Reducing hip fracture risk during sideways falls: Evidence in young adults of the protective effects of impact to the hands and stepping
Reducing hip fracture risk during sideways falls: Evidence in young adults of the protective effects of impact to the hands and stepping
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DOI：
10.1016/j.jbiomech.2007.01.019
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发表时间：
2007-01-01
影响因子：
2.4
通讯作者：
Robinovitch, Stephen N.
中科院分区：
文献类型：
--
作者：
Feldman, Fablo;Robinovitch, Stephen N.
髋关节骨折在年轻人中是罕见的，尽管有证据表明跌倒时的能量足以使年轻人股骨近端骨折。这可能是由于保护性反应，使年轻人避免髋关节的影响，在侧面福尔斯。为了验证这一假设，我们对44名年龄在19-26岁之间的人（31名女性和13名男性）进行了实验，他们被指示在突然不可预测的侧向平移施加到他们所站的平台上后试图保持平衡。虽然平台附近的表面是由健身房垫形成的，但我们没有提供关于表面柔度或扰动方向和速度的信息。90%的参与者跌倒并撞击骨盆，其中98%的病例涉及直接撞击臀部区域。98%的福尔斯跌倒时发生手部撞击，并且在骨盆撞击之前平均50 ms（SD=40，范围= -12-175 ms）。骨盆的冲击速度下降3.6%，每增加10毫秒之间的手和骨盆的冲击之间的时间间隔，并减少了22%，平均通过在冲击前的步进。我们的研究结果表明，年轻人髋部骨折的缺乏不能解释为避免髋关节的影响，在侧面福尔斯。相反，这可能与使用手和踩踏有关，并且仅仅是通过拥有足够的骨骼强度来承受伴随侧向福尔斯摔倒而对大转子的直接打击。(c)2007年由Elsevier Ltd.出版
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 50ms 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. (c) 2007 Published by Elsevier Ltd.