ARM RESPONSE IN EXPERIMENTAL FALLS AMONG OLDER ADULTS

Research Objectives: Recent data suggests that upper limb bracing is common in real-world falls, however, is associated with a higher risk of head injuries in older adults. This counterintuitive finding mismatches the hypothesis of the potential benefits of arm use preventing head injuries. Therefore, this study aims to analyze the natural arm response and head impacts in experimentally induced falls among older adults.

Design: Observational study.

Setting: Laboratory Setting.

Participants: 15 older adults (66 – 88 yrs, 3 males, 12 females) at risk of injurious falls.

Interventions: Not applicable.

Main Outcome Measures: Participants experienced a total of six experimentally induced falls in the directions of backwards, left, and right with standardized procedures. Videos of falls were independently reviewed by three researchers. Arm response and head impacts were analyzed with a structured questionnaire. Inter-rater discrepancies were reconciled by group discussion.

Results: A total of 88 fall videos were included in the final analysis. There were 23 falls without arm use. Of those without arm response, 21 (91.3%) had head impacts with 18 (85%) having severe impacts. In contrast, there were 65 falls with arm use, of which 25 (38.5%) falls had head impact with 12 (48%) of them having severe impacts. Elbow/forearm was the primary (28/65) site of greatest energy absorption, among which 7.1% showed head impacts. In the remaining 37 falls with arm use but no apparent energy absorbed by arm, 23 (70%) had head impacts.

Conclusions: Older adults tend to have arm response in falls. In the laboratory setting, arm use could reduce the likelihood and severity of fall-related head impacts. Elbow/forearm appears to be important in minimizing head impacts. This study informs the potential benefits of arm use in the prevention of fall-related head injuries. Complicated environmental factors may impede the effectiveness of arm use in reducing head impact in real-world falls, necessitating further study.

Author(s) Disclosures: Authors declare that no relevant or material financial interests that relate to the research described in this paper.