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Environmental objects (such as furniture, walls, and handrails) may act as hazards or facilitators to balance maintenance and safe landing. There is lack of objective evidence on how older adults interact with objects during falls. We addressed this gap by characterizing body part contacts with objects other than the floor during real-life falls in long-term care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed videos of 1759 falls experienced by 584 residents to characterize the prevalence of contacts with objects before, during, and after fall initiation. Using generalized estimating equations, we compared the prevalence of falls with versus without contact to objects after fall initiation. Using linear mixed models, we tested for differences across body parts in the probability of contacting objects after fall initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In nearly one-third of falls, interactions with objects (e.g., trips over objects, loss of support with objects) or with other people (e.g., being pushed by another person) had a primary role in causing imbalance and initiating the fall. After fall initiation, participants contacted objects in 60% of falls, with intentional hand contacts to objects via reach-to-grasp or bracing being the most common type of interaction (Probability\u2009\u00b1\u2009SE\u2009=\u20090.32\u2009\u00b1\u20090.01), followed by unintentional impacts to the torso (0.21\u2009\u00b1\u20090.01) and head (0.16\u2009\u00b1\u20090.01). Intentional hand contact to an object was more common during forward than backward falls (\n                      <jats:italic>p\u2009&lt;\u2009<\/jats:italic>\n                      0.001), while head and torso contacts to objects were more common during backward and sideways falls than forward falls (multiple\n                      <jats:italic>p<\/jats:italic>\n                      values\u2009\u2264\u20090.003). The hand most often contacted chairs, wheelchairs or couches, followed by tables or counters, walls, other people,\u00a0walkers, and handrails. The head, torso, and shoulder most often contacted a wall.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most falls in long-term care involved contacts with objects other than the ground, indicating that complex environments often accompany falls in long-term care. Higher probabilities of intentional hand contacts in forward falls, versus unintentional head and torso impacts in backward and sideways falls may reflect the influence of being able to visualize and adjust one\u2019s falling patterns to nearby objects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12877-024-05306-5","type":"journal-article","created":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T04:02:18Z","timestamp":1725249738000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Interactions during falls with environmental objects: evidence from real-life falls in long-term care captured on video"],"prefix":"10.1186","volume":"24","author":[{"given":"Nataliya","family":"Shishov","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicki","family":"Komisar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel S.","family":"Marigold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-S\u00e9bastien","family":"Blouin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen N.","family":"Robinovitch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,9,2]]},"reference":[{"key":"5306_CR1","unstructured":"World Health Organization, Falls. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/falls. 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Med Biol Eng Comput. 2017;55(1):45\u201355.","journal-title":"Med Biol Eng Comput."}],"container-title":["BMC Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-024-05306-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12877-024-05306-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-024-05306-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T05:06:46Z","timestamp":1725253606000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgeriatr.biomedcentral.com\/articles\/10.1186\/s12877-024-05306-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,2]]},"references-count":48,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["5306"],"URL":"https:\/\/doi.org\/10.1186\/s12877-024-05306-5","relation":{},"ISSN":["1471-2318"],"issn-type":[{"value":"1471-2318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,2]]},"assertion":[{"value":"21 March 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 August 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 September 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in accordance with the Declaration of Helsinki. This study protocol was reviewed by the Office of Research Ethics at Simon Fraser University (protocol number H21-00741), and by the equivalent review board in the Fraser Health Authority. Upon admission to the long-term care facilities, all residents provided permission (by themselves or via a proxy) for the facility to obtain video footage in common areas (e.g. lounges, dining halls and corridors) for safety purposes. Video footage of falls and corresponding fall incident reports were shared with our research team as secondary data. A separate consent was obtained from a subset of residents to access their medical records. This consent process was also reviewed and approved by the Office of Research Ethics at Simon Fraser University (approval number H21-00741), and the by the Fraser Health Authority.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"We have secured informed consent from all individuals whose images are shown in Fig.\u00a0\n                      \n                      , or their proxy decision makers, using an institutional consent form approved by our Office of Research Ethics, for inclusion of their images in this publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"726"}}