User-specific factors associated with ladder handrail use Jami Stuckeya, Michelle Tsizhovkina, Kurt Beschornera, Erika Plinerb, Daina Sturnieksb, Stephen Lordb Human Movement and Balance Laboratory, Department of Bioengineering, bFalls, Balance, and Injury Research Centre, Neuroscience Research Australia a
Jami Stuckey
Jami Stuckey is an undergraduate biomedical engineering student at the University of Pittsburgh. Her research interests include biomechanics and rehabilitation engineering. After her time at the Human Movement and Balance Laboratories, she accepted a co-op program with the Human Engineering Research Laboratories. Kurt Beschorner is an Associate Professor of Bioengineering at the University of Pittsburgh. He utilizes techniques in tribology, biomechanics and ergonomics to generate understanding and interventions for falling accidents.
Kurt Beschorner, Ph.D.
Significance Statement
Understanding user-specific factors of ladder fall risk in older adults is important since ladder falls are a frequent cause of injury and fatality among this population. This study found greater risk-taking, as measured by a survey tool, was associated with less use of a safety handrail. Therefore, promoting less risk-taking behaviors may promote safer use of ladders.
Category: Experimental Research
Keywords: Ladder safety, fall risk, handrail use, user-specific factors, individual factors Abbreviations: Physiological Profile Assessment (PPA), Mini-Mental State Exam (MMSE)
90 Undergraduate Research at the Swanson School of Engineering
Abstract
Unintentional injuries and fatalities caused by ladder falls are especially common among retirement-age adults living independently at home. Past research has focused on environmental factors that increase one’s fall risk, but there is a lack of knowledge on user-specific factors that promote safe ladder use. This study recruited older adult participants to determine the user-specific factors that influence an individual’s ladder handrail use during a domestic ladder task. Two trials of the ladder task were completed, one without a cognitive distraction (single task) and one while naming animals (dual task). Investigated user-specific factors comprised of physical ability, measured by the Physiological Profile Assessment (PPA); global cognition, measured by the Mini-Mental State Exam (MMSE); and risk-taking, measured by a self-assessment. Through Spearman’s ρ correlation analyses, this study found greater risk-taking to be associated with less use of the ladder safety handrail (ρsingle = -0.418, p < 0.0001; ρdual = -0.466, p < 0.0001). Focusing interventions to reduce propensity for risk-taking may promote safer use of ladders.
1. Introduction
Ladder falls are a frequent cause of unintentional injuries and fatalities; the estimated annual cost of ladder injuries in the U.S. is $24 billion [1,2]. Ladder injuries are particularly common among older adults at home (aged 65+ years) [1], but past ladder safety research has focused on falls of adults occurring at the workplace [3-5]. Similar investigation of ladder falls in older people working from home is emerging, yet gaps in our understanding remain. Furthermore, previous research has primarily studied the influence of environmental factors on ladder fall risk [6,7], and there is limited knowledge on user-specific factors that influence safe ladder use. Handrail use is a presumed safety strategy that can improve balance and enhance a person’s response to a destabilizing balance perturbation [8]. Not all individuals use the ladder handrails while on a stepladder, but there is a lack of knowledge characterizing handrail use. Relevant factors of general fall risk in older adults include physiological, cognitive, and psychological traits and abilities [9]. Thus, these user-specific factors may also be relevant to handrail use. This study quantifies the relationship of sensorimotor function (physiological factor), global cognition (cognitive factor), and risk taking (psychological factor) with handrail use of older adults when changing a lightbulb on a common household stepladder. The goal of this study is to improve current strategies for preventing unintentional ladder falls. We hypothesized that the user-specific factors would be associated with handrail use.
