Lachance Chantelle C, Jurkowski Michal P, Dymarz Ania C, Robinovitch Stephen N, Feldman Fabio, Laing Andrew C, Mackey Dawn C
Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada.
Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada.
PLoS One. 2017 Feb 6;12(2):e0171652. doi: 10.1371/journal.pone.0171652. eCollection 2017.
Compliant flooring, broadly defined as flooring systems or floor coverings with some level of shock absorbency, may reduce the incidence and severity of fall-related injuries in older adults; however, a lack of synthesized evidence may be limiting widespread uptake.
Informed by the Arksey and O'Malley framework and guided by a Research Advisory Panel of knowledge users, we conducted a scoping review to answer: what is presented about the biomechanical efficacy, clinical effectiveness, cost-effectiveness, and workplace safety associated with compliant flooring systems that aim to prevent fall-related injuries in healthcare settings? We searched academic and grey literature databases. Any record that discussed a compliant flooring system and at least one of biomechanical efficacy, clinical effectiveness, cost-effectiveness, or workplace safety was eligible for inclusion. Two independent reviewers screened and abstracted records, charted data, and summarized results.
After screening 3611 titles and abstracts and 166 full-text articles, we included 84 records plus 56 companion (supplementary) reports. Biomechanical efficacy records (n = 50) demonstrate compliant flooring can reduce fall-related impact forces with minimal effects on standing and walking balance. Clinical effectiveness records (n = 20) suggest that compliant flooring may reduce injuries, but may increase risk for falls. Preliminary evidence suggests that compliant flooring may be a cost-effective strategy (n = 12), but may also result in increased physical demands for healthcare workers (n = 17).
In summary, compliant flooring is a promising strategy for preventing fall-related injuries from a biomechanical perspective. Additional research is warranted to confirm whether compliant flooring (i) prevents fall-related injuries in real-world settings, (ii) is a cost-effective intervention strategy, and (iii) can be installed without negatively impacting workplace safety. Avenues for future research are provided, which will help to determine whether compliant flooring is recommended in healthcare environments.
顺应性地板广义上是指具有一定程度减震功能的地板系统或地板覆盖物，可能会降低老年人跌倒相关伤害的发生率和严重程度；然而，缺乏综合证据可能会限制其广泛应用。
以阿克西和奥马利框架为依据，并在知识使用者研究咨询小组的指导下，我们进行了一项范围综述，以回答以下问题：关于旨在预防医疗环境中跌倒相关伤害的顺应性地板系统的生物力学功效、临床有效性、成本效益和工作场所安全性，有哪些相关内容？我们检索了学术和灰色文献数据库。任何讨论顺应性地板系统以及生物力学功效、临床有效性、成本效益或工作场所安全性中至少一项的记录都符合纳入标准。两名独立评审员筛选并提取记录、绘制数据图表并总结结果。
在筛选了3611篇标题和摘要以及166篇全文文章后，我们纳入了84条记录以及56份配套（补充）报告。生物力学功效记录（n = 50）表明，顺应性地板可以减少与跌倒相关的冲击力，对站立和行走平衡的影响最小。临床有效性记录（n = 20）表明，顺应性地板可能会减少伤害，但也可能增加跌倒风险。初步证据表明，顺应性地板可能是一种具有成本效益的策略（n = 12），但也可能导致医护人员的体力需求增加（n = 17）。
总之，从生物力学角度来看，顺应性地板是预防跌倒相关伤害的一种有前景的策略。有必要进行更多研究以确认顺应性地板是否（i）能在现实环境中预防跌倒相关伤害，（ii）是一种具有成本效益的干预策略，以及（iii）安装后不会对工作场所安全产生负面影响。本文提供了未来研究的方向，这将有助于确定在医疗环境中是否推荐使用顺应性地板。
