Empirical verification of the potential to reduce the extreme risk of physical injury during a backward fall in various circumstances – using physiotherapy students as a case study

Abstract

Background and Study Aim. The primary aim of any preventative measure is to reduce incidents that pose a potential risk. The subject of our long-term research is the risk of bodily injury (SFI risk) resulting from the impact with the ground at the end of a fall. The cognitive aim of this study is to gain an understanding of the possible patterns of motor responses in young women and men during impact with the ground in repeatedly simulated backward falls. These were carried out under safe laboratory conditions, with the circumstances varying each time. The practical aim is to provide recommendations concerning both the methodological criteria for improving tools for measuring SFI risk and day-to-day preventative measures. Material and Methods. Secondary analysis was performed on observations of 30 physiotherapy students participating in the ‘test-retest’ (20.97 ± 1.16 years of age) during the fifth semester of 2017–2018 at Podhale State College of Applied Sciences (PSCAS) in Nowy Targ, Poland. The ‘retest’ procedure of STBIDF-M was repeated 7 days after the ‘test’. The analysis was based on modified (more precise) criteria for observing the SFI phenomenon in six external circumstances. Task 1: a simulated backward fall on soft ground involved adopting a horizontal stance from a vertical stance as quickly as possible after a GO command (these are the circumstances of collision with the ground on which the person is standing or moving and, for some reason, falls). Task 2: preceded by a backward jump from a 20 cm platform after a GO command (as a simulated fall from a height with the feet down). Each subsequent odd test fall was repeated after jumping backwards from a 20 cm platform (Tasks 4 and 6). Results. Without the need for verbal explanations, it is possible to reduce, albeit to a limited extent, the impact of the body striking the ground during a backward fall. In order to effectively instill in people a conscious habit of protecting the most distal parts of the body (head and hands), even during the act of changing from an upright to a horizontal posture repeated several times a day, innovative interventions are required. These interventions should take into account the need to convey relevant knowledge about the phenomenon in a manner appropriate to human perceptual capabilities. Conclusions. Improving the accuracy of diagnosing the risk of unintended consequences of falls and effectively reducing extreme projections (premature biological death and years lived with disability) is primarily linked to refining the tools used to measure this phenomenon at various stages of ontogenesis. Passing the preliminary tests will authorize the use of four basic simulations. Either changing from an upright to a horizontal position on a soft, safe surface on which the person is standing, or using a height-adjustable platform, should assess the quality of motor responses. These responses should be associated with five body parts (similar to the STBIDF-M criteria) during four tasks, starting with lying down freely on a safe surface and increasing the number of motor modifications in each subsequent task. The last two tasks should be performed after jumping down from a 20 cm platform.