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Martial arts fall training to prevent hip fractures in the elderly

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Abstract

Summary

Hip fractures are a common and serious consequence of falls. Training of proper fall techniques may be useful to prevent hip fractures in the elderly. The results suggested that martial arts fall techniques may be trainable in older individuals. Better performance resulted in a reduced impact force.

Introduction

Hip fractures are a common and serious consequence of falls. Fall training may be useful to prevent hip fractures in the elderly. This pilot study determined whether older individuals could learn martial arts (MA) fall techniques and whether this resulted in a reduced hip impact force during a sideways fall.

Methods

Six male and nineteen female healthy older individuals completed a five-session MA fall training. Before and after training, force and kinematic data were collected during volitional sideways falls from kneeling position. Two MA experts evaluated the fall performance. Fear of falling was measured with a visual analog scale (VAS).

Results

After fall training, fall performance from a kneeling position was improved by a mean increase of 1.6 on a ten-point scale (P < 0.001). Hip impact force was reduced by a mean of 8% (0.20 N/N, P = 0.016). Fear of falling was reduced by 0.88 on a VAS scale (P = 0.005).

Conclusion

MA techniques may be trainable in older individuals, and a better performance may reduce the hip impact force in a volitional sideways fall from a kneeling position. The additional reduction of fear of falling might result in the prevention of falls and related injuries.

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References

  1. Cooper C, Campion G, Melton LJ III (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2(6):285–289

    Article  CAS  PubMed  Google Scholar 

  2. Farahmand BY, Michaelsson K, Ahlbom A et al (2005) Survival after hip fracture. Osteoporos Int 16(12):1583–1590

    Article  PubMed  Google Scholar 

  3. Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359(9319):1761–1767

    Article  PubMed  Google Scholar 

  4. Cumming RG, Klineberg RJ (1994) Fall frequency and characteristics and the risk of hip fractures. J Am Geriatr Soc 42(7):774–778

    CAS  PubMed  Google Scholar 

  5. Hochberg MC, Greenspan S, Wasnich RD et al (2002) Changes in bone density and turnover explain the reductions in incidence of nonvertebral fractures that occur during treatment with antiresorptive agents. J Clin Endocrinol Metab 87(4):1586–1592

    Article  CAS  PubMed  Google Scholar 

  6. Orwoll E, Ettinger M, Weiss S et al (2000) Alendronate for the treatment of osteoporosis in men. N Engl J Med 343(9):604–610

    Article  CAS  PubMed  Google Scholar 

  7. Harris ST, Watts NB, Genant HK et al (1999) Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: a randomized controlled trial. Vertebral Efficacy With Risedronate Therapy (VERT) Study Group. JAMA 282(14):1344–1352

    Article  CAS  PubMed  Google Scholar 

  8. McClung MR, Geusens P, Miller PD et al (2001) Effect of risedronate on the risk of hip fracture in elderly women. Hip Intervention Program Study Group. N Engl J Med 344(5):333–340

    Article  CAS  PubMed  Google Scholar 

  9. Chesnut CH III, Skag A, Christiansen C et al (2004) Effects of oral ibandronate administered daily or intermittently on fracture risk in postmenopausal osteoporosis. J Bone Miner Res 19(8):1241–1249

    Article  CAS  Google Scholar 

  10. Greenspan SL, Myers ER, Maitland LA et al (1994) Fall severity and bone mineral density as risk factors for hip fracture in ambulatory elderly. JAMA 271(2):128–133

    Article  CAS  PubMed  Google Scholar 

  11. Nevitt MC, Cummings SR (1993) Type of fall and risk of hip and wrist fractures: the study of osteoporotic fractures. The Study of Osteoporotic Fractures Research Group. J Am Geriatr Soc 41(11):1226–1234

    CAS  PubMed  Google Scholar 

  12. Wei TS, Hu CH, Wang SH et al (2001) Fall characteristics, functional mobility and bone mineral density as risk factors of hip fracture in the community-dwelling ambulatory elderly. Osteoporos Int 12(12):1050–1055

    Article  CAS  PubMed  Google Scholar 

  13. Kannus P, Parkkari J, Poutala J (1999) Comparison of force attenuation properties of four different hip protectors under simulated falling conditions in the elderly: an in vitro biomechanical study. Bone 25(2):229–235

    Article  CAS  PubMed  Google Scholar 

  14. Robinovitch SN, Hayes WC, McMahon TA (1995) Energy-shunting hip padding system attenuates femoral impact force in a simulated fall. J Biomech Eng 117(4):409–413

    Article  CAS  PubMed  Google Scholar 

  15. van Schoor NM, van der Veen AJ, Schaap LA et al (2006) Biomechanical comparison of hard and soft hip protectors, and the influence of soft tissue. Bone 39(2):401–407

    Article  PubMed  Google Scholar 

  16. Kiel DP, Magaziner J, Zimmerman S et al (2007) Efficacy of a hip protector to prevent hip fracture in nursing home residents: the HIP PRO randomized controlled trial. JAMA 298(4):413–422

    Article  CAS  PubMed  Google Scholar 

  17. Parker MJ, Gillespie WJ, Gillespie LD (2005) Hip protectors for preventing hip fractures in older people. Cochrane Database Syst Rev (3):CD001255.

  18. DeGoede KM, Ashton-Miller JA, Schultz AB (2003) Fall-related upper body injuries in the older adult: a review of the biomechanical issues. J Biomech 36(7):1043–1053

    Article  CAS  PubMed  Google Scholar 

  19. Sabick MB, Hay JG, Goel VK et al (1999) Active responses decrease impact forces at the hip and shoulder in falls to the side. J Biomech 32(9):993–998

    Article  CAS  PubMed  Google Scholar 

  20. Groen BE, Weerdesteyn V, Duysens J (2007) Martial arts fall techniques decrease the impact forces at the hip during sideways falling. J Biomech 40(2):458–462

    Article  CAS  PubMed  Google Scholar 

  21. Weerdesteyn V, Groen BE, van Swigchem R et al (2008) Martial arts fall techniques reduce hip impact forces in naive subjects after a brief period of training. J Electromyogr Kinesiol 18(2):235–242

    Article  CAS  PubMed  Google Scholar 

  22. Lo J, Ashton-Miller JA (2008) Effect of pre-impact movement strategies on the impact forces resulting from a lateral fall. J Biomech 41(9):1969–1977

    Article  CAS  PubMed  Google Scholar 

  23. Weerdesteyn V, Rijken H, Geurts AC et al (2006) A five-week exercise program can reduce falls and improve obstacle avoidance in the elderly. Gerontol 52(3):131–141

    Article  Google Scholar 

  24. Elders P, Leusing G, Graafmans W, Bolhuis A, Van der Spoel O, Keimpema J (2005) NHG-standaard Osteoporose. Huisarts Wet 48:559–570

    Google Scholar 

  25. Soderkvist I, Wedin PA (1993) Determining the movements of the skeleton using well-configured markers. J Biomech 26(12):1473–1477

    Article  CAS  PubMed  Google Scholar 

  26. Groen BE, Weerdesteyn V, Duysens J (2008) The relation between hip impact velocity and hip impact force differs between sideways fall techniques. J Electromyogr Kinesiol 18(2):228–234

    Article  CAS  PubMed  Google Scholar 

  27. Cheng XG, Lowet G, Boonen S et al (1997) Assessment of the strength of proximal femur in vitro: relationship to femoral bone mineral density and femoral geometry. Bone 20(3):213–218

    Article  CAS  PubMed  Google Scholar 

  28. Courtney AC, Wachtel EF, Myers ER et al (1994) Effects of loading rate on strength of the proximal femur. Calcif Tissue Int 55(1):53–58

    Article  CAS  PubMed  Google Scholar 

  29. Friedman SM, Munoz B, West SK et al (2002) Falls and fear of falling: which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention. J Am Geriatr Soc 50(8):1329–1335

    Article  PubMed  Google Scholar 

  30. Robinovitch SN, Brumer R, Maurer J (2004) Effect of the “squat protective response” on impact velocity during backward falls. J Biomech 37(9):1329–1337

    Article  PubMed  Google Scholar 

  31. van Swigchem R, Groen BE, Weerdesteyn V, Duysens J (2009) The effects of time pressure and experience on the performance of fall techniques during a fall. J Electromyogr Kinesiol 19:521–531

    Article  PubMed  Google Scholar 

  32. Feldman F, Robinovitch S (2004) Safe landing during a fall: effect of response time on ability to avoid hip impact during sideways falls. In: Proceedings of the 28th Annual Meeting of the American Society of Biomechanics, Portland, Oregon

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Sint Maartenskliniek, Department of Research, Development, and Education, P.O. Box 9011, Nijmegen, 6500 GM, The Netherlands

    B. E. Groen, E. Smulders, D. de Kam, J. Duysens & V. Weerdesteyn

  2. Institute for Fundamental and Clinical Human Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands

    B. E. Groen, E. Smulders, J. Duysens & V. Weerdesteyn

  3. Research Center for Movement Control and Neuroplasticity, Department of Biomedical Kinesiology, Katholieke Universiteit Leuven, Leuven, Belgium

    J. Duysens

  4. Department of Rehabilitation, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    V. Weerdesteyn

Authors
  1. B. E. Groen
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  2. E. Smulders
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  3. D. de Kam
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  4. J. Duysens
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  5. V. Weerdesteyn
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Corresponding author

Correspondence to B. E. Groen.

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Groen, B.E., Smulders, E., de Kam, D. et al. Martial arts fall training to prevent hip fractures in the elderly. Osteoporos Int 21, 215–221 (2010). https://doi.org/10.1007/s00198-009-0934-x

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  • DOI: https://doi.org/10.1007/s00198-009-0934-x

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