Strategies to Minimize Fall-related Injuries in Older Adults at Risk of Falls: The Falling Safely Training Study

Background: Falls are the leading cause of accidental injury among older adults. Current fall prevention programs are useful but do not target the key variable for injury (ie, impact force). An approach, which has shown promise in robust older adults, is to teach safe-falling strategies to reduce impact forces. In this single-anonymized, pilot randomized controlled trial, we explored the feasibility and preliminary efficacy of a safe-falling program. Methods: Twenty-four older adults at risk of injurious falls were randomly assigned either to Falling Safely Training (FAST), a standardized progressive training of safe-falling strategies, or an active control group consisting of evidence-based balance training. Participants underwent a series of experimentally induced falls at baseline, after the 4-week intervention, and 3 months after the intervention. Hip and head acceleration (proxies of impact force) and the number of head impacts experienced during the falls were collected. Results: No adverse events were reported, and 11 of 12 FAST participants completed the intervention. The FAST group had a greater reduction in the number of fall-related head impacts following the intervention (odds ratio = 0.10, 95% CI: 0.02, 0.61, p = .012). This improvement coincided with a significant reduction in head acceleration in the FAST group compared to control (between-group mean difference = -9.54 m/s(2), p = .028). Hip acceleration decreased significantly in both groups (ps < .001). Conclusions: Teaching older adults at risk of falls safe-falling strategies is safe and feasible and has the potential to minimize fall-related head impacts and reduce fall morbidity.