UD research: Practicing falling may help prevent it

 

Jeremy Crenshaw monitors a research participant practicing “fall recovery” on in the University of Delaware’s Fall and Mobility lab using a treadmill and body mapping software. (Submitted)

NEWARK — During these winter months, slipping and falling on ice can ruin your day — if you fall hard enough, it can be life-changing.

According to the Centers for Disease Control and Prevention, about 8.9 million injuries are reported in falling incidents per year, resulting in a total of 26,000 deaths. This leads to an estimated $30 billion in directly related medical costs annually. Surprisingly enough, falling is the leading cause of accidental death in the country among people 65 and older. This age group is considered to carry both a higher risk of falling and sustaining injuries from falling. The most serious injuries stemming from falls are hip fractures and head trauma.

The University of Delaware’s Falls and Mobility Lab has been making an intensive study of slips, trips and falls with the intention of designing interventions that can help at-risk groups increase their ability to avoid injury.

Jeremy Crenshaw, Ph.D., an assistant professor in UD’s Department of Kinesiology and Applied Physiology, has been heading up the lab since 2014. The general advice Mr. Crenshaw has for walking in icy conditions is: shuffling and take short steps if the ground is slippery, always using handrails, avoiding slopes, not carrying anything so your hands remain free and break your fall with your hands if you’re unlucky enough to lose your balance. He notes that landing on your hands increases the likelihood of fracturing your wrists, but it decreases the chance you’ll fracture your hip, which is a far more serious injury. Tai chi, a form of martial arts exercise, has also been known to help limit and reduce certain types of falls.

Aware that this advise isn’t particularly novel and many people already follow it, Mr. Crenshaw says that much of what the lab research has uncovered about “fall recovery” — regaining balance during a trip or slip — is highly specific to individuals and must be exercised to become effective.

Jeremy Crenshaw

“Recovery from a slip on the ice, or any slip really, is a rapid process,” said Mr. Crenshaw. “You have about a half a second to get your feet out to catch the fall.”

The speed with which a slipping person reacts and the placement of their next step play an important role in whether they will regain their balance. Because it happens so quickly, it’s difficult to provide failsafe advice. What surprised the research team was, within a controlled environment, people have been able to reduce their “fall risk” through practice.

“In our lab, we’re able to safely simulate falls with our special treadmill,” he said. “With our intervention studies, we focus on recovery — so the very simple idea is: if you want to get better at something, you should practice it. As you practice fall recovery over and over, you improve. The evidence is starting to show that when you’ve improved that skill, you’re actually able to reduce your overall fall risk when you leave the lab.”

The research is young, but Mr. Crenshaw says that because the in-lab exercises appear to be reducing fall risk outside the lab, the techniques they use may be especially beneficial to high-risk groups such as people who’ve suffered a stroke or people with Parkinson’s disease.

Jamie Pigman, graduate students and member of the research team, said studies with participants in these populations are already proving to be beneficial.

“It was interesting to see how we were able to specifically target all the mechanisms that normally help us prevent falls and improve them through practice,” he said. “We’ve been working with people who have had stokes, because they have a higher fall risk. It can be especially difficult for this population to step with their affected paretic limb. We’re able to coach and train them to improve their stability. That would be hard to do safely in most environments, but in this facility, we have a treadmill and harness system, so falls, that would normally be dangerous, can be simulated safely.”

The participants walk on the lab treadmill which can jut forward or backward suddenly to recreate the sensation of a slip or trip. The lab uses body mapping cameras and software to watch how each participant’s body reacts to the sudden changes. From there, the team can make recommendations, and the participant can run through the exercises repeatedly until they can reliably recover balance during most falls.

Mr. Crenshaw said that this is a type of “perturbation training” is similar to the regimes used for athletes to improve reaction time in reflexive actions. However, his lab’s research is unique in its application of the technique to strengthen fall recovery. Although they are still in the thick of the data-gathering and grant application phase, he says early results are promising. Long term, he believes the research may lead to a physical rehabilitation program that may help certain at-risk populations avoid potential falls.

“We’re really still at the stage where we’re trying to find out definitively if this is effective,” he said. “If it is, or proves to be a good compliment to other approaches to reduce falls, then we envision that it could eventually be a service for individuals — whether it’s be a part of rehabilitation or more of a habitual exercise routine. In the long term, we are seeing it as a clinical type program.”

CDC statistics say that one in three people over the age of 65 will fall during the next year. Mr. Pigman says that what starts as a simple fall, especially for at-risk individuals, can quickly become life-altering — which is why they are so important to avoid.

“You can quickly have a snowball effect after someone falls,” he said. “They can develop a fear of falling again, and become less active, which may further exacerbate any conditions they have. For example, if they’ve had a stroke, they might decrease their physical activity after a fall. A lack of healthy activity could lead to another stroke or decrease their overall health. If we can prevent them from falling, we can hopefully improve their confidence and thereby help them maintain a healthy amount of activity.”

Reach staff writer Ian Gronau at igronau@newszap.com

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