• Physical Therapy Korea
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• v.28 no.2
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• pp.123-131
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• 2021

Background: Only 2% of falls in older adults result in serious injuries (i.e., hip fracture). Therefore, it is important to differentiate injurious versus non-injurious falls, which is critical to develop effective interventions for injury prevention. Objects: The purpose of this study was to a. extract the best features of surface electromyography (sEMG) for classification of injurious falls, and b. find a best model provided by data mining techniques using the extracted features. Methods: Twenty young adults self-initiated falls and landed sideways. Falling trials were consisted of three initial fall directions (forward, sideways, or backward) and three knee positions at the time of hip impact (the impacting-side knee contacted the other knee ("knee together") or the mat ("knee on mat"), or neither the other knee nor the mat was contacted by the impacting-side knee ("free knee"). Falls involved "backward initial fall direction" or "free knee" were defined as "injurious falls" as suggested from previous studies. Nine features were extracted from sEMG signals of four hip muscles during a fall, including integral of absolute value (IAV), Wilson amplitude (WAMP), zero crossing (ZC), number of turns (NT), mean of amplitude (MA), root mean square (RMS), average amplitude change (AAC), difference absolute standard deviation value (DASDV). The decision tree and support vector machine (SVM) were used to classify the injurious falls. Results: For the initial fall direction, accuracy of the best model (SVM with a DASDV) was 48%. For the knee position, accuracy of the best model (SVM with an AAC) was 49%. Furthermore, there was no model that has sensitivity and specificity of 80% or greater. Conclusion: Our results suggest that the classification model built upon the sEMG features of the four hip muscles are not effective to classify injurious falls. Future studies should consider other data mining techniques with different muscles.

• Physical Therapy Korea
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• v.28 no.3
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• pp.161-167
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• 2021

Understanding sciences behind fall-related hip fractures in older adults is important to develop effective interventions for prevention. The aim of this review is to provide biomechanical understanding and prevention strategies of falls and related hip fractures in older adults, in order to guide future research directions from biomechanical perspectives. While most hip fractures are due to a fall, a few of falls are injurious causing hip fractures, and most falls are non-injurious. Fall mechanics are important in determining injurious versus non-injurious falls. Many different biomechanical factors contribute to the risk of hip fracture, and effects of each individual factors are known well. However, combining effects, and correlation and causation among the factors are poorly understood. While fall prevention interventions include exercise, vision correction, vitamin D intake and environment modification, injury prevention strategies include use of hip protectors, compliant flooring and safe landing strategies, vitamin D intake and exercise. While fall risk assessments have well been established, limited efforts have been made for injury risk assessments. Better understanding is necessary on the correlation and causation among factors affecting the risk of falls and related hip fractures in older adults. Development of the hip fracture risk assessment technique is required to establish more efficient intervention models for fall-related hip fractures in older adults.

• Journal of Korean Academy of Nursing
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• v.45 no.4
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• pp.469-482
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• 2015

Purpose: The purpose of this study was to identify which nursing interventions are the most effective in fall prevention for hospitalized patients. Methods: From 3,675 papers searched, 34 were selected for inclusion in the meta-analysis. Number of fallers, falls, falls per 1,000 hospital-days, and injurious falls, fall protection activity, knowledge related to falls, and self-efficacy about falls were evaluated as outcome variables. Data were analyzed using the Comprehensive Meta Analysis (CMA) 2.2 Version program and the effect sizes were shown as the Odd Ratio (OR) and Hedges's g. Results: Overall effect size of nursing interventions for fall prevention was OR=0.64 (95% CI: 0.57~0.73, p <.05) and Hedges's g= - 0.24. The effect sizes (OR) of each intervention ranged from 0.34 to 0.93, and the most effective nursing intervention was the education & environment intervention (OR=0.34, 95% CI: 0.28~0.42, p<.001), followed by education intervention (OR=0.57, 95% CI: 0.50~0.67, p=.001). Subgroup analyses showed that multifaceted interventions (OR=0.76, 95% CI: 0.73~0.79, p<.001) were more effective than unifactorial interventions, and that activities for prevention of falls (OR=0.08, 95% CI: 0.05~0.15, p<.001) showed the largest effect size among outcome variables. Conclusion: Falls in hospitalized patients can be effectively prevented using the nursing interventions identified in this study. These findings provide scientific evidence for developing and using effective nursing interventions to improve the safety of hospitalized patients.

• Journal of The Korean Society of Clinical Toxicology
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• v.21 no.2
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• pp.69-80
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• 2023

Purpose: Suicide ranks among the top causes of death among youth in South Korea. This study aimed to identify the characteristics of suicidal individuals treated at emergency departments between 2011 and 2020. Methods: A retrospective analysis was conducted using data from January 2011 to December 2020 in the Injury Surveillance Cohort, a prospective registry. Patients' sex, age, mortality, methods of self-harm, and previous suicide attempts were analyzed. The methods of self-harm were categorized into falls, asphyxiation, blunt injuries, penetrating injuries, poisoning, and others. Sub-groups with and without poisoning were compared. Results: The proportion of self-harm/suicide attempts increased from 2.3% (2011) to 5.0% (2020). The mortality rate decreased from 10.8% (2011) to 6.3% (2020). Poisoning was the most common method (61.7%). Mortality rates ranged from 42.0% for asphyxiation to 0.2% for blunt injuries. Individuals in their 20s showed a marked increase in suicide/self-harm attempts, especially in the last three years. A large proportion of decedents in their 70s or older (52.6%) used poisoning as a method of suicide. The percentage of individuals with two or more previous attempts rose from 7.1% (2011) to 19.7% (2020). The death rates by poisoning decreased from 7.7% (2011) to 2.5% (2020). Conclusion: Our findings underscore the urgent need for targeted interventions and suicide prevention policies. Managing and reducing suicide and self-harm in emergency settings will require a focus on poisoning, the 10-29 age group, and the elderly. This paper will be valuable for future policies aiming to reduce the societal burden of suicide and self-harm.