Volitional protective responses to reduce impact severity during falls: A systematic review and meta-analysis

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-07-04 DOI:10.1016/j.clinbiomech.2025.106608

Jia-hao Shen , Cindy Hui-ping Sit , Stanley Sai-chuen Hui , Joseph Woochol Choi , Yi-jian Yang

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引用次数: 0

Abstract

Background

Volitional protective responses during falls, which are voluntary motor skills that can be learned by older adults, may reduce the impact severity of a fall. The objective of this study is to classify protective responses into load sharing, body-segment flexion and muscle relaxation categories based on their biomechanical characteristics and to examine their effectiveness in reducing the impact severity during a fall.

Methods

Studies were searched from the inception of each database to mid-June 2024 through PubMed, Web of Science, Cochrane Library, SPORTDiscus, and Cumulative Index to Nursing and Allied Health Literature. Cross-sectional studies examined the effects of volitional protective responses on reducing the impact severity of falls from standing or lower heights in adults.

Findings

Totally 23 studies were included in the systematic review and 14 of them were included in meta-analyses. Meta-analyses showed that the category of load sharing had a pooled effect size of 1.02 (95 % CI = 0.51 to 1.52, P < 0.001), and the category of body-segment flexion had a pooled effect size of 2.43 (95 % CI = 0.48 to 4.38, P = 0.01). Protective responses with muscle relaxation had no significant pooled effect on reducing the impact severity (P = 0.36).

Interpretation

Protective responses with load sharing were effective. Body-segment flexion responses were effective overall, but their effect on reducing the impact severity of a fall varied depending on the fall direction and impact body parts. The effect of muscle relaxation on reducing impact severity is still not clear and requires further research.

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意志保护反应降低跌倒时冲击的严重程度：一项系统回顾和荟萃分析

背景跌倒时的意志保护反应是老年人可以学习的自主运动技能，可以降低跌倒的影响程度。本研究的目的是根据其生物力学特征将保护反应分为负荷分担、身体节段屈曲和肌肉放松三类，并检查它们在降低跌倒时冲击严重程度方面的有效性。方法通过PubMed、Web of Science、Cochrane Library、SPORTDiscus和护理及相关健康文献累积索引（Cumulative Index to Nursing and Allied Health Literature）检索从每个数据库建立到2024年6月中旬的研究。横断面研究检验了意志保护反应对降低成人站立或较低高度跌落的冲击严重程度的影响。系统综述共纳入23项研究，其中14项纳入荟萃分析。荟萃分析显示，负荷分担类别的综合效应量为1.02 (95% CI = 0.51 ~ 1.52, P <；体节屈曲类别的合并效应大小为2.43 （95% CI = 0.48 ~ 4.38, P = 0.01）。肌肉松弛的保护反应在降低冲击严重程度方面没有显著的综合效果（P = 0.36）。解释：负荷分担的保护反应是有效的。身体部分屈曲反应总体上是有效的，但其对降低坠落冲击严重程度的影响取决于坠落方向和撞击身体部位。肌肉放松对降低冲击严重程度的作用尚不清楚，需要进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.