Dataset Information

Effects of upper body strength, hand placement and foot placement on ladder fall severity.

ABSTRACT: BACKGROUND:A plurality of fatal falls to lower levels involve ladders. After a slip/misstep on a ladder, climbers use their upper and lower limbs to reestablish contact with the ladder. RESEARCH QUESTION:This study investigates the impact of upper body strength, hand placement and foot placement on fall severity after a ladder climbing perturbation. METHODS:Participants performed upper body strength tests (breakaway and grip strength) and climbed a vertical, fixed ladder while a misstep perturbation was applied under the foot. After the perturbation, three hand placement and two foot placement responses were generally observed. Common hand placement responses included the hand moving two rungs, one rung, or did not move to a different rung. Foot placement responses included at least one foot or no feet reestablished contact with the ladder rung(s). Fall severity was quantified by the peak harness force observed after the perturbation. RESULTS:Increased strength, reestablishing at least one foot on the ladder, and ascending (compared with descending) the ladder was associated with a reduction in fall severity. An interaction effect indicated that the impact of hand placement was altered by climbing direction. Moving the hand one rung during ascent and moving the hand two rungs during descent was associated with an increased fall severity. Cases where the hand decoupled from the ladder was associated with higher fall severity. Upper body strength assessed using a portable grip dynamometer was sufficient to predict fall severity. DISCUSSION:This study confirms the multifactor role of upper body strength, hand placement and foot placement in preventing falls from ladders. Furthermore, a portable dynamometer shows potential to screen for high-risk individuals. Results of this investigation may guide targeted interventions to prevent falls from ladders.

SUBMITTER: Pliner EM

PROVIDER: S-EPMC6380680 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Effects of upper body strength, hand placement and foot placement on ladder fall severity.

Pliner Erika M EM Seo N J NJ Ramakrishnan Viswanathan V Beschorner Kurt E KE

Gait & posture 20181102

<h4>Background</h4>A plurality of fatal falls to lower levels involve ladders. After a slip/misstep on a ladder, climbers use their upper and lower limbs to reestablish contact with the ladder.<h4>Research question</h4>This study investigates the impact of upper body strength, hand placement and foot placement on fall severity after a ladder climbing perturbation.<h4>Methods</h4>Participants performed upper body strength tests (breakaway and grip strength) and climbed a vertical, fixed ladder wh ...[more]

PMID: 30439684

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Project description:BackgroundHand, foot, and mouth disease (HFMD) is an epidemic infectious disease in China. Relationship of neighborhood greenness with human health has been widely studied, yet its association with severe HFMD has not yet been established.MethodsIndividual HFMD cases that occurred in Guangdong province in 2010 were recruited and were categorised into mild and severe cases. Residential greenness was assessed using global land cover data. We used a case-control design (i.e., severe versus mild cases) with logistic regression models to assess the association between neighborhood greenness and HFMD severity. Effect modification was also examined.ResultsA total of 131,606 cases were included, of whom 130,840 were mild cases and 766 were severe cases. In an unadjusted model, HFMD severity increased with higher proportion of neighborhood greenness (odds ratio, OR = 1.029, 95%CI: 1.009-1.050). The greenness-HFMD severity association remained (OR = 1.031, 95%CI: 1.006-1.057) after adjusting for population density, demographic variables and climate variables. Both population density (Z = 4.148, P < 0.001) and relative humidity (Z = -4.297, P < 0.001) modified the association between neighborhood greenness and HFMD severity. In the stratified analyses, a protective effect (OR = 0.769, 95%CI: 0.687-0.860) of greenness on HFMD severity were found in the subgroup of population density being lower than and equal to 5 ln(no.)/km2. While in both the subgroups of population density being higher than 5, the greenness had hazard effects (subgroup of > 5 & ≤7: OR = 1.071, 95%CI: 1.024-1.120; subgroup of > 7: OR = 1.065, 95%CI: 1.034-1.097) on HFMD severity. As to relative humidity, statistically significant association between greenness and HFMD severity was only observed in the subgroup of being lower than and equal to 76% (OR = 1.059, 95%CI: 1.023-1.096).ConclusionsOur study found that HFMD severity is associated with the neighborhood greenness in Guangdong, China. This study provides evidence on developing a prevention strategy of discouraging the high-risk groups from going to the crowded green spaces during the epidemic period.

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Dataset Information

Effects of upper body strength, hand placement and foot placement on ladder fall severity.

Publications

Effects of upper body strength, hand placement and foot placement on ladder fall severity.

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