Preventing Fall-Related Vertebral Fractures

STUDY DESIGN: In vivo biomechanical study of 11 male volunteers. OBJECTIVE: To measure the peak forces applied to the buttocks in a backward fall from standing, and to determine whether this force is lowered by reductions in floor stiffness. SUMMARY OF BACKGROUND DATA: Fall-related vertebral fractures are common and backward falls result in impact to the buttocks. Compliant flooring may reduce impact force and risk for vertebral fracture during a fall. However, we have little knowledge of the peak forces applied to the body during a backward fall, or how floor stiffness affects this force. METHODS: Eleven males, mean age 25 +/- 5 (SD) years, were suddenly released from a backward lean of 15 degrees , falling backward onto the ground which was covered with 4.5, 7.5, or 10.5 cm of ethylene vinyl acetate foam rubber. We measured 3-dimensional impact forces applied to the buttocks at 960 Hz with a force plate. We used repeated measures analysis of variance and post hoc t tests to compare peak forces between conditions. We also modeled peak vertical force for falls onto a bare floor. RESULTS.: There was a significant difference in peak vertical force between falls onto the 10.5 cm foam condition compared with the 7.5 cm (P = 0.002) and 4.5 cm (P < 0.001) conditions. Peak vertical force (N) was (mean +/- SD) 5099 +/- 868, 4788 +/- 702, and 4544 +/- 672 for the 4.5, 7.5, and 10.5 cm foam conditions, respectively, and estimated at 6027 +/- 988 for the rigid (bare floor) condition. Compared with the bare floor, these foam floors provided, on average, 24, 20, and 15% force attenuation respectively. CONCLUSION: In a backward fall onto the buttocks, peak impact forces are 6.4 to 9.0 times body weight in a fall onto a bare floor. Reducing floor stiffness using even a thin (4.5 cm) layer of foam may provide 15% vertical force attenuation during a fall onto the buttocks.