer. This was true whether the paired-associate words were in or out of context in training or in transfer. Only when the training and transfer tasks were in context was there more transfer of learning due to context than no context. Contrary to the theory of transfer, there was no difference due to S, R, or S-R similarity being varied between training and transfer.

scholarly journals Effect of Handrail Height and Age on Trunk and Shoulder Kinematics Following Perturbation-Evoked Grasping Reactions During Gait

2021 ◽  
pp. 001872082110136
Author(s):  
Vicki Komisar ◽  
Alison C. Novak
Keyword(s):  
Angular Displacement ◽  
Unintentional Injury ◽  
Workplace Safety ◽  
Contact Forces ◽  
Balance Recovery ◽  
Safety Standards ◽  
Angular Displacements ◽  
Shoulder Kinematics ◽  
And Control ◽  
Balance Loss

Objective To characterize the effect of handrail height and age on trunk and shoulder kinematics, and concomitant handrail forces, on balance recovery reactions during gait. Background Falls are the leading cause of unintentional injury in adults in North America. Handrails can significantly enhance balance recovery and help individuals to avoid falls, provided that their design allows users across the lifespan to reach and grasp the rail after balance loss, and control their trunk by applying hand-contact forces to the rail. However, the effect of handrail height and age on trunk and shoulder kinematics when recovering from perturbations during gait is unknown. Method Fourteen younger and 13 older adults experienced balance loss (sudden platform translations) while walking beside a height-adjustable handrail. Handrail height was varied from 30 to 44 inches (76 to 112 cm). Trunk and shoulder kinematics were measured via 3D motion capture; applied handrail forces were collected from load cells mounted to the rail. Results As handrail height increased (up to 42 inches/107 cm), peak trunk angular displacement and velocity generally decreased, while shoulder elevation angles during reaching and peak handrail forces did not differ significantly between 36 and 42 inches (91 and 107 cm). Age was associated with reduced peak trunk angular displacements, but did not affect applied handrail forces. Conclusion Higher handrails (up to 42 inches) may be advantageous for trunk control when recovering from destabilizations during gait. Application Our results can inform building codes, workplace safety standards, and accessibility standards, for safer handrail design.

scholarly journals Strategy for Application of Support Object for Fall Prevention in the Elderly Based on Balance Recovery Characteristics

Machines ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 60
Author(s):  
Soichiro Matsuda ◽  
Yukio Takeda
Keyword(s):  
Fall Prevention ◽  
Reaction Force ◽  
The Elderly ◽  
Design Concept ◽  
Balance Recovery ◽  
Hand Evaluation ◽  
Anterior Direction ◽  
Support Devices ◽  
Assessment Results

This research proposes a strategy for applying support objects—equipment, tools, and even furniture/environment from which humans can receive reaction force through their hands—for fall prevention in the elderly. This paper presents an assessment example of support objects based on balance recovery characteristics and a discussion regarding their application according to the assessment results. The balance recovery characteristics depend on the direction in which reaction force can be obtained based on the shape of the support object and direction in which the force is easily exerted on the hand. Evaluation indices for assessing the height and shape of nonportable support objects and determining a position of the tip on the ground of a cane, a typical portable support object, in the anterior direction are briefly introduced based on the authors’ previous works. The strategy for the application of support objects utilizing the evaluation indices is proposed; better use of support objects, their locations, new-shaped ones, and support devices with a new design concept are discussed and introduced based on the values of the calculated indices according to the type/usage of the support objects.

scholarly journals Effectiveness of a Robot-Mediated Strategy While Counteracting Multidirectional Slippages

Robotica ◽  
2019 ◽  
Vol 37 (12) ◽  
pp. 2119-2131 ◽  
Author(s):  
F. Aprigliano ◽  
V. Monaco ◽  
P. Tropea ◽  
D. Martelli ◽  
N. Vitiello ◽  
...  
Keyword(s):  
Older Adults ◽  
Sagittal Plane ◽  
Frontal Plane ◽  
Balance Recovery ◽  
Margin Of Stability ◽  
Set Up ◽  
Balance Loss

SummaryThis study investigates the effectiveness of a robot-mediated strategy aimed at promoting balance recovery after multidirectional slippages. Six older adults were asked to manage anteroposterior and mediolateral slippages while donning an active pelvis orthosis (APO). The APO was set up either to assist volunteers during balance loss or to be transparent. The margin of stability, in sagittal and frontal planes, was the main metric to assess the effectiveness of balance recovery. Results showed that the assistive strategy is effective at promoting balance recovery in the sagittal plane, for both perturbing paradigms; however, it is not effective at controlling stability in the frontal plane.

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