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      Children’s Improvement of a Motor Response during Backward Falls through the Implementation of a Safe Fall Program

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          Abstract

          The World Health Organization has warned that, in children, the second cause of death from unintentional injuries are falls. The objective of this study was to analyze the motor response of primary schoolchildren when a backwards fall occurs. These analyses occurred before and after interventions of the Safe Fall program, which aims to teach safe and protected ways of backward falling. A quasi-experimental research design was used, with a sample of 122 Spanish (Sevillian) schoolchildren in the 10–12 age bracket. The INFOSECA ad-hoc observation scale was used for data collection: this scale registers 5 essential physical reactions throughout the process of a safe and protected backwards fall. After that, a number of descriptive, correlational and contrast statistics were applied. The value used in the McNemar test to establish statistical significance was p < 0.05. Results showed that over 85% of students had developed the competence to correctly perform all five physical motions that allow for a safer backward fall. The teaching of safe and protected techniques for falling backwards in child population in Primary Education is possible through the implementation of the Safe Fall program in Physical Education classes, which can help making falls safer, diminishing the risk and severity of the injuries they cause.

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          Common protective movements govern unexpected falls from standing height.

          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.
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            Reducing hip fracture risk during sideways falls: evidence in young adults of the protective effects of impact to the hands and stepping.

            Hip fracture is rare in young adults, despite evidence that the energy available in a fall is sufficient to fracture the young proximal femur. This might be explained by protective responses that allow young individuals to avoid hip impact during sideways falls. To test this hypothesis, we conducted experiments with 44 individuals (31 women and 13 men) aged 19-26 years, who were instructed to try to maintain balance after a sudden unpredictable sideways translation was applied to the platform they stood upon. While the surface adjacent to the platform was formed of gymnasium mats, we provided no information on surface compliance, or the direction and speed of the perturbation. Ninety percent of participants fell and impacted the pelvis, and 98% of those cases involved direct impact to the hip region. Impact occurred to the hand in 98% of falls, and preceded impact to the pelvis by 50 ms on average (SD=40, range=-12-175 ms). The impact velocity of the pelvis decreased 3.6% for every 10 ms increase in the interval between hand and pelvis impact, and was reduced by 22% on average by stepping prior to impact. Our results suggest that the lack of hip fractures in young adults cannot be explained by avoidance of hip impact during sideways falls. Rather, it probably relates to use of the hands and stepping, and by simply possessing sufficient bone strength to withstand the direct blow to the greater trochanter that tends to accompany sideways falls.
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              A 10-year review of child injury hospitalisations, health outcomes and treatment costs in Australia

              Background Childhood injury is a leading cause of hospitalisation, yet there has been no comprehensive examination of child injury and survival over time in Australia. To examine the characteristics, temporal trend and survival for children who were hospitalised as a result of injury in Australia. Method A retrospective examination of linked hospitalisation and mortality data for injured children aged 16 years or less during 1 July 2001 to 30 June 2012. Negative binomial regression examined change in injury hospitalisation trends. Cox proportional hazard regression examined the association of risk factors on 30-day survival. Results There were 6 86 409 injury hospitalisations, with an age-standardised rate of 1489 per 1 00 000 population (95% CI 1485.3 to 1492.4) in Australia. Child injury hospitalisation rates did not change over the 10-year period. For every severely injured child, there are at least 13 children hospitalised with minor or moderate injuries. The total cost of child injury hospitalisations was $A2.1 billion (annually $A212 million). Falls (38.4%) were the most common injury mechanism. Factors associated with a higher risk of 30-day mortality were: child was aged ≤10 years, higher injury severity, head injury, injured in a transport incident or following drowning and submersion or other threats to breathing, during self-harm and usual residence was regional/remote Australia. Conclusions Childhood injury hospitalisation rates have not reduced in 10 years. Children’s patterns of injury change with age, and priorities for injury prevention alter according to developmental stages. The development of a national multisectorial childhood injury monitoring and prevention strategy in Australia is long overdue.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                27 November 2018
                December 2018
                : 15
                : 12
                : 2669
                Affiliations
                [1 ]Physical Education and Sports Department, University of Seville, 41013 Seville, Spain; lth00003@ 123456red.ujaen.es (L.T.-H.); carolinacv@ 123456us.es (C.C.-V.); mccampos@ 123456us.es (M.d.C.C.-M.)
                [2 ]Department of Research Methods in Education, University of Seville, 41013 Seville, Spain; rodri@ 123456us.es
                Author notes
                [* ]Correspondence: ocastillo@ 123456us.es ; Tel.: +34-670-90-5026
                Author information
                https://orcid.org/0000-0002-3024-1097
                https://orcid.org/0000-0002-0647-507X
                Article
                ijerph-15-02669
                10.3390/ijerph15122669
                6313405
                30486425
                3e64bae0-8cc8-4493-bb13-84651a69ac21
                © 2018 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 22 October 2018
                : 25 November 2018
                Categories
                Article

                Public health
                childhood injuries,falls,public health,education,health education
                Public health
                childhood injuries, falls, public health, education, health education

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