Zanotto Tobia, Chen Lingjun, Fang James R, Tabatabaei Abbas, He Jianghua, Bhattacharya Shelley B, Alexander Neil B, Sosnoff Jacob J
Department of Occupational Therapy Education, School of Health Professions, University of Kansas Medical Center, Kansas City, Kansas, USA.
Landon Center on Aging, University of Kansas Medical Center, Kansas City, Kansas, USA.
J Gerontol A Biol Sci Med Sci. 2025 Jun 10;80(7). doi: 10.1093/gerona/glaf076.
BACKGROUND: Falls are the leading cause of accidental injury among older adults. Current fall prevention programs are useful but do not target the key variable for injury (ie, impact force). An approach, which has shown promise in robust older adults, is to teach safe-falling strategies to reduce impact forces. In this single-anonymized, pilot randomized controlled trial, we explored the feasibility and preliminary efficacy of a safe-falling program. METHODS: Twenty-four older adults at risk of injurious falls were randomly assigned either to Falling Safely Training (FAST), a standardized progressive training of safe-falling strategies, or an active control group consisting of evidence-based balance training. Participants underwent a series of experimentally induced falls at baseline, after the 4-week intervention, and 3 months after the intervention. Hip and head acceleration (proxies of impact force) and the number of head impacts experienced during the falls were collected. RESULTS: No adverse events were reported, and 11 of 12 FAST participants completed the intervention. The FAST group had a greater reduction in the number of fall-related head impacts following the intervention (odds ratio = 0.10, 95% CI: 0.02, 0.61, p = .012). This improvement coincided with a significant reduction in head acceleration in the FAST group compared to control (between-group mean difference = -9.54 m/s2, p = .028). Hip acceleration decreased significantly in both groups (ps < .001). CONCLUSIONS: Teaching older adults at risk of falls safe-falling strategies is safe and feasible and has the potential to minimize fall-related head impacts and reduce fall morbidity.
背景:跌倒是老年人意外伤害的主要原因。目前的预防跌倒计划很有用,但并未针对损伤的关键变量(即冲击力)。一种在身体健壮的老年人中已显示出前景的方法是教授安全跌倒策略以降低冲击力。在这项单盲、试点随机对照试验中,我们探讨了安全跌倒计划的可行性和初步疗效。 方法:24名有跌倒致伤风险的老年人被随机分配到安全跌倒训练(FAST)组,即一种标准化的安全跌倒策略渐进式训练,或由循证平衡训练组成的积极对照组。参与者在基线、4周干预后以及干预后3个月接受了一系列实验诱导的跌倒。收集跌倒期间的髋部和头部加速度(冲击力的替代指标)以及头部撞击次数。 结果:未报告不良事件,12名FAST参与者中有11名完成了干预。干预后,FAST组与跌倒相关的头部撞击次数减少得更多(优势比=0.10,95%CI:0.02,0.61,p=0.012)。与对照组相比,FAST组头部加速度显著降低,这一改善与之相符(组间平均差异=-9.54m/s²,p=0.028)。两组的髋部加速度均显著降低(p<0.001)。 结论:向有跌倒风险的老年人教授安全跌倒策略是安全可行的,并且有可能将与跌倒相关的头部撞击降至最低并降低跌倒发病率。
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