Effects of flooring on static and dynamic balance in young and older adults.

BACKGROUND: Reducing fall-related injuries is difficult due to the multi-factorial nature of falls, and challenges in implementing injury-preventative strategies. While safety floors are effective at absorbing energy and reducing fall-related impact forces, the low stiffness component of these floors may impair an individual's balance and mobility, thereby increasing fall risk. RESEARCH QUESTION: Therefore, the objective of this study was to investigate the influence of compliant flooring (i.e., safety flooring) on balance and mobility in young and older adults. METHODS: Kinematics were measured with inertial measurement units from 20 young and 10 older adults. Static balance was evaluated during quiet stance on three flooring surfaces (traditional, safety, foam) with three stance positions (regular, tandem, one-legged). Mobility was evaluated using the 3 m timed-up-and-go test on two flooring surfaces (traditional, safety). RESULTS: All participants were able to complete quiet standing trials on normal and safety flooring surfaces; however, most older adults could not complete one-legged stance trials or standing on foam. Significant age-related effects were observed for several balance and mobility tasks, particularly during the more challenging tandem stance condition, and the dynamic timed-up-and-go mobility test. In contrast, the introduction of safety flooring (compared to traditional flooring) had limited effects on balance/mobility (1 of 16 outcome variables showed negative effects). SIGNIFICANCE: Overall, the findings demonstrate minimal effects of a novel safety floor compared to the age-related differences, and provide insights to assist researchers, consumers, and industry stakeholders in the development of environments that support safe movement and maintained independence for older adults.

The Effects of Body Position on Trochanteric Soft Tissue Thickness-Implications for Predictions of Impact Force and Hip Fracture Risk During Lateral Falls.

Trochanteric soft tissue thickness (TSTT) is a protective factor against fall-related hip fractures. This study's objectives were to determine: (1) the influence of body posture on TSTT and (2) the downstream effects of TSTT on biomechanical model predictions of fall-related impact force (Ffemur) and hip fracture factor of risk. Ultrasound was used to measure TSTT in 45 community-dwelling older adults in standing, supine, and side-lying positions with hip rotation angles of -25°, 0°, and 25°. Supine TSTT (mean [SD] = 5.57 [2.8] cm) was 29% and 69% greater than in standing and side-lying positions, respectively. The Ffemur based on supine TSTT (3380 [2017] N) was 19% lower than the standing position (4173 [1764] N) and 31% lower than the side-lying position (4908 [1524] N). As factor of risk was directly influenced by Ffemur, the relative effects on fracture risk were similar. While less pronounced (<10%), the effects of hip rotation angle were consistent across TSTT, Ffemur, and factor of risk. Based on the sensitivity of impact models to TSTT, these results highlight the need for a standardized TSTT measurement approach. In addition, the consistent influence of hip rotation on TSTT (and downstream model predictions) support its importance as a factor that may influence fall-related hip fracture risk.

Manual patient transfers: factors that influence decisions and kinematic strategies employed by nursing aides.

While extensive literature has characterised factors that influence the acceptable mass of 'boxes' during MMH tasks, less is known about these factors when moving 'people' in healthcare settings. This study examined factors that influence decisions/approaches employed during manual patient transfers. Sixteen nursing aides manually-transferred a standardised 'patient'; patient mass was adjusted (using a weight vest) to determine a maximum acceptable patient mass for this task (massmax). Grip strength was the only worker characteristic significantly associated with massmax (r = 0.48). Older worker age was associated with smaller peak trunk flexion (r = -0.58) and shoulder abduction (r = -0.59), and greater trunk axial twist (r = 0.52). Workers emphasised that patient characteristics (e.g. physical/cognitive status) influenced their decisions when performing transfers. These findings extend previous literature by suggesting that grip strength is a useful predictor of perceived work capacity, older workers adapt protective postural strategies during patient transfers and worker-patient dynamics are crucial during this high-risk occupational task. Practitioner Summary: This study examined manual patient transfers performed by nursing aides. Worker grip strength (but not age or size) was associated with perceptions of maximum acceptable patient mass. Kinematic changes suggested more conservative strategies used by older workers. Workers emphasised that patient characteristics substantially influenced their decisions when performing transfer tasks.