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Effect of the Safe Fall Programme on Children's Health and Safety: Dealing Proactively with Backward Falls in Physical Education Classes

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The aim of this study is to show that the implementation of the Safe Fall programme in physical education classes can help to reduce the negative effects of unintentional backward falls in the adolescent population, by teaching them how to protect themselves when falling. A quasi-experimental research design was applied in a sample of 120 children (M = 15.1 years, SD = 2.45), attending a secondary school in Seville (Spain). Data was collected on an ad hoc observation scale INFOSECA (which records five basic elements during a backward fall: position of the neck, the hands, the trunk, the hips, and the knees), applying descriptive, correlational, and contrast statistics. The criteria for considering statistical significance was p < 0.05 in McNemar's test. The data indicates that learning safe and protected ways of falling backward is possible through the implementation of the Safe Fall programme, and no differences were found in terms of gender.
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sustainability
Article
Effect of the Safe Fall Programme on Children’s
Health and Safety: Dealing Proactively with
Backward Falls in Physical Education Classes
Luis Toronjo-Hornillo 1, *, Óscar DelCastillo-Andrés1ID , María del Carmen Campos-Mesa 1ID ,
Víctor Manuel Díaz Bernier 1and María Luisa Zagalaz Sánchez 2ID
1
Facultad de Ciencias de la Educación, Universidad de Sevilla, 41013 Sevilla, Spain; ocastillo@us.es (Ó.D.-A.);
mccampos@us.es (M.d.C.C.-M.); victormd2007@gmail.com (V.M.D.B.)
2Faculty of Humanities and Education Sciences, University of Jaén, 23071 Jaén, Spain; lzagalaz@ujaen.es
*Correspondence: ltoronjo@gmail.com; Tel.: +34-619-23-1176
Received: 22 March 2018; Accepted: 10 April 2018; Published: 13 April 2018


Abstract:
The aim of this study is to show that the implementation of the Safe Fall programme
in physical education classes can help to reduce the negative effects of unintentional backward
falls in the adolescent population, by teaching them how to protect themselves when falling.
A quasi-experimental research design was applied in a sample of 120 children (M = 15.1 years,
SD = 2.45), attending a secondary school in Seville (Spain). Data was collected on an ad hoc
observation scale INFOSECA (which records five basic elements during a backward fall: position
of the neck, the hands, the trunk, the hips, and the knees), applying descriptive, correlational, and
contrast statistics. The criteria for considering statistical significance was p< 0.05 in McNemar ’s test.
The data indicates that learning safe and protected ways of falling backward is possible through the
implementation of the Safe Fall programme, and no differences were found in terms of gender.
Keywords: falls; childhood; prevention; education; school health
1. Introduction
The study of falls among the school population has attracted a great deal of social interest in
terms of public health, safety, and the protection of minors, becoming an important component of
intervention in developed societies throughout the world. This interest in the study of fall-induced
injuries and their consequences has been reflected in studies published in high-impact Spanish and
international journals in the area of psychology and public health [16].
The World Health Organisation [
7
], drew attention to the fact that falls represent the
second-leading cause of death from unintentional injuries among minors throughout the world.
In Spain, different studies [
3
,
8
10
] have presented falls as the third most common cause of death from
unintentional injuries among this population (approximately 13% of child mortality). In first place are
traffic accidents (23.7%), followed closely by drownings (20%). In the context of Andalusia, a previous
study [
11
] pointed out that falls represent 4.3% of accidental deaths at that age, and of these falls
26% take place at school. Likewise, a study supported by the Spanish Association of Pediatrics and
Primary Health Care [
12
] pointed out that falls are the main cause of unintentional injury in children
under 14. The figures from Spain tie in with those of the European Child Safety Alliance [
13
] at an
international level. To give an idea of what this costs in terms of health care, the USA reports an annual
health expenditure of 50 billion dollars associated with fall-related injuries in children from 0 to 14
years [8].
Sustainability 2018,10, 1168; doi:10.3390/su10041168 www.mdpi.com/journal/sustainability
Sustainability 2018,10, 1168 2 of 8
The scientific community has reacted in Spain [
8
,
10
12
] and internationally [
2
,
4
,
14
] with
preventive programmes that, from a multisector approach [
6
], partially solve the problem of falls,
as children will continue to have falls since it is in their nature to do so [15].
To provide a response to fall-related issues in children beyond mere prevention programmes,
something not found in the specialized literature on falls, this study presents a proactive educational
programme, Safe Fall [
16
], which introduces the teaching of safe and protected ways of falling to
schoolchildren as an adapted physical activity to be included in physical education (PE) classes.
The programme is in line with proposals of the WHO internationally, and the Ministry of Health in
Spain [
17
] encouraging multisector programmes designed to minimize fall-related injuries. Interest in
the Safe Fall programme amongst future health and education professionals was underlined by a
recent study amongst this group showing great demand for training in this area [18].
Safe Fall has been designed to minimize the consequences of injuries from unintentional falls in
schoolchildren through group work on movements, balance, and basic and specific motor abilities.
Above all, it focuses on automating movements to ensure children protect themselves in the event of
an unintentional fall. The programme also aims to bolster the competencies of specialists in PE, sports,
and health in more protected and safer ways of falling. This is an addition to current programmes
focusing on fall-prevention; it gives teachers an important and innovative, proactive tool with which
they can teach children in PE classes how to fall more safely.
The aim of this study is to show that the implementation of the Safe Fall programme can help
reduce the consequences of unintentional backward falls in schoolchildren by teaching them motor
responses that are associated with less harmful ways of falling.
2. Materials and Methods
With an explanatory objective, and from a positivist paradigmatic approach, a quantitative
methodology based on the experimental method was adopted to apply a pretest–posttest
quasi-experimental research design.
2.1. Sample
Sample selection was performed using incidental sampling [
19
], with the final sample consisting
of 120 schoolchildren whose ages ranged from 12 to 17 years (M = 15.1 years, SD = 2.45), all attending
a private, but partially publicly-funded, secondary school in Seville (Spain). Information was
collected from 1st, 2nd, and 3rd year students (26.8%, 23.3%, and 23.3%, respectively) in compulsory
secondary education, and the rest (26.6%) were in their first year of baccalaureate studies during the
2016/17 school year. By gender, 54.2% were male and 45.8% female.
2.2. Process
The study intervention period lasted 5 weeks, from 17 April to 19 May 2017. Empirical data
were collected using the INFOSECA ad hoc observation scale (Information Scale on Safe Ways of
Falling) (Appendix A). A video-graphic record was made of each student for of the pretest and posttest
for subsequent analysis by 5 independent experts, plus the principal investigator. The experts were
previously trained to collect data as follows: each of them viewed 10 execution models at different
time points (twice in a row, every two days, for a total of 5 training sessions). On the collected data,
the level of reliability intra-evaluators for this scale presents a value for the Kappa index of 0.95 for the
neck variable, 0.99 for the hands, 0.93 for the trunk variable, 0.87 for the hip, and 0.88 for the knees.
Later, it was established that the level of reliability between evaluators for this scale presents a value
for the Kappa index of 0.93 for the neck variable, 0.98 for the hands, 0.75 for the trunk variable, and
0.82 and 0.84 for the hip and knees, respectively. Pupils’ parents or tutors were informed about the
implementation characteristics of the programme and gave their informed consent for the study.
The design of the resulting instrument meant that 5 fundamental elements to be taken into account
during the process of a safe and protected backward fall would be recorded dichotomously (on a
Sustainability 2018,10, 1168 3 of 8
nominal scale, either well executed or badly executed): first, protect the head (reduces the frequency
and/or intensity of the blow to the neck on the ground); second, avoid using hands to break the fall
(reduces the frequency and/or intensity of the support of the upper limbs on the ground); third, roll up
into a ball (progressively increases the surface of the impact on the ground); fourth and fifth, bend the
hips and the knees (reduces the height of the fall and helps in rolling up into a ball). Content validity
was demonstrated via the conjugation of two fundamental perspectives: the theoretical review about
the state of the question and the assessment of two judo specialists who were experts in falls.
The pretest was done only once by each student and it recorded pupils’ spontaneous motor
response to a sudden backward fall. The programme was then implemented in three phases as part
of P.E. classes. First was a theoretical presentation about falls and their consequences at school age
(1 h), which consisted of a practice session, Level I in the gym, on the specific techniques of Safe Fall
(the content of the 50 min practical lesson consisted of a presentation of the positions to be avoided in
the event of a fall, presenting to the students which positions are protected and safe in the event of
a fall, and a battery of exercises and games to allow them to practice but also to encourage them to
think about the information and the aforementioned items). In the 10 successive sessions (within the
warm-up of the physical education class) two 5 min exercises or one 10 min exercise were performed,
so the total time spent was 10 min per 10 sessions. These last exercises are chosen in a sequence and,
depending on their level of difficulty at the teacher’s discretion, adjusting to the learning progressions
established in the program, reviewing some known exercises and introducing new ones depending on
the level of student achievement. After the implementation of the Safe Fall programme, a posttest was
conducted to collect the assimilated motor response to a sudden backward fall (Appendix A). Again,
to collect this data, each student performed the test once (posttest).
Data was analyzed with the statistical package IBM SPSS v24 (IBM, New York, NY, USA) in a
Mac environment. Descriptive, correlational, and contrast statistics were applied. The criteria for
considering statistical significance was p< 0.05 in McNemar’s test. The gender contrast was determined
via a Student’s t-test.
3. Results
The following section presents the main results of the study, in relation to learning protected and
safe ways of falling backward. First, general descriptive information was provided. The application
of contrast statistics confirmed the impact of the programme: the assimilation of the protected fall
procedure was positive.
3.1. Backward-Fall Mechanization Routines for Secondary and Baccalaureate Students
Table 1illustrates performance results before and after the application of the programme. The data
reflect that, before the application of the programme, less than a third of the sample bent their neck for
protection in the fall (10.8%) and there were even lower values (less than 1%) for subjects who did not
use hands to minimize the impact for upper limbs on the ground.
As for rolling up, the safety position, which increases the surface area hitting the ground, the data
show that only 15% of the students did this correctly before the implementation of the programme. To
this last figure, another notable figure can be added: not one student bent their upper limbs during the
fall. The descriptive analysis concluded that 1.6% of the students correctly bent their knees during the
unintended backward fall as a measure of safety and protection.
As Figure 1shows, after the application of the Safe Fall programme, the posttest shows results
that are clearly different from those obtained in the pretest (the students had correctly learnt each of the
five technical movements involved in a safe and protected backward fall, with this being particularly
notable in the variables of bending the neck and using hands).
Sustainability 2018,10, 1168 4 of 8
Table 1.
Statistics on assimilation of variables for safe and protected backward falls (* p< 0.05 in
McNemar test; N = number of subjects; X2= chi square).
Pretest N Posttest N X2p
Yes No Yes No
Bending the neck 13 107 107 * 13 105.009 0.000
Using hands 1 119 106 * 14 104.009 0.000
Rolling up 18 102 85 * 35 65.015 0.000
Bending hip 0 120 86 * 34 84.012 0.000
Bending knees 2 118 109 * 11 105.009 0.013
Figure 1.
Effects of the program on the competence of pupils to assimilate a safe and protected
backward fall.
3.2. Effects of the Programme on the Competence of Secondary and Baccalaureate Pupils to Assimilate a Safe
and Protected Backward Fall
Contrast statistics (chi-square and bilateral exact significance) were applied to determine whether
there were significant differences because of the application of the Safe Fall programme and not due to
chance (Table 1). The pairs of data were analyzed from the pretest and posttest for each of the recorded
direct variables by applying McNemar’s exact test (p< 0.05).
Regarding the five direct variables of protection and safety proposed in the study for a sudden
backward fall, Figure 1shows an increase in the correct protection position for students in all the
variables after the application of the programme. The proportion of students who bent their neck in a
sudden fall was 10.8% before the application of the programme and 89.2% afterwards. In this case,
McNemar’s test presented a (bilateral) exact significance below 0.05 (Table 1). This figure indicates
that pupils improved their ability to bend their necks in the fall from what they had learnt in the Safe
Fall programme.
On the action of not putting their hands on the ground during the fall, the percentage of students
who did this correctly before the programme was 0.8%, compared to the 99.2% who did perform
it correctly after implementation [(bilateral) exact significance = 0.00]. For the rolling up variable,
the proportion of students who did perform this correctly before the programme was 15.0%, compared
to the 85.0% afterwards [(bilateral) exact significance = 0.00]. The bending of the hip was done
incorrectly by all students before the programme, compared to the 100.0% afterwards [(bilateral) exact
significance = 0.00]. Finally, the bending of knees variable was done correctly by 1.7% of the sample
before the Safe Fall programme, with this figure dropping to 98.3% after implementation [(bilateral)
exact significance = 0.013]. As the McNemar test presented a (bilateral) exact significance below or
Sustainability 2018,10, 1168 5 of 8
equal to 0.01 in all the direct variables, there is a 99% probability of not being mistaken when affirming
that this improvement is due to the Safe Fall programme and not to chance.
Differences of the effect of the programme in terms of the pupils’ gender were examined using a
Student’s t-test for contrast. No significant statistical differences were found for this variable, showing
that the programme was equally effective for boys and girls.
4. Discussion
The proposal for implementation of the Safe Fall programme constitutes a step forward for fall
prevention programmes [
4
,
8
,
10
,
12
,
14
] as it responds in a preventive and proactive way to the problem
for public health and safety posed by backward falls in the school population. It responds to calls
from the WHO [
7
], at an international level and the Ministry of Health [
17
] in Spain, for the design of
effective prevention programmes, which are extensive and versatile, in order to eliminate the factors
that lead to falls and reduce the severity of the injuries that do occur, with the latter being possible by
teaching children how to protect themselves and minimize their injuries when they do fall [16].
The Safe Fall programme is coherent with child safety in the event of falls as it teaches the process
of falling backward by automating protective motor actions for specific parts of the body that are more
often injured in falls [3,810]: the head, the upper limbs, and the hip or lower limbs, amongst others.
Child development between 12 and 17 years brings with it more dynamic and complex
physical-sport activities from a motor point of view (e.g., Parkour, mountain biking, and climbing),
and this leads to an increase in the number and type of falls endured [
15
,
20
]. Together with this, in
developed countries, children at this age become involved in more sporting activities, and many of
them have an inherently high risk of injury [
3
,
10
]. The development of basic motor skills, work on
turning, learning how to balance, and general dynamic coordination worked on through the theoretical
basics of motor tasks proposed in the Safe Fall programme [
16
] prepare children to react in the event
of a sudden backward fall and to impact in a safer and more protected way, as has been demonstrated
in the study.
It is vital to establish the factors and circumstances that come into play in a fall [
13
,
15
], to lay
out the appropriate methodological development to enable the automation of protected ways of
falling backward. The results of this study are coherent with the more frequent types of injuries [
3
,
21
]
and show that it is possible to avoid or reduce, for example, the intensity of the impact of the head
against the ground, thereby preventing the most serious type of injury produced by a fall [8].
No significant differences were found in terms of gender after the implementation of the
programme, which proves the programme is suitable for both boys and girls, despite the formers’
greater tendency to experience falls [12].
Learning a safe and protected way of falling backward using the Safe Fall programme has a direct
influence on the main cause of injuries among children [
11
13
]. It should be noted that there is no
proactive and specific programme in the world that teaches school-age children to fall in a safe and
protected way.
The Regional Government of Andalusia [
11
] found that 26% of children’s falls occur at school. As a
result, given the need to train secondary school teachers [
18
] in the specific area of falls, this programme
has been designed as a useful and practical tool for future education and health professionals working
with adolescents.
The implementation time of this research made it possible to verify that an assimilation of motor
gestures that allows students to fall safely. Regarding the length of the programme, one of the
premises of its success is the individuals’ long-term continuity of physical activity. It is necessary to
continue with new longitudinal studies that center their objective in assessing the minimum time
of implementation of the programme needed to guarantee the automation of the protective motor
gestures or the persistence of the gestures learned through the programme. Likewise, new lines of
research that look at, for example, the number and severity of injuries caused in a school population as
a consequence of an unintentional fall, before and after the implementation of the Safe Fall programme,
Sustainability 2018,10, 1168 6 of 8
are proposed. This would allow for a prediction of the transfer of the learned motor gestures to
other contexts.
It must be mentioned as one of the limitations of the study that not many references were found
in the literature [
22
] that would allow us to contrast the results obtained with the Safe Fall programme
with another on a regional, state, or international level and to enable a meta-analysis of data.
In light of these results, the programme could be extended to include specific exercises to learn
to fall sideways and forward. Likewise, ad-hoc observation scales will have to be developed and
validated to record the learning of safe and protected ways of falling in these directions. In turn,
the results of the study open new study perspectives whose hypotheses have not been considered here.
Thus, a correlation between learning a safe and protected way of falling and raising the self-confidence
of students when performing motor activities in PE classes needs to be established.
5. Conclusions
The conclusions stemming from this study show that, by using the Safe Fall programme in P.E
classes, it is possible to teach adolescent secondary school students techniques for falling backward in
a safe and protected way. In turn, the Safe Fall programme responds proactively to the call from the
WHO for the implementation of education programs based on fall-related research.
It responds in this way to the overall objective of reducing the risk and severity of injuries
produced by a sudden fall backward.
Author Contributions:
Luis Toronjo-Hornillo conceived and designed the experiments; Óscar DelCastillo-Andrés
performed the experiments, analyzed the data, and wrote the paper; Víctor Manuel Díaz Bernier
reagents/materials/analysis tools; María Luisa Zagalaz Sánchez performed the experiments and contributed
reagents/materials/analysis tools.
Conflicts of Interest: The authors declare no conflict of interest.
Appendix
crouching position (buttocks slightly clear of the floor)
wrists held by a classmate
Sustainability 2018,10, 1168 7 of 8
position of imbalance with the trunk angled forward while the classmate holds on to the wrists
(they will later let go without warning to provoke the backward fall)
When the classmate lets go of the wrists, the observer records on the following table whether the
subject performed the actions in the different areas.
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2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access
article distributed under the terms and conditions of the Creative Commons Attribution
(CC BY) license (http://creativecommons.org/licenses/by/4.0/).
... Los estudios sobre programas, talleres, intervenciones y simulacros relacionados con las crisis en las escuelas se centran en los efectos de un programa para aprender a caerse y evitar heridas mayores (Toronjo-Hornillo et al., 2018); la efectividad de un programa para prevenir y tratar heridas (O'Neill et al., 2013); la eficacia de las intervenciones escolares para reducir las lesiones infantiles no intencionadas (Holla et al., 2021); la eficacia de los simulacros (León et al., 2021), y el conocimiento de las niñeces tras un taller para brindar herramientas con respecto al bullying (Brenick et al., 2014). ...
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... Toronjo-Hornillo et al. in their research assessed school children using an original test which records five basic elements during a backward fall: position of the neck, the hands, the trunk, the hips, and the knees. Next, they implemented safe falls program during physical education (PE) classes (Toronjo-Hornillo et al., 2018). Invernizzi et al. recommend Safe Fall, Safe Schools Program (SFSSP) based on 10-min warm-up sessions during PE classes (Invernizzi et al., 2019). ...
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The child's first experience in the development of his postural functions is a fall. At the core of this phenomenon is a loss of balance. Our previous findings have proven that in the course of motor activity of children aged 2 to 6, two-year-olds will make the fewest mistakes when falling and colliding with the ground. The fourth year of life is the moment when this number increases from year to year. The aim of the study is to recommend a modified fun forms of falling (FFF-M) method for children to diagnose susceptibility to body injuries during a fall (SFI). We examined 86 children (boys and girls) aged: 4 years (n = 22); 5- (n = 30); 6- (n = 34). A modification of the SFI research method based on fun forms of falling involves the introduction of three elements: (1) accurate recording of the duration of each FFF; (2) while playing 'puddle with obi' (obi means judo belt), subjective estimation of the force used (L-light, M-medium, H-high) - this is the conventional level B, i.e. the force causing the fall is located at the height of the center of gravity; (3) more accurate estimation of collision errors with the ground (supporting with hands, rolling onto the back, hitting the head). The shortest session lasted 14 minutes, the longest 30 minutes. Fun form at level ‘a’ (localization of force below the center of gravity) lasted the shortest (3 min), and at level ‘c’ (localization of force above the center of gravity or together with criteria ‘a’, but identical FFF) lasted the longest (19 min). During FFF at level ‘b’, medium use of force to throw the child off balance was predominant. Children from all age groups were most likely to make upper limb errors during FFF (on average: 16 four-year-olds; 20 five-year-olds, 24 six-year-olds). Head impacts were observed in 1 four-year-old, 3 five-year-olds, and 3 six-year-olds. One child from each age group made no mistakes (0%) during FFF, and one child made mistake every time (100%). The conjunction of the research results (duration of the session, subjectively estimated strength, accurate estimation of errors during a fall) with the directive to simplify the diagnosis authorizes the recommendation of FFF 'puddle with obi' as a sufficient criterion for diagnosing the SFI phenomenon in children from two to six years of age. However, the assumption should be made that the evaluation should be based on the results of careful observation of at least 5 child falls.
... Of similar importance is the desire to prevent the occurrence of dangerous falls in the elderly or those with diseases related to the progress of civilisation, and special prevention programmes are increasingly being developed that include exercises with elements of hand-to-hand combat, combat sports or martial arts. Appropriate elements of this impact avoid the effects of lengthy treatment and even prevent injuries that would eliminate elderly people from public life [74][75][76][77][78][79][80][81]. ...
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The purpose of this publication is to provide generalized knowledge of the area of changes that took place over past centuries in relation to health, social and cultural conditions. In Greek mythology, it was necessary to nurture both body and spirit to be a perfect human being. This link between the concepts of physical beauty and goodness can be also found in later works dedicated to ancient Greek history. Particularly in Greek myths, and in Greek education in general, it was believed that both physical and spiritual excellence were necessary to raise men to achieve their true form.
... The quantified results of this observation (scores) are a simple measure of injury risk for single or multiple body parts in cases of falls during everyday physical activities. The Information Scale on Safe Ways of Falling (INFOSECA) developed by Toronjo-Hornillo et al. [26] assesses motor activities in people during backward falls. Although the approach to identification of the body parts that are most exposed to fall-related injuries is very similar to the STBIDF, the authors of the above mentioned scale cite the review paper presenting test results [27] without mentioning the reference sources [24,25]. ...
Article
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Background and Study Aim. Falling is an increasingly frequent problem. Assessment of the ability to control the body parts that are most susceptible to injury during a fall is the primary goal of prevention of fall-related injuries. The susceptibility test of the body injuries during a fall (STBIDF) is of note. To date, investigations of the STBIDF have been limited to validity assessment. Aim. Verify the reliability and objectivity of the STBIDF test. Material and Methods. Thirty-five female physiotherapy students participated in this study voluntarily. The sample was selected from 45 males and females undertaking their first-degree studies during the fifth semester of 2017–2018 at Podhale State College of Applied Sciences (PSCAS) in Nowy Targ, Poland. The STBIDF questionnaire was applied. Each student was recorded during STBIDF test performance. The STBIDF reliability assessment was performed using the test-retest method. The STBIDF objectivity assessment was performed using the Delphi method, with a panel consisting of three experts. Results. A significant correlation (rs = 0.865, p < 0.001) between the IndexSBIDF scores for the test and retest was observed. The Wilcoxon signed-rank test result did not reveal any significant differences between the test and retest. Conclusions. The STBDIF is characterized by reliability and objectivity; therefore, it is a good tool for analysis of the susceptibility to injury of the body parts most exposed during falls in people from different risk groups. This non-apparatus test is a reliable and easy to use tool, available for experts dealing with falls and their consequences, and preventive approaches. It can also be used in medical, pedagogical, and athletic environments.
... Backward falls are especially dangerous due to their directions [23]. Previously designed tests have been developed for a fall technique similar to a gymnastic backward roll [15,[24][25][26]. These tests are easy to perform, but the disadvantage is that the tested falls are not induced by an external force. ...
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(1) Background: This research aimed to determine the effect of the backward fall technique on the sagittal linear acceleration of the head in students training in different sports. (2) Methods: The study involved 41 students divided into two study groups. Group A included 19 students training in martial arts who practised falls with side aligning of the body. Group B included 22 handball players who practised falls performed in a way similar to a gymnastic backward roll. A rotating training simulator (RTS) was used to force falls, and Wiva ® Science apparatus was used to assess acceleration. (3) Results: Significant changes in head acceleration were only obtained between immediate fall tests (IFTs) and forced fall tests (FFTs) in group B. Significant differences were noted between groups for the IFT and FFT. Greater changes in head acceleration were noted in group B. (4) Conclusions: Smaller changes in head acceleration in group A students indicate a lower susceptibility to head, pelvic and cervical spine injuries in falls performed backward with side aligning of the body. This technique in group A limited the differences in head acceleration between IFTs and FFTs. Negative acceleration values obtained in group B confirmed that the head may suffer a moment of force, tilting it backwards, but then forward when the buttocks hit the ground.
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El objetivo de este estudio fue comprender cómo un equipo de trabajo en una escuela primaria de la costa de Yucatán afronta las crisis a través de un estudio de caso. Se usaron observaciones, entrevistas semiestructuradas y grupos de enfoque para recabar información con 14 agentes escolares: 1 directora, 1 administradora, 2 mujeres intendentes y 10 docentes. Los resultados evidenciaron riesgos ambientales y vehiculares, y problemas sociales como violencia e inseguridad en la comunidad. Dentro de la escuela hay limitaciones en infraestructura y recursos y personal; organización, pero falta de cohesión del personal, estudiantes con conductas disruptivas y familias complejas. Respecto a las crisis que han ocurrido se reportaron: caídas, heridas, peleas, ahorcamiento, abuso verbal, robos, riesgo de secuestro, huracanes, etc. El equipo de trabajo priorizó: problemas emocionales, accidentes en zonas de riesgo y agresividad. Se compartieron varias estrategias preventivas durante toda la jornada; algunos acuerdos para la respuesta inmediata; y pocos sobre la restauración tras la crisis. Se propuso para las crisis priorizadas: pláticas con familias, delimitar áreas de riesgo, identificación de estudiantes de riesgo y grupos de trabajo con la psicóloga. Finalmente, tras una capacitación, se compartió que fue una experiencia enriquecedora y necesaria para estar alerta y saber cómo actuar. Se discute cómo el contexto permea en el fenómeno para identificar riesgos y desarrollar estrategias oportunas. Se resalta la prevención como fortaleza; y la capacitación del personal, la infraestructura y recursos adecuados, como imprescindible para afrontar crisis de manera efectiva y fortalecer una cultura de prevención.
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The International Judo Federation (IJF) has often changed the rules to protect judokas, increase the intensity of competitions, score more, and achieve greater attention and popularity. This research aims to determine the impact of judo rule change on the effectiveness of floor techniques in competitors at the Europa Judo Open in Sarajevo 2021-2022. The research was conducted on a sample of (n=217) senior fights and a sample of (n=130) senior women's fights in 2021. and a sample of (n=206) senior fights and a sample of (n=119) senior women's fights in 2022. in all 7 weight categories at the Sarajevo European Open. It was found that the most commonly performed techniques of procedures are Hon-gesa-gatame, yoko-shiho-gatame and sankaku-jime. The highest percentage of osaekomi-waza (holding in the grip) is immediately after the throw, and the highest percentage of shime-waza (choking techniques) were performed after a failed opponent's attack. The percentage of kansetsu-waza (leverage) is reduced. By analyzing, we found that in the lower weight categories there was an increase in ground wins (senior men category: 60kg 7 % in 2021, 19% in 2022,66 kg 22% in 2021, 28% in 2022, 73 kg 11% 2021,32% in 2022), that is, generally the application of parterre techniques during the combat, while in the larger weight categories (81, 90, 100, +100) the percentage of wins in ne-waza decreased slightly (category 81 kg 18% in 2021, 12% in 2022,90kg 19% in 2021, 18% in 2022, 100 kg 18% in 2021, 7% in 2022, +100kg 33% in 2021, 22% in 2022). In the women's categories 48 kg, 52 kg and +78 kg, significant progress was observed (senior women category 48kg 18,75% in 2021, 38,46% in 2022,52 kg 20% in 2021, 25% in 2022, +78 kg 33.33% in 2021, 55,56% in 2022), while in other female weight categories, the efficiency in ne-waza was higher in 2021 (57 kg 32% in 2021,26,32% in 2022, 63kg 31,50% in 2021, 25% in 2022,70 kg 34,78% in 2021, 11,54% in 2022, 78 kg 26,67% in 2021, 25% in 2022). In seniors, control techniques improved slightly while senior women performed better at performing shime-waza and kansetsu-waza techniques compared to 2021 (15,15% in 2021, 25,81% in 2022). With the introduction of new rules in judo, more time space was given to the ne-waza so that growth was recorded in osaekomi-waza, while the number of kansetsu-waza and shime-waza decreased.
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Las lesiones musculoesqueléticas están relacionadas en gran medida con la práctica de actividad físico-deportiva. En el caso de los niños y adolescentes se vinculan al ejercicio que realizan en el transcurso de las clases de Educación Física o las actividades deportivas extraescolares. En esta revisión sistemática, el objetivo de investigación es conocer la tipología lesional existente en el contexto escolar educativo y los programas de prevención vinculados a la descripción de las lesiones que se producen en él y conocer los programas de prevención que se implementan por docentes de Educación Física en el transcurso de sus clases. Se realizó una búsqueda de literatura científica durante los meses de enero y febrero del año 2023 en las bases de datos Web of Science, SCOPUS y PubMed. Como motores de búsqueda se utilizaron las siguientes palabras clave: "injur*", "prevent*”, “program*" y "physical education"; empleándose el operador boleano “and”. Como conclusión destaca la necesidad de continuar investigando y desarrollando programas efectivos de prevención de lesiones en el ámbito escolar y deportivo con el fin de proteger la salud y seguridad de los estudiantes.
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Background: The formation of large accelerations on the head and cervical spine during a backward fall is particularly dangerous due to the possibility of affecting the central nervous system (CNS). It may eventually lead to serious injuries and even death. This research aimed to determine the effect of the backward fall technique on the linear acceleration of the head in the transverse plane in students practicing various sports disciplines. Methods: The study involved 41 students divided into two study groups. Group A consisted of 19 martial arts practitioners who, during the study, performed falls using the side aligning of the body technique. Group B consisted of 22 handball players who, during the study, performed falls using the technique performed in a way similar to a gymnastic backward roll. A rotating training simulator (RTS) was used to force falls, and a Wiva® Science apparatus was used to assess acceleration. Results: The greatest differences in backward fall acceleration were found between the groups during the buttocks' contact with the ground. Larger changes in head acceleration were noted in group B. Conclusions: The lower changes in head acceleration obtained in physical education students falling with a lateral body position compared to students training handball indicate their lower susceptibility to head, cervical spine, and pelvis injuries when falling backwards as caused by horizontal force.
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New pedagogical proposals are important to promote debates regarding the judo training process. Thus, Olivio Junior and Drigo (2015) proposed a new methodology called Judo Complex Pedagogy. Such proposal is an alternative to the traditional training model (TT), usually composed of cyclical training of techniques and simulation of fights, since it advocates the organization of the training in Functional Units (FU): approach, contact, opportunity creation, unbalance, application, projection, transitioning and ground combat and using them with the objective of developing the athlete’s tactics through the situational method (ST). As a methodological proposal, ST intensity has not been compared with TT. Hence, the objective of this study was to compare the intensity of TT and that of ST. 24 judo practitioners were evaluated during a training session. 12 of them underwent TT, and 12 underwent ST. The intensity of training was verified through the analysis of blood lactate response [La-], measured 1 minute after the ending of Uchikomi (UCK), judo techniques training, 1 minute after the ending of fight training (RAN), and 1 minute after the ending of the training session. [La-] at the end of UCK was significantly higher in TT = 3.8 ± 1.7 in comparison to FT =1.9 ± 0.4 mmol/L, while in RAN (TT = 4.0 ± 2.7 and TF = 3.7 ± 1.5 mmol/L) and in the total session (4.0 ± 2.2 and TF = 3.3 ± 1.1 mmol/L) there was not a significant difference. On the other hand, although there was not a significant difference in [La-] in the training as a whole, ST athletes did 10 minutes less in UCK and 16 minutes less in RAN, which may be an indicative of training optimization. That is also possible that the reduction in the number of Randoris in TT, as well as the analysis of all the athletes undergoing both training sessions, for paired analysis, may give further information. Different physiological parameters and the subjective perception of athletes should also be studied.
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DelCastillo-Andrés, O.; Toronjo-Hornillo, L.; González-Campos, G.; Toronjo-Urquiza, M.T. (2017). Propuesta de intervención " Safe Fall " : prevención de lesiones en escolares mediante formas seguras y protegidas de caer. Journal of Sport and Health Research. 9(supl 1):137-142.
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Background: Injury to children in Europe, resulting in both death and disability, constitutes a significant burden on individuals, families and society. Inequalities between high and low-income countries are growing. The World Health Organisation Health 2020 strategy calls for inter-sectoral collaboration to address injury in Europe and advocates the whole of government and whole of society approaches to wicked problems. In this study we explore which sectors (e.g. health, transport, education) are relevant for four domains of child safety (intentional injury, water, road and home safety). We used the organigraph methodology, originally developed to demonstrate how organizations work, to describe the governance of child safety interventions. Members of the European Child Safety Alliance, working in the field of child safety in 24 European countries, drew organigraphs of evidence-based interventions. They included the different actors involved and the processes between them. We analyzed the organigraphs by counting the actors presented and categorizing them into sectors using a pre-defined analysis framework. We received 44 organigraphs from participants in 24 countries. Twenty-seven sectors were identified across the four domains. Nine of the 27 identified sectors were classified as 'core sectors' (education, health, home affairs, justice, media, recreation, research, social/welfare services and consumers). This study reveals the multi-sectoral nature of child safety in practice. It provides information for stakeholders working in child safety to help them implement inter-sectoral child safety interventions taking a whole-of-government and whole-of-society approach to health governance.
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Background Sustaining public health programmes in the long-term is key to ensuring full manifestation of their intended benefits. Although an increasing interest in sustainability is apparent within the global literature, empirical studies from within the European setting are few. The factors that influence sustainability are generally conceptualized at three levels: programme level, the immediate context and the wider environment. To-date attention has focused primarily on the former two. Using a community-based child injury prevention programme in England as an exemplar, this paper explores the concept of sustainability within the wider policy environment, and considers the impact of this on local programmes. Methods A content review of global and UK national public health policies (1981–2014) relevant to child safety was undertaken. Interviews were held with senior representatives of global and UK agencies involved in developing child safety policy. Results Forty-nine policies were reviewed. The term ‘sustain’, or its derivatives, featured in 36 (73%) of these. Its’ use however, related primarily to conservation of resources rather than continued programme operation. Potential mechanisms for supporting programme sustainability featured within some documents; however, the approach to sustainability was inconsistent between policies and over time. Policy stakeholders identified programme sustainability as relevant to their core business, but its’ conceptualization varied according to individual interpretation. Conclusions Programme sustainability is poorly addressed within global and UK-based public health policy. Strengthening a national and international policy focus on sustainability and incorporating sustainability into public health planning frameworks may create a more supportive environment for local programmes.
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Background: Numerous safety promotion interventions in schools exist but these are rarely subject to impact evaluation. Few available studies are focused on intermediate outcomes. Our objective is to evaluate the impact of prevention interventions on school injuries in a number of schools in Italy. Methods: A pre-post-study with a control group was used. One hundred and three intervention units were selected; control units were selected randomly from those which did not implement safety projects. The general objective was to promote a safety culture by increasing expertise and knowledge, and by enabling the adoption of appropriate behavior. All projects combined various elements: training and educational, information and communication, as well as organizational. The projects evaluated in this article were specifically aimed at safety in indoor premises; they were implemented in 2009-10. Injury rates standardized by gender were calculated for 5 school years (from 2007/2008 to 2011/2012) stratified by type of school and place of occurrence. To assess the effectiveness the difference-in-differences method was used. Results: Overall, 207 012 student-years and 2918 school injuries were considered. In all types of schools, the injury rates in indoor areas show a decreasing trend in the intervention units and an increasing trend in the control units. In high schools, there were no changes in the trend of injuries occurring in the gym and/or related to sports activities. Conclusions: The results suggest a positive short-term effect of the programs on injuries occurring in indoor premises. The quasi-experimental design has never been previously used to evaluate the effectiveness of a prevention program in schools.
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Objectives: To describe the epidemiological characteristics of unintentional injuries due to falls in children under one year and to analyse the risk factors associated with severe injuries. Patients and methods: This multicentre, observational and cross-sectional study included all children less than one year treated for unintentional fall in the Emergency Departments of 8 Spanish Hospitals, belonging to the «Unintentional Paediatric Injury Workshop» of the Spanish Paediatric Emergency Society, between March 1st, 2014 and February 28th, 2015. Results: Out of 289,887 emergency department cases, 1,022 were due to unintentional falls. The median age was 8 months and 52.5% were males. Fall injuries were more frequent among children aged 9-12 months (37.6%), and 83.5% occurred at home. The most common mechanism was fall from nursery equipment (69.4%), and 47.8% occurred from a height under 50cm. More than two-thirds (68%) of falls were witnessed, but in half of the cases (329) the caregiver was not in area. Serious injuries were seen in 12% of cases. In this study, a fall height greater than 50cm, falls in the street, from the arms of the carer, and from the stairs were identified as independent risk factors for worse outcomes. Conclusions: The most serious injuries occur in children <3 months and from a height of >50cm, though not related to unwitnessed falls. Because the most common serious injury mechanism is the fall from the arms of the carer, from stairs, and falls in the street, these facts should be highlighted in order to avoid morbidity.
Book
This book describes cutting-edge applications of human factors for sports, injury prevention and outdoor recreation disciplines and provide practical guidance on a range of methods for describing, representing, and evaluating human, team, and system performance in various domains. Contributions in this book show how various human factors methods, applied historically in the complex safety critical domains, are suited to describing and understanding sports performance and sports injury prevention. The book discusses a wealth of methods for different purposes, such as data collection, task analysis (including cognitive task analysis), workload measurement, assessing situation awareness, performance assessment (including team performance assessment),decision making and cognition in sports, human error identification, and interface evaluation methods. With respect to other publications in human factors and ergonomics, which have been more focused on the biomechanical, physiological, environmental, and equipment-related aspects of sports performance, this book gives a special emphasis to research on analysis of individual and team sports, cognitive and social human factors, and covers both sports and outdoor recreation disciplines. Based on the AHFE 2017 Conference on Human Factors in Sports, Injury Prevention and Outdoor Recreation, held on July 17-21, 2017, in Los Angeles, California, USA, this book provides readers with a timely survey of new methods that can be implemented during any sport or outdoor recreation event, and for analyzing and improving the performance and safety of both individuals and teams.
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The purpose of this paper is to identify if the students who attend the Primary Education Degree of the Faculty of Education of the University of Seville know the risk of falls in childhood, what kind of training has it and if Important or not a specific training on the teaching of safe techniques and protected from falling. For this purpose, the ad hoc questionnaire called "INFOSECA Questionnaire" has been designed and passed to 125 students. Once analyzed the data have been obtained as main results that: the students in their initial formation as future teacher, is not aware of the possible consequences that the falls can produce to the minors. 88% state that they have no specific training in this type of content. It is concluded that it is necessary and essential to introduce in the initial training of future primary education teachers, especially those in charge of Physical Education classes, an active intervention program to try to minimize the consequences of accidents in students through teaching Of safe and protected techniques to fall, responding to the current problem that we are facing from different public organisms such as the World Health Organization (WHO).
Article
Background: Understanding patterns of injury in England is challenging due to a lack of national injury surveillance data. Through recent linkage of a large primary care research database to hospitalization and mortality data, we describe the epidemiology of poisonings, fractures and burns over a 14-year period. Methods: We used linked English primary care, hospitalisation and mortality data from the Clinical Practice Research Datalink, Hospital Episode Statistics and Office for National Statistics between 1998 and 2011 to establish a cohort of 2,106,420 0-24 year olds. Incidence rates, per 10 000 person-years (PY) were estimated by age, sex, calendar year and socioeconomic status. Using Poisson regression we estimated incidence rate ratios, adjusting for age and sex. Results: Age patterns of injury incidence varied by injury type, with peaks at age 2 (74.3/10 000 PY) and 18 (74.7/10 000 PY) for poisonings, age 13 for fractures (305.1/10 000 PY) and age 1 for burns (116.8/10 000 PY). Over time, fracture incidence increased, whereas poisoning incidence increased only among 15-24 year olds and burns incidence reduced. Poisoning and burns incidence increased with deprivation, with the steepest socioeconomic gradient for poisonings among 20-24 year olds (IRR 2.63, 95% confidence interval 2.24-3.09). Conclusion: Differing patterns according to age and injury type reflect differences in underlying injury mechanisms, highlighting the importance of developing tailored preventative interventions across the life course. Inequalities in injury occurrences support the targeting of preventative interventions to children and young people living in the most deprived areas.
Article
Falls from a height are a leading cause of injury for children globally, yet few effective prevention strategies have been developed. For young children, serious falls occur mostly in the home, which implicates caregivers’ safety practices in prevention. This qualitative study examined parents’ views about this issue. Parents of 1 through 4 year olds participated in focus groups and provided opinions about in-home falls, including preventability, facilitators and barriers to falls’ prevention, and strategies for prevention. Results revealed that parents were surprised about the frequency of serious falls affecting young children. They recognized that children falling from heights (stairs and off furniture) posed risk of head injury, but varied in beliefs about preventability of falls. They emphasized teaching safe practices (stairs) and enforcing rules (prevent hazardous actions on furniture), but did not use or favor stair gates. Barriers to prevention included wanting children to be active and independent and believing children learn risk avoidance from injury experiences. Parents sought suggestions for prevention approaches that are sensitive to their individual needs and allow them to make personal choices, rather than prescriptive strategies about using stair gates or supervising constantly.
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Introducción. Las lesiones por trauma son la mayor causa de morbimortalidadad en niños, adolescentes y adultos menores de 40 años. Después de los eventos por vehículo motor, las caídas son la causa más frecuente de muerte en niños.Objetivo. Se evaluó la incidencia de lesiones en niños traumatizados por caída de altura para proponer un protocolo de estudio.Población, material y métodos. Se estudiaron en forma retrospectiva 100 pacientes que presentaron traumatismos por caída de altura, atendidos entre enero de 2001 y diciembre de 2003. Criterios de inclusión: 1) edad: 0 a 16 años. 2) Altura mínima de caída de 1 metro para los menores de 2 años y de 2 metros para los mayores de 2 años (se intentó dar relevancia a la altura de caída en relación con la longitud corporal del niño). 3) Los pacientes fueron estudiados y recibieron su tratamiento definitivo en nuestro hospital siguiendo las normas ATLS. Los pacientes se dividieron en tres grupos: A, de 0 a 2 años; B, de 3 a 10 años y C, de 11 a 16 años, en base a las diferencias antropométricas entre estos grupos etarios. Se registró edad, sexo, lugar de la caída, superficie de aterrizaje, tipo de lesiones, causa de la caída. Análisis estadístico: se utilizó el programa Epi info, para la variable fracturas en los distintos grupos erarios; se realizó el análisis de varianza con diferencias estadísticamente significativas para valores de p< 0,05.Resultados. De los 100 traumas 67 fueron de sexo masculino. Edad mediana, 5 años (rango 4 meses a 15 años). El grupo A comprendió 27 pacientes, 59 el grupo B y 14 el grupo C. El 64% de las caídas ocurrió en el ámbito domiciliario. Las lesiones del sistema nervioso central fueron las más comunes (77% del grupo A tuvo fractura de cráneo). La mayor incidencia de fracturas de los miembros (16 pacientes) y de trauma abdominal (18 pacientes) fue en el grupo B.Conclusiones. El traumatismo craneoencefálico es la lesión más común en los menores de 2 años. El grupo de 3 a 10 años presentó la mayor incidencia de fracturas de los miembros y de trauma abdominal. En el grupo de 11 a 16 años el patrón lesional es semejante al del adulto.