@article{ref1,
title="Wrist and hand postures when falling and description of the upper limb falling  reflex",
journal="Injury",
year="2020",
author="Giddins, Grey and Giddins, Hugo",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="INTRODUCTION: Falling studies, i.e. assessing what happens when an individual falls,  have been conducted in controlled environments but not in field studies for ethical  reasons; this potentially limits the validity and applicability of previous studies. We performed field studies on existing YouTube © videos of skateboarders falling. The aims of these studies were to measure the wrist angle at impact on videos of  real unprotected falls and to study the dynamics of the upper limbs when falling. <br><br>METHODS: Youtube © videos of skateboarders falling were studied assessing the  direction of the fall, the positions of both upper limbs and especially the wrists  on impact quantitatively and qualitatively. This study would not be ethical by other  means. <br><br>RESULTS: In study one (the more quantitative study) there were 48 men and 50  falls. The mean elbow flexion was 30(0) (range 0(0) to 80(0)) and the mean maximal  wrist extension was 80(0) (range 50(0) to 110(0)). The second wrist extended less or  the same in > 90%. The second wrist only once (of 31) extended > 90(0) which should  minimise the risk of toppling. Falls onto only one wrist gave significantly greater  maximal wrist extension. In the second more qualitative study we observed the &quot;upper  limb falling reflex&quot; where the response to falling is for the upper limb(s) to align  the upper limb with the direction of falling of the body with the elbow mostly but  not fully extended. Initially the wrists extend c. 40(0)-50(0) with the fingers held  mildly flexed. Immediately before impact the fingers hyper-extend with some  compensatory wrist flexion to c. 30(0) of extension. The fingertips impact the  ground first followed by the hand. <br><br>CONCLUSION: These studies confirm wrist extension  at impact around 80(0) but the wrist(s) may hyper-extend risking toppling. Falls on  both wrists minimise the risk of toppling. The &quot;upper limb falling reflex&quot; is  defined; it is a rapid dynamic response leading to the fingers impacting the ground  first on falling. Abnormalities with the upper limb falling reflex may indicate  problems with development in young children and may increase the risk of injury in  older people.<p /> <p>Language: en</p>",
language="en",
issn="0020-1383",
doi="10.1016/j.injury.2020.11.056",
url="http://dx.doi.org/10.1016/j.injury.2020.11.056"
}