Feet kinematics upon slipping discriminate between recoveries and three types of slip-induced falls

This study investigated the relationship between feet kinematics upon slipping while walking and the outcome of the slip. Seventy-one slips (induced by walking over an unexpectedly slippery surface) were analysed, which included 37 recoveries, 16 feet-split falls, 11 feet-forward falls and seven lateral falls. Feet kinematics differed between recoveries and three types of slip-induced falls, and a discriminant model including six measures of feet kinematics correctly predicted 87% of slip outcomes. Two potentially modifiable characteristics of the feet kinematics upon slipping that can improve the likelihood of successfully averting a fall were identified: (1) quickly arresting the motion of the slipping foot and (2) a recovery step that places the trailing toe approximately 0–10% body height anterior to the sacrum. These results may inform the development of task-specific balance training interventions that promote favourable recovery responses to slipping.

Practitioner Summary: This study investigated the relationship between feet movements upon slipping and outcomes of the slip. Potentially modifiable characteristics that can reduce the likelihood of falling were: (1) quickly arresting slipping foot motion and (2) a recovery step that places the trailing toe approximately 0–10% body height anterior to the sacrum.     

Duration of slip-resistant shoe usage and the rate of slipping in limited-service restaurants: results from a prospective and crossover study

Several studies have indicated that slip-resistant shoes may have a positive effect on reducing the risk of slips and falls, a leading cause of injury at work. Few studies, however, have examined how duration of shoe usage affects their slip-resistance properties. This study examined the association between the duration of slip-resistant shoes usage and the self-reported rate of slipping in limited-service restaurant workers. A total of 475 workers from 36 limited-service restaurants in the USA were recruited to participate in a 12-week prospective study of workplace slipping. Of the 475 participants, 83 reported changing to a new pair of shoes at least once during the 12-week follow-up. The results show that slip-resistant shoes worn for less than six months were moderately more effective than those worn for more than six months. Changing to a new pair of shoes among those wearing slip-resistant shoes at baseline was associated with a 55% reduction in the rate of slipping (RR = 0.45, 95% CI = 0.23–0.89). Further research is needed to develop criteria for the replacement of slip-resistant shoes.

Practitioner Summary: The duration of usage impacts the slip-resistance properties of slip-resistant shoes. Slip-resistant shoes worn for less than six months were moderately more effective in reducing slips than slip-resistant shoes worn for more than six months. Shoe use policies should not only encourage or require their use but also include guidance on replacing slip-resistant shoes at regular intervals.     

State of science: occupational slips,trips and falls on the same level*

Occupational slips, trips and falls on the same level (STFL) result in substantial injuries worldwide. This paper summarises the state of science regarding STFL, outlining relevant aspects of epidemiology, biomechanics, psychophysics, tribology, organisational influences and injury prevention. This review reaffirms that STFL remain a major cause of workplace injury and STFL prevention is a complex problem, requiring multi-disciplinary, multi-faceted approaches. Despite progress in recent decades in understanding the mechanisms involved in STFL, especially slipping, research leading to evidence-based prevention practices remains insufficient, given the problem scale. It is concluded that there is a pressing need to develop better fall prevention strategies using systems approaches conceptualising and addressing the factors involved in STFL, with considerations of the full range of factors and their interactions. There is also an urgent need for field trials of various fall prevention strategies to assess the effectiveness of different intervention components and their interactions.

Practitioner Summary: Work-related slipping, tripping and falls on the same level are a major source of occupational injury. The causes are broadly understood, although more attention is needed from a systems perspective. Research has shown preventative action to be effective, but further studies are required to understand which aspects are most beneficial.     

Straight ladder inclined angle in a field environment: the relationship among actual angle,method of set-up and knowledge

Ladder inclined angle is a critical factor that could lead to a slip at the base of portable straight ladders, a major cause of falls from heights. Despite several methods established to help workers achieve the recommended 75.5° angle for ladder set-up, it remains unclear if these methods are used in practice. This study explored ladder set-up behaviours in a field environment. Professional installers of a company in the cable and other pay TV industry were observed for ladder set-up at their worksites. The results showed that the actual angles of 265 ladder set-ups by 67 participants averaged 67.3° with a standard deviation of 3.22°. Although all the participants had training on recommended ladder set-up methods, only 3 out of 67 participants applied these methods in their daily work and even they failed to achieve the desired 75.5° angle. Therefore, ladder set-up remains problematic in real-world situations.

Practitioner Summary: Professional installers of a cable company were observed for portable straight ladder set-up at their worksites. The ladder inclined angle averaged 67.3° with a standard deviation of 3.22°, while the recommended angle is 75.5°. Only a few participants used the methods that they learned during training in their daily work.     

Optimal fall indicators for slip induced falls on a cross-slope

Slip-induced falls are among the most common cause of major occupational injuries in the UK as well as being a major public health concern in the elderly population. This study aimed to determine the optimal fall indicators for fall detection models which could be used to reduce the detrimental consequences of falls. A total of 264 kinematic variables covering three-dimensional full body model translation and rotational measures were analysed during normal walking, successful recovery from slips and falls on a cross-slope. Large effect sizes were found for three kinematic variables which were able to distinguish falls from normal walking and successful recovery. Further work should consider other types of daily living activities as results show that the optimal kinematic fall indicators can vary considerably between movement types.

Practitioner Summary: Fall detection models are used to minimise the adverse consequences of slip-induced falls, a major public health concern. Optimal fall indicators were derived from a comprehensive set of kinematic variables for slips on a cross-slope. Results suggest robust detection of falls is possible on a cross-slope but may be more difficult than level walking.     

Predicting slips based on the STM 603 whole-footwear tribometer under different coefficient of friction testing conditions

Assessing footwear slip-resistance is critical to preventing slip and fall accidents. The STM 603 (SATRA Technology) is commonly used to assess footwear friction but its ability to predict human slips while walking is unclear. This study assessed this apparatus’ ability to predict slips across footwear designs and to determine if modifying the test parameters alters predictions. The available coefficient of friction (ACOF) was measured with the device for nine different footwear designs using 12 testing conditions with varying vertical force, speed and shoe angle. The occurrence of slipping and the required coefficient of friction was quantified from human gait data including 124 exposures to liquid contaminants. ACOF values varied across the test conditions leading to different slip prediction models. Generally, a steeper shoe angle (13°) and higher vertical forces (400 or 500?N) modestly improved predictions of slipping. This study can potentially guide improvements in predictive test conditions for this device.

Practitioner Summary: Frictional measures by the STM603 (SATRA Technology) were able to predict human slips under liquid contaminant conditions. Test parameters did have an influence on the measurements. An increased shoe-floor testing angle resulted in better slip predictions than test methods specified in the ASTM F2913 standard.     

The addition of stripes (a version of the ‘horizontal-vertical illusion’) increases foot clearance when crossing low-height obstacles

Trips over obstacles are one of the main causes of falling in older adults, with vision playing an important role in successful obstacle negotiation. We determined whether a horizontal-vertical illusion, superimposed onto low-height obstacles to create a perceived increase in obstacle height, increased foot clearances during obstacle negotiation thus reducing the likelihood of tripping. Eleven adults (mean ± 1?SD: age 27.3 ± 5.1 years) negotiated obstacles of varying heights (3, 5, 7 cm) with four different appearance conditions; two were obstacles with a horizontal-vertical illusion (vertical stripes of different thickness) superimposed on the front, one was a plain obstacle and the fourth a plain obstacle with a horizontal black line painted on the top edge. Foot clearance parameters were compared across conditions. Both illusions led to a significant increase in foot clearance when crossing the obstacle, compared to the plain condition, irrespective of obstacle height. Superimposing a horizontal-vertical illusion onto low-height obstacles can increase foot clearance, and its use on the floor section of a double-glazing door frame for example may reduce the incidence of tripping in the home.

Practitioner Summary: Low-height obstacles such as the floor section of a double-glazing door frame are potential tripping hazards. In a gait lab-based study we found that a horizontal-vertical illusion superimposed onto low-height obstacles led to significantly higher foot clearances; indicating their potential as a useful safety measure.     

The effect of age on in-vivo spine stiffness,postures and discomfort responses during prolonged sitting exposures

Many industrialised working populations are ageing and prolonged sitting exposures are prevalent across occupational sectors. The purpose of this work was to determine the effect of age and sex on passive spine stiffness, postures and discomfort in response to seated work. A total of 34 participants were recruited, with 17 older adults with an average age of (standard deviation) 63.7 (±3.9) years and 17 younger adults aged 23.8 (±5.0) years. Participants were asked to sit continuously for 90?min while typing. Baseline passive spine stiffness was higher in older adults at 40% flexion compared to younger adults (p?=?.0233). Older adults sat in less normalised flexion, at 33.4% (±16.4) compared to 60.9% (±20.2) in the younger group (p?=?.0003). Discomfort was higher among older adults in the neck, right shoulder and middle back regions (p?<?.0086). An understanding of age-specific responses to workplace exposures is essential to determine whether age-specific interventions are warranted.

 

Practitioner summary: Older adults had higher passive spine stiffness and sat with less flexion during prolonged sitting. Discomfort was higher among older adults and occurred earlier in the simulation compared to younger participants, indicating that interventions, such as walking breaks may need to be implemented earlier during sitting for aged workers.     

Slip resistance of winter footwear on snow and ice measured using maximum achievable incline

Protective footwear is necessary for preventing injurious slips and falls in winter conditions. Valid methods for assessing footwear slip resistance on winter surfaces are needed in order to evaluate footwear and outsole designs. The purpose of this study was to utilise a method of testing winter footwear that was ecologically valid in terms of involving actual human testers walking on realistic winter surfaces to produce objective measures of slip resistance. During the experiment, eight participants tested six styles of footwear on wet ice, on dry ice, and on dry ice after walking over soft snow. Slip resistance was measured by determining the maximum incline angles participants were able to walk up and down in each footwear–surface combination. The results indicated that testing on a variety of surfaces is necessary for establishing winter footwear performance and that standard mechanical bench tests for footwear slip resistance do not adequately reflect actual performance.

Practitioner Summary: Existing standardised methods for measuring footwear slip resistance lack validation on winter surfaces. By determining the maximum inclines participants could walk up and down slopes of wet ice, dry ice, and ice with snow, in a range of footwear, an ecologically valid test for measuring winter footwear performance was established.     

Driving comfort,enjoyment and acceptance of automated driving – effects of drivers’ age and driving style familiarity

Automated driving has the potential to improve the safety and efficiency of future traffic and to extend elderly peoples’ driving life, provided it is perceived as comfortable and joyful and is accepted by drivers. Driving comfort could be enhanced by familiar automated driving styles based on drivers’ manual driving styles. In a two-stage driving simulator study, effects of driving automation and driving style familiarity on driving comfort, enjoyment and system acceptance were examined. Twenty younger and 20 older drivers performed a manual and four automated drives of different driving style familiarity. Acceptance, comfort and enjoyment were assessed after driving with standardised questionnaires, discomfort during driving via handset control. Automation increased both age groups’ comfort, but decreased younger drivers’ enjoyment. Younger drivers showed higher comfort, enjoyment and acceptance with familiar automated driving styles, whereas older drivers preferred unfamiliar, automated driving styles tending to be faster than their age-affected manual driving styles.

Practitioner Summary: Automated driving needs to be comfortable and enjoyable to be accepted by drivers, which could be enhanced by driving style individualisation. This approach was evaluated in a two-stage driving simulator study for different age groups. Younger drivers preferred familiar driving styles, whereas older drivers preferred driving styles unaffected by age.     

Influence of smartphone use styles on typing performance and biomechanical exposure

Twenty-seven subjects completed 2-min typing tasks using four typing styles: right-hand holding/typing (S-thumb) and two-hand typing at three heights (B-low, B-mid and B-high). The styles had significant effects on typing performance, neck and elbow flexion and muscle activities of the right trapezius and several muscles of the right upper limb (p < 0.0001 by repeated-measure analysis of variance). The subjects typed the fewest words (error-adjusted characters per minute: 78) with the S-thumb style. S-thumb style resulted in similar flexion angles of the neck, elbow and wrist, but significantly increased muscle activities in all tested muscles compared with the B-mid style. Holding the phone high or low reduced the flexion angles of the neck and right elbow compared with the B-mid style, but the former styles increased the muscle activity of the right trapezius. Right-hand holding/typing was not a preferable posture due to high muscle activities and slow typing speed.

Practitioner Summary: Right-hand holding/typing was not favoured, due to increased muscle activities and slower typing speed. Holding the phone high or low reduced the flexion angles of the neck and right elbow, but the former styles increased the muscle activity of the right trapezius compared with holding the phone at chest level.     

Staying on your feet: the effectiveness of posture and handles in counteracting balance perturbation

Stairways, public transport and inclined walkways are often considered as sites with higher likelihood of falls due to a sudden loss of balance. Such sites are usually marked with warning signs, equipped with non-slip surfaces and handles or handrails to avert or decrease this likelihood. Especially, handles are supposed to provide additional support in cases of a sudden loss of balance. However, the mechanisms of using handles for balance at different heights are not yet fully disclosed. We simulated full body perturbations by applying an anterior force to the waist and investigated effectiveness and mechanisms of balance recovery in five different postures: step stance and normal stance with or without holding handles at different heights. Results indicate that both step stance and holding handles at different vertical positions sufficiently assist balance recovery, compared to normal stance. While there was no significant effect of handle in CoM displacement, the shoulder height handle required the lowest handle force, indicating a difference in using the handle.

Practitioner summary: To investigate handle use for balance recovery, we perturbed healthy young adults in different standing positions. Even though the use of different handles had a similar effect, the lowest forces were exerted on the shoulder height handle indicating a preferred handle position for balance recovery.

Abbreviation: AP: antero-posterior; CNS: Central nervous system; CoM: Center of Mass; CoMmax: Maximal displacement of the center of mass; CoP: Center of pressure; FHmax: Maximal resultant force exerted on the handle; hFHmax: Maximal horizontal force exerted on the handle; vFHmax; Maximal vertical force exerted on the handle; M1-M8: Perturbation force magnitude     

The three-dimensional shapes of underground coal miners’ feet do not match the internal dimensions of their work boots

Mining work boots provide an interface between the foot and the ground, protecting and supporting miners’ feet during lengthy coal mining shifts. Although underground coal miners report the fit of their work boots as reasonable to good, they frequently rate their boots as uncomfortable, suggesting that there is a mismatch between the shape of their feet and their boots. This study aimed to identify whether dimensions derived from the three-dimensional scans of 208 underground coal miners’ feet (age 38.3 ± 9.8 years) differed from the internal dimensions of their work boots. The results revealed underground coal miners wore boots that were substantially longer than their feet, possibly because boots available in their correct length were too narrow. It is recommended boot manufacturers reassess the algorithms used to create boot lasts, focusing on adjusting boot circumference at the instep and heel relative to increases in foot length.

Practitioner Summary: Fit and comfort ratings suggest a mismatch between the shape of underground coal miners’ feet and their boots exists. This study examined whether three-dimensional scans of 208 miners’ feet differed from their boot internal dimensions. Miners wore boots substantially longer than their feet, possibly due to inadequate width.     

Effects of accessible website design on nondisabled users: age and device as moderating factors

This study examined how implementing recommendations from Web accessibility guidelines affects nondisabled people in different age groups using different technical devices. While recent research showed positive effects of implementing such recommendations for nondisabled users, it remains unclear whether such effects would apply to different age groups and kind of devices. A 2 × 2 × 2 design was employed with website accessibility (high accessibility vs. very low accessibility), age (younger adults vs. older adults) and type of device (laptop vs. tablet) as independent variables. 110 nondisabled participants took part in a usability test, in which performance and satisfaction were measured as dependent variables. The results showed that higher accessibility increased task completion rate, task completion time and satisfaction ratings of nondisabled users. While user age did not have any effects, users showed faster task completion time under high accessibility when using a tablet rather than a laptop. The findings confirmed previous findings, which showed benefits of accessible websites for nondisabled users. These beneficial effects may now be generalised to a wide age range and across different devices.

Practitioner Summary: This work is relevant to the design of websites since it emphasises the need to consider the characteristics of different user groups. Accessible website design (aimed at users with disabilities) leads to benefits for nondisabled users across different ages. These findings provide further encouragement for practitioners to apply WCAG 2.0.     

A comfort assessment of existing cervical orthoses

Purpose: Identify location and intensity of discomfort experienced by healthy participants wearing cervical orthoses.

Method: Convenience sample of 34 healthy participants wore Stro II, Philadelphia, Headmaster, and AspenVista^® cervical orthoses for four-hour periods. Participants reported discomfort level (scale 0–6) and location.

Results: Participants reported mean discomfort for all orthoses over the four-hour test between ‘a little discomfort’ and ‘very uncomfortable’ (mean discomfort score = 1.64, SD = 1.50). Seven participants prematurely stopped tests due to pain and six reported maximum discomfort scores. Significant linear increase in discomfort with duration of wear was found for all orthoses. Significantly less discomfort was reported with Stro II than Headmaster and Philadelphia. Age correlated with greater perceived discomfort. Orthoses differed in the location discomfort was experienced.

Conclusion: Existing cervical orthoses cause discomfort influenced by design and duration of wear with orthoses’ design the more significant factor. This work informed the design of a new orthosis and future orthoses developments.

Practitioner Summary: The purpose of this study was to gain greater knowledge about the discomfort caused by wearing of existing neck orthoses in order to inform the design and development of a new neck orthosis. This study gathers empirical data from a surrogate population and concludes that orthosis design is more influential than the duration of wear.     

Thermal and cardiovascular strain imposed by motorcycle protective clothing under Australian summer conditions

Motorcycle protective clothing can be uncomfortably hot during summer, and this experiment was designed to evaluate the physiological significance of that burden. Twelve males participated in four, 90-min trials (cycling 30 W) across three environments (25, 30, 35 °C [all 40% relative humidity]). Clothing was modified between full and minimal injury protection. Both ensembles were tested at 25 °C, with only the more protective ensemble investigated at 30 and 35 °C. At 35 °C, auditory canal temperature rose at 0.02 °C min^?1 (SD 0.005), deviating from all other trials (p < 0.05). The thresholds for moderate (>38.5 °C) and profound hyperthermia (>40.0 °C) were predicted to occur within 105 min (SD 20.6) and 180 min (SD 33.0), respectively. Profound hyperthermia might eventuate in ~10 h at 30 °C, but should not occur at 25 °C. These outcomes demonstrate a need to enhance the heat dissipation capabilities of motorcycle clothing designed for summer use in hot climates, but without compromising impact protection.

Practitioner’s Summary:

Motorcycle protective clothing can be uncomfortably hot during summer. This experiment was designed to evaluate the physiological significance of this burden across climatic states. In the heat, moderate (>38.5 °C) and profound hyperthermia (>40.0 °C) were predicted to occur within 105 and 180 min, respectively.     

Notifications Efficiency,Impact, and Interference in Second-Screen Scenarios

The growing use of second-screen devices stresses the importance of finding a balance between engagement, distraction, and disturbance of its users, while simultaneously watching television. In this framework, this article reports on a study designed to analyze the efficiency, impact, and interference of different notification strategies aiming to identify the best approach to be used when an alert is needed in second-screen scenarios.

A prototype able to deliver synchronized information related with TV content, with intervals of 10, 30 and 60 s, followed by individual or combined notifications (e.g., audio, visual, and haptic—on the tablet and visual—on the TV) was developed. A laboratory adapted to replicate a living room was set up and a test that involved watching three segments of a 20-min clip while using the prototype was carried with 30 participants, under a cognitive walk-through protocol.

Quantitative and qualitative results show that receiving notifications while watching TV is effective in alerting users about new information, despite its inherent cognitive disturbance for the TV viewing experience. It was also possible to highlight that in an HCI perspective, the most suitable strategy for integrating notifications (considering type and cadence) should be based on a combination of a visual notification (displayed only on the TV screen) along with a haptic notification (vibration on the tablet); spaced by an interval of at least 30 s.     

The ageing Australian firefighter: an argument for age-based recruitment and fitness standards for urban fire services

Currently, there is no enforcement of physical standards within Australian fire services post-recruitment, possibly leading to inappropriate fitness and body composition. This study evaluated the impacts of ageing on physical standards of Australian firefighters. Seventy-three firefighters from three different 10-year age groups [25–34 years (n = 27), 35–44 years (n = 27), 45–54 years (n = 19)] volunteered for physical testing using dual-energy X-ray analysis and existing fitness tests used for recruitment by an Australian fire service. Older (45–54 years) participants demonstrated significantly poorer physical standards compared with younger participants including cardiovascular fitness (p < 0.05), strength (p = 0.001) and simulated operational power testing tasks (p < 0.001). Age-related body composition changes were also observed independent of body mass index. Minimum recruitment standards and fitness programs need to account for age-related declines in physical capabilities to ensure that the minimum standard is maintained regardless of age.

Practitioner Summary: Using dual-energy X-ray analysis and established fitness testing protocols, this study aimed to gain an appreciation of the current standards of body composition and fitness of Australian firefighters and the effects of ageing on their physical abilities post-recruitment. The study demonstrated a significant decline in physical standards due to age.     

An observational comparison of the older and younger bus passenger experience in a developing world city

This study was an unobtrusive observational analysis of 333 older and younger bus passengers in Guadalajara, Mexico. A set of data were collected for each observed passenger, as well as more general observations related to driver behaviour, bus design and bus service characteristics. There were significant differences between older and younger passengers in terms of boarding and alighting times, use of handrails, seat location preferences, passenger stability and coping strategies in order to maintain postural stability. The conditions of travel are conducive to a poor passenger experience for the older passengers in particular. Although the problems may be attributed to bus design and driver behaviour typical of that in developing countries, they are also influenced by the wider transport infrastructure, and a lack of a regulatory regime which places drivers under time pressure and in direct competition with each other.

Practitioner Summary: Bus services must cater for all ages of passengers, including the elderly. This unobtrusive observational study investigated the passenger experience in a developing world city. Bus and wider service design were found to compromise the journey experience, with the older users being particularly negatively impacted. Design recommendations are provided.