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      A method for simulating forward falls and controlling impact velocity

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          Abstract

          Assessment of protective arm reactions associated with forward falls are typically performed by dropping research participants from a height onto a landing surface. The impact velocity is generally modulated by controlling the total height of the fall. This contrasts with an actual fall where the fall velocity is dependent on several factors in addition to fall height and not likely predictable at the onset of the fall. A counterweight and pulley system can be used to modulate the fall velocity in simulated forward falls in a manner that is not predictable to study participants, enhancing experimental validity. However, predicting the fall velocity based on participant height and weight and counterweight mass is not straightforward. In this article, the design of the FALL simulator For Injury prevention Training and assessment (FALL FIT) system is described. A dynamic model of the FALL FIT and counterweight system is developed and model parameters are fit using nonlinear optimization and experimental data. The fitted model enables prediction of fall velocity as a function of participant height and weight and counterweight load. The method can be used to provide controllable perturbations thereby elucidating the control strategy used when protecting the body from injury in a forward fall, how the control strategy changes because of aging or dysfunction or as a method for progressive protective arm reaction training.

          • Construction of device to simulate forward falls with controllable impact velocity using material that are commercially available is described

          • A dynamic model of the FALL FIT is developed to estimate the impact velocity of a simulated forward fall using participant height and counterweight load

          • The dynamic model is validated using data from 3 previous studies

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          Most cited references44

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          The major determinants in normal and pathological gait.

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            Geriatric falls: injury severity is high and disproportionate to mechanism.

            Falls are a well-known source of morbidity and mortality in the elderly. Fall-related injury severity in this group, however, is less clear, particularly as it relates to type of fall. Our purpose is to explore the relationship between mechanism of fall and both pattern and severity of injury in geriatric patients as compared with a younger cohort. Our trauma registry was queried for all patients evaluated by the trauma service over a 412-year period (1994-1998). Two cohorts were formed on the basis of age greater than 65 or less than or equal to 65 years and compared as to mechanism, Injury Severity Score (ISS), Abbreviated Injury Scale score, and mortality. Over the study period, 1,512 patients were evaluated, 333 greater than 65 years and 1,179 less than or equal to 65 years of age. Falls were the injury mechanism in 48% of the older group and 7% of the younger group (p 15, with 32% of all falls resulting in serious injury (ISS >15). In contrast, falls in the younger group constituted only 11% of ISS >15 patients, with falls causing serious injury only 15% of the time (both p 15 30-fold more in the older group (31% vs. 0.05). The fall-related death rate was higher in the older group (7% vs. 4%), with falls seven times more likely to be the cause of death compared with the younger group (55% vs. 7.5%) (both p < 0.05). Same-level falls as a cause of death was 10 times more common in the elderly (25% vs. 2.5%, p < 0.05). Falls among the elderly, including same-level falls, are a common source of both high injury severity and mortality, much more so than in younger patients. A different pattern of injury between older and younger fall patients also exists.
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              Traumatic brain injuries evaluated in U.S. emergency departments, 1992-1994.

              To describe the incidence and patient characteristics of traumatic brain injuries (TBIs) treated in U.S. emergency departments (EDs). A secondary analysis was performed on data from the National Hospital Ambulatory Medical Care Survey administered from 1992 to 1994. An ED visit was determined to represent a case of TBI if the case record contained ICD-9-CM codes of 800.0-801.9, 803.0-804.9, or 850.0-854.1. The average annual estimate of new TBI treated in U.S. EDs was 1,144,807, equaling 444 per 100,000 persons (95% CI = 390 to 498), which represents approximately 3,136 new cases of TBI per day and accounts for 1.3% of all ED visits. Males were 1.6 times as likely as females to suffer TBI until the age of 65 years, when the female rate exceeded the male. The rate for blacks was 35% higher than that for whites. The highest overall incidence rate of TBI occurred in the less-than-5-year age group (1,091 per 100,000), closely followed by the more-than-85-year age group (1,026 per 100,000). Falls represented the most common mechanism of TBI injury, followed by motor vehicle-related trauma. This study underscores the ongoing need for effective surveillance of all types of TBI and evaluation of prevention strategies targeting high-risk individuals. It serves as a clinically grounded and ED-based corroboration of prior survey research, providing a basis for comparison of incidence rates over time and a tool with which to measure the efficacy of future interventions.
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                Author and article information

                Contributors
                Journal
                MethodsX
                MethodsX
                MethodsX
                Elsevier
                2215-0161
                26 September 2023
                December 2023
                26 September 2023
                : 11
                : 102399
                Affiliations
                [a ]Biomedical Engineering, Stevenson University
                [b ]Department of Exercise Science, Lebanon Valley College
                [c ]Department of Physical Therapy and Rehabilitation Science, University of Maryland
                Author notes
                [* ]Corresponding author. jborrelli@ 123456stevenson.edu
                Article
                S2215-0161(23)00395-3 102399
                10.1016/j.mex.2023.102399
                10565865
                37830002
                782b87dd-af2c-4a13-a904-273c8f91268b
                © 2023 The Authors

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 11 May 2023
                : 24 September 2023
                Categories
                Medicine and Dentistry

                upper extremity,forward falls,fall-injury,biomechanics,fall simulator for injury prevention training and assessment

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