Exploring infant fall events using online parenting discussion forums (Preprint)

BACKGROUND Falls are the most common mechanism of hospitalised injury in children under 12 months and commonly result in traumatic brain injuries. Epidemiological studies exploring infant falls demonstrate the burden but lack the contextual information vital to the development of preventive interventions. The objective of this study was to examine contextual information for falls involving children under 12 months. OBJECTIVE The objective of this study was to examine contextual information for falls involving children under 12 months using online parenting discussion forums. METHODS Online parenting forums provide an unobtrusive rich data source for collecting detailed information about fall events. Relevant discussions related to fall incidents were identified and downloaded using site-specific google search queries and a programming script. A qualitative descriptive approach was used to analyse the incidents and categorise contextual information into ‘pre-cursor events’ and ‘influencing factors’ for infant falls. RESULTS 461 infant fall incidents were identified. Common fall mechanisms included: falls from furniture; falls when being carried or supported by someone; falls from baby products and falls on the same level. Across the spectrum of fall mechanisms, common precursor events were: infant rolling off; being alone on furniture; product misuse; caretaker falling asleep while holding the infant; and caretaker tripping/slipping while carrying the infant. Common influencing factors included: infant’s rapid motor development; lapses in caretaker attention; and trip hazards. CONCLUSIONS The findings define targets for intervention to prevent infant falls and suggest the most viable intervention approach may be to target parental behaviour change. Online forums have provided rich information critical for preventive interventions aimed at changing behaviour.

Exploring Infant Fall Events Using Online Parenting Discussion Forums

Background: Falls are the most common mechanism of hospitalised injury in children under 12 months and commonly result in traumatic brain injuries. Epidemiological studies exploring infant falls demonstrate the burden but lack the contextual information vital to the development of preventive interventions. The objective of this study was to examine contextual information for falls involving children under 12 months.Methods: Online parenting forums provide an unobtrusive rich data source for collecting detailed information about fall events. Relevant discussions related to fall incidents were identified and downloaded using site-specific google search queries and a programming script. A qualitative descriptive approach was used to analyse the incidents and categorise contextual information into ‘pre-cursor events’ and ‘influencing factors’ for infant falls.Results: 461 infant fall incidents were identified. Common fall mechanisms included: falls from furniture; falls when being carried or supported by someone; falls from baby products and falls on the same level. Across the spectrum of fall mechanisms, common precursor events were: infant rolling off; being alone on furniture; product misuse; caretaker falling asleep while holding the infant; and caretaker tripping/slipping while carrying the infant. Common influencing factors included: infant’s rapid motor development; lapses in caretaker attention; and trip hazards.Conclusions: The findings define targets for intervention to prevent infant falls and suggest the most viable intervention approach may be to target parental behaviour change. Online forums have provided rich information critical for preventive interventions aimed at changing behaviour.

Fall Inducing Movable Platform (FIMP) for Overground Trips and Slips

The study of falls and any related fall prevention/intervention device requires the recording of true falls incidence. However, true falls are rare, random and difficult to collect. Therefore, a system that can perturb falls in an ecologically valid and repeatedly manner will greatly benefit the understanding of the neuromuscular mechanisms underpinning real-world falls events. A fall inducing movable platform (FIMP) was designed to arrest and accelerate the subject's ankle to induce trip via a brake and slip via a motor respectively. A gait phase detection algorithm was also created to allow the timely activation of the fall mechanisms to induce different recovery actions. Statistical Parametric Mapping (SPM1D) and two sample t-test were used to evaluate the transparency of the platform before it was used to induce falls. Thereafter, SPM1D and one-way repeated measure ANOVA were used assess the effectiveness of FIMP in inducing realistic falls. Walking with the FIMP's fall mechanisms attached on the ankle (SW) was found to be similar to normal walking (NW), except for a slight increase in ankle flexion during the swing phase. However, the magnitude of change would be considered negligible when compared to the changes in joint angles during the trips and slips of interest. During the FIMP induced trips, the brake activates at the terminal-swing and mid-swing gait phase to induce the lowering and skipping strategies respectively. The characteristic leg lowering and the subsequent contralateral leg swing was seen in all subjects for the lowering strategy. Likewise, for skipping strategy, all subjects skipped forward on the perturbed leg. On the other hand, slip was induced by FIMP using the motor to impart unwanted forward acceleration to the ankle with the help of friction-reducing ground sliding sheets. Joints stiffening was observed during slips, and subjects adopt the \textit{surfing} strategy after the initial slip. Results indicate that FIMP can induce reliable and ecologically valid falls repeatedly under simulated experimental conditions. The usage of SPM1D with FIMP allows the creation of the first ever quantifiable trip and slip reactive kinematics comparison. Effects of fall recovery anomalies can now be easily identified.