Department of Research, Development and Education, Sint Maartenskliniek, Hengstdal 3, 6522 JV Nijmegen, The Netherlands.
J Biomech. 2012 Jun 1;45(9):1650-5. doi: 10.1016/j.jbiomech.2012.03.024. Epub 2012 Apr 24.
Sideways falls onto the hip are a major cause of femoral fractures in the elderly. Martial arts (MA) fall techniques decrease hip impact forces in sideways falls. The femoral fracture risk, however, also depends on the femoral loading configuration (direction and point of application of the force). The purpose of this study was to determine the effect of fall techniques, landing surface and fall height on the impact force and the loading configuration in sideways falls. Twelve experienced judokas performed sideways MA and Block ('natural') falls on a force plate, both with and without a judo mat on top. Kinematic and force data were analysed to determine the hip impact force and the loading configuration. In falls from a kneeling position, the MA technique reduced the impact force by 27%, but did not change the loading configuration. The use of the mat did not change the loading configuration. Falling from a standing changed the force direction. In all conditions, the point of application was distal and posterior to the greater trochanter, but it was less distal and more posterior in falls from standing than from kneeling position. The present decrease in hip impact force with an unchanged loading configuration indicates the potential protective effect of the MA technique on the femoral fracture risk. The change in loading configuration with an increased fall height warrant further studies to examine the effect of MA techniques on fall severity under more natural fall circumstances.
侧方摔倒对老年人髋部骨折是一个主要原因。武术（MA）摔倒技术可降低侧方摔倒时髋部的撞击力。然而，股骨骨折的风险还取决于股骨的受力配置（力的方向和作用点）。本研究的目的是确定摔倒技术、着地面和摔倒高度对侧方摔倒时撞击力和受力配置的影响。12 名有经验的柔道运动员在力板上进行了 MA 和 Block（“自然”）侧方摔倒，同时在力板上放置和不放置柔道垫。分析运动学和力数据以确定髋部撞击力和受力配置。从跪姿摔倒时，MA 技术将撞击力降低了 27%，但没有改变受力配置。使用垫子并没有改变受力配置。从站立位摔倒改变了力的方向。在所有情况下，力的作用点都在大转子的远端和后方，但从站立位摔倒时比从跪姿摔倒时更靠远端和更靠后。髋部撞击力的降低与受力配置不变表明 MA 技术对股骨骨折风险具有潜在的保护作用。随着摔倒高度的增加而改变受力配置，需要进一步研究，以检查 MA 技术在更自然的摔倒情况下对摔倒严重程度的影响。
