Effects of fall training on fall severity in healthy elderly subjects

Falling is a major health problem in the elderly causing physical and
psychosocial problems. Several fall prevention programs have been developed to
prevent falls. Despite successful reductions of the number of falls by these
programs, falls still occur. Little is known about interventions in which older
individuals learn how to fall safely to prevent injuries, such as hip
fractures. In the Sint Maartenskliniek Nijmegen a fall prevention program has
been developed that includes fall training. This fall training is based on the
principles of martial arts techniques. The most important principles are head
protection and changing the fall into a rolling movement. Previously, it has
been shown that these martial arts techniques reduced the hip impact forces
during the fall in experienced martial artists and in young adults after brief
instruction. From experience with the Nijmegen fall prevention program it is
known that older individuals are able to learn these techniques. However, the
effects of the fall techniques on impact forces have not been evaluated in
older individuals. Furthermore, it is unknown if older individuals are able to
perform these techniques some time after the fall training has been finished.

The purpose of this pilot study is to evaluate the fall training in older
individuals by reduction of hip impact forces. Furthermore, to determine if
older individuals are able to perform these fall techniques after training,
fall performance is measured six month after training as well.

Experimental intervention study

During 5 weekly fall training sessions of 30-45 minutes, subjects will be
taught to use fall techniques based on martial arts techniques in sideways,
backward and forward directions. The training group consists of 8-10 subjects.

Participation has benefits as fall techniques are taught that are expected to
reduce the severity of fall incidents. Furthermore, it is expected that fear of
falling will reduce because of the fall training. The difficulty of the
exercises is gradually increased. First, falls are performed on thick mats and
later, when performed correctly, on judo mats. The composition and contents of
the fall training is similar the training of the Nijmegen fall prevention
program. The previous fall prevention project for elderly has been revieuwed by
the medical ethical committee of the Sint Maartenkliniek. In their review they
stated that there was no increased risk for the participants.
The measurements will take place prior to the first session, after the fifth
and a half year after the program has finished. During the measurements, in the
laboratory of the Sint Maartenskliniek (RD&E), sideway falls from knee height
are preformed onto a force plate, covered with judo mats. This kind of fall
causes no risk for elderly without osteoporosis. For extra safety and to ensure
the participants, they will wear hip protectors during the measurements. The
duration of each measurement is half an hour.