title: Common protective movements govern unexpected falls from standing height.
abstract: Simple energy considerations suggest that any fall from standing height has the potential to cause hip fracture. However, only 1-2% of falls among the elderly actually result in hip fracture, and less than 10% cause serious injury. This suggests that highly effective movement strategies exist for preventing injury during a fall. To determine the nature of these, we measured body segment movements as subjects (aged 22-35 yr) stood upon a gymnasium mattress and attempted to prevent themselves from falling after the mattress was made to translate abruptly. Subjects were more than twice as likely to fall after anterior translations of the feet, when compared to posterior or lateral translations. In falls which resulted in impact to the pelvis, a complex sequence of upper extremity movements allowed subjects to impact their wrist at nearly the same instant as the pelvis (average time interval between contacts = 38 ms), suggesting a sharing of contact energy between the two body parts. Finally, marked trunk rotation was exhibited in falls due to lateral (but not anterior or posterior) perturbations, resulting in the avoidance of impact to the lateral aspect of the hip. These results suggest that body segment movements during falls, rather than being random and unpredictable, involve a repeatable series of responses which facilitate safe landing.
authors.affiliation: Department of Orthopaedic Surgery, San Francisco General Hospital, University of California, San Francisco, 94110, USA.
authors.forename: E T
authors.initials: ET
authors.lastname: Hsiao
authors.forename: S N
authors.initials: SN
authors.lastname: Robinovitch
mesh_terms: D000058:Accidental Falls; D000328:Adult; D001132:Arm / Q000502:physiology; D001696:Biomechanical Phenomena; D005260:Female; D006620:Hip Fractures / Q000517:prevention & control*; D006801:Humans; D008297:Male; D009068:Movement / Q000502:physiology*; D010388:Pelvis / Q000502:physiology; D012399:Rotation; D014953:Wrist / Q000502:physiology