2022, Volume 18, Issue 1
Innovative method of diagnosing the susceptibility to the body injuries during the fall of children from 2 to 6 years
Roman Maciej Kalina1, Natalia Dłubacz2, Judyta Zachwieja2, Paulina Piekarska2, Dawid Dobosz3, Bartłomiej Gąsienica Walczak4
1EKO-AGRO-FITNES Prof. Roman M. Kalina, Piwniczna Zdroj, Poland
2Independent physiotherapist, -, Poland
3Physiotherapist at EPIONE Sp. z o.o., Katowice, Poland
4Health Institute, Podhale State College of Applied Sciences in Nowy Targ, Nowy Targ, Poland
Author for correspondence: Bartłomiej Gąsienica Walczak; Health Institute, Podhale State College of Applied Sciences in Nowy Targ, Nowy Targ, Poland; email: bgw@interia.pl
Abstract
Background & Study Aim: Fall is inherent in people’s physical activity. It occurs through entire human ontogenesis and is unavoidable (the risk of fall is reduced only in people who stay in bed for longer periods of time or their whole life). Falls occur the most frequently in childhood, especially during the first years of life (adopting an upright posture and beginning of locomotion). However, if the environment meets certain conditions (essentially soft surface), children who don’t suffer from any neurological dysfunctions will fall safely. Children’s motor response to fall changes with increasing age. It includes shock absorption with hands and large parts of the trunk (both done simultaneously or one after another) during a collision with the ground. The cognitive aim of the study is knowledge about errors in controlling distal parts of the body in children (from 2 to 6 years old) during forced fall (laboratory conditions), whereas application aim is the recommendation of an innovative method to diagnose such phenomenon.
Material & Methods: Study group consisted of 191 children at the age of: 2 years (n = 34); 3- (n = 32); 4- (n = 47); 5- (n = 39); 6- (n = 39) years old. Each of them was diagnosed independently by a physiotherapist (woman) during a special session on a soft surface. The child started the session by rolling the rehabilitation ball during walking or trotting backwards. The physiotherapist (at any time she decided) knocked the ball aside to make the child fall (task 1: force acting below the child’s centre of gravity). After at least three falls physiotherapist introduced the next play – the child was instructed to pull a judo belt held by a physiotherapist and try to drag him to a predetermined place (task 2: force acting around the child’s centre of gravity, when the physiotherapist unexpectedly released the grip). After at least three falls last play was introduced. A physiotherapist was holding a toy above the child’s head. The child was reaching for it (with one or both hands) during walking backwards until got to a pile of mattresses; the child tripped and fell (task 3: force applied simultaneously over and below the child’s centre of gravity). Every session has no time restriction.
The physiotherapist recorded a number of falls during each task taking criteria concerning quality (correct/incorrect) control of distal parts of the body (hands, head) during a collision with the ground into consideration. SFI index (susceptibility to the body injuries during the fall) is a proportion of the number of falls with at least one error related to control of distal parts of the body (numerator) to the number of falls during a diagnostic session (denominator). The diagnosis was qualified for the analysis if was based on at least 9 falls (three for each task) and this criterion was met for all children.
Results: The shortest session lasted 10 minutes (the child was not interested in continuing play), and the longest was 40 minutes (but some children demonstrated dissatisfaction because the play ended). All children fell 2616 times in total. The 38.23% of 2-year-old children make no errors in controlling distal parts of the body (there was only one such child in each of the other age populations). Almost all 6-year-old children (84.61%) make some errors (in proportion to all possible, from 61% to 100%). The lowest value of the SFI index was in the population of 2-year-old children (7.66%). In general, the older children population (3-, 4-, 5-, 6-year-old), the higher value of the SFI index (21.53%; 41.08%; 65.14%; 73.34% respectively). Differences between proportions are statistically significant: p<0.001 (between 5- and 6-year-old children: p<0.05; non-directional versus test).
Conclusions: The main finding of this study is that the older child, the higher likelihood of injury to distal parts of the body (especially hands) as a consequence of a backward fall. The younger the child who makes frequent errors in controlling distal body parts during forced fall, the higher probability of occurrence of neurological deficits and suffering a bodily injury in similar situations later in life. The most critical recommendation is that children (since the third year of life) should regularly (several times a day) participate in such plays allowing for preserving their natural aptitude to control distal parts of the body during a fall.
Key words: fun forms of martial arts, ontogenesis, safe fall theory
