Ladder Use Ability, Behavior and Exposure by Age and Gender.

This study aimed to quantify and compare ladder use ability and behavior in younger and older men and women from three ladder use behavior experiments. The experimental tasks comprised (1) changing a lightbulb on a household stepladder under two cognitive demands (single and dual task), (2) clearing a simulated roof gutter on a straight ladder and (3) querying ladder choice in different exigency scenarios. Ladder use ability and behavior data were captured from recorded time, performance, motion capture and user choice data. In addition, this study surveyed ladder use frequency and habitual behaviors. The experimental findings indicate that older adults require more time to complete ladder tasks; younger adults display riskier ladder use behaviors; men and women display similar ladder use ability; and men are more willing to climb riskier ladders. The survey found older adults to report more frequent ladder use than younger adults, and men use straight ladders more frequently than women. These results suggest that the reported higher ladder fall rates experienced by older adults and men are linked to increased ladder use exposure and riskier ladder choice. This knowledge can help guide population-specific interventions to reduce ladder falls in both young and older people.

Prospective validity assessment of a friction prediction model based on tread outsole features of slip-resistant shoes.

Shoe outsole design strongly influences slip and fall risk. Certain tread features that can be readily measured have been shown to predict friction performance. This research aimed to replicate those findings and quantify their ability to predict slipping. Participants (n = 34) were exposed to a low friction oil-coated floor surface, while wearing slip-resistant shoes. The coefficient of friction (COF) of each shoe were predicted based on tread surface area, the presence of a bevel, and hardness. The COF was measured, and the slip outcome was determined. Predicted and measured COF were correlated, and measured COF was a sensitive predictor of slip outcome. The relationship of predicted COF on slip outcome was weaker than anticipated and was not statistically significant. This study partially confirmed the ability of previous regression equations to predict COF. However, the effect size was weaker than previously reported and predicted COF was not sensitive for predicting slips.

Validation of a portable shoe tread scanner to predict slip risk.

PROBLEM: Worn shoes are an important contributor to occupational slip and fall injuries. Tools to assess worn tread are emerging; imaging tools offer the potential to assist. The aim of this study was to develop a shoe tread scanner and evaluate its effectiveness to predict slip risk. METHODS: This study analyzed data from two previous studies in which worn or new slip-resistant shoes were donned during an unexpected slip condition. The shoe tread for each shoe was scanned using a portable scanner that utilized frustrated total internal reflection (FTIR) technology. The shoe tread parameters of the worn region size (WRS) for worn shoes and total contact area for new shoes were measured. These parameters were then used to predict slip risk from the unexpected slip conditions. RESULTS: The WRS was able to accurately predict slip risk, but the contact area was not. DISCUSSION: These findings support that increased WRS on the shoe outsole is associated with worse slip outcomes. Furthermore, the tool was able to offer robust feedback across a wide range of tread designs, but the results of this study show that the tool may be more applicable for slip-resistant shoes that are worn compared to their new counterparts. SUMMARY: This study shows that FTIR technology utilized in this tool may be a useful and portable method for determining slip risk for worn shoes. PRACTICAL APPLICATIONS: This tool has the potential to be an efficient, objective, end-user tool that improves timely replacement of shoes and prevention of injuries.

During roof-to ladder transitions, walk-through extensions modify required friction direction.

Severe and fatal falls involving ladders commonly occur during transitions across the ladder and another support surface. Slipping is a common initiating event in ladder falls. This study characterized the friction requirements and body kinematics of descending roof-to-ladder transitions with and without a walk-through extension. Healthy adults who regularly climb ladders (n = 17) completed descending roof-to-ladder transitions, while foot-rung kinetics and body kinematics were recorded. The peak required coefficient of friction (RCOF) with respect to the plane of the shoe sole was calculated. The RCOF and body angle were calculated using their resultant values and projections in the frontal and sagittal planes. Foot angle was calculated in the sagittal plane. Repeated-measures ANOVA determined that compared to a walk-through ladder, a traditional ladder was associated with a higher RCOF in the medial-lateral (ML) direction (F1,16 = 190.07, p < 0.001) and a lower RCOF in the anterior-posterior (AP) direction (F1,16 = 11.02, p = 0.004), but had no significant relationship with the resultant RCOF (F1,16 = 0.098, p = 0.76). Spearman's rho tests performed across all testing configurations identified significant associations between foot angle and overall RCOF (rs = -0.724, p < 0.001), foot angle and AP RCOF (rs = -0.871, p < 0.001), and frontal plane body angle and ML RCOF (rs = 0.782, p < 0.001). Clustering in the data suggests that ladder attachments reduced frontal plane kinematics, which altered the direction of RCOF by reducing the medial-lateral component. These results have implications for designing rungs with good friction in multiple directions and the potential for body position monitoring in ladder tasks.

Correlations between reach, lean and ladder tipping risk.

Overreaching is a common cause of ladder falls, which occur frequently among older adults in the domestic setting. Reaching and body leaning during ladder use likely influence the climber-ladder combined center of mass and subsequently center of pressure (COP) position (location of the resultant force acting at the base of the ladder). The relationship between these variables has not been quantified, but is warranted to assess ladder tipping risk due to overreaching (i.e. COP traveling outside the ladder's base of support). This study investigated the relationships between participant maximum reach (hand position), trunk lean, and COP during ladder use to improve assessment of ladder tipping risk. Older adults (n = 104) were asked to perform a simulated roof gutter clearing task while standing on a straight ladder. Each participant reached laterally to clear tennis balls from a gutter. Maximum reach, trunk lean, and COP were captured during the clearing attempt. COPwas positively correlated withmaximum reach(p < 0.001; r = 0.74) and trunk lean (p < 0.001; r = 0.85). Maximum reach was positively correlated with trunk lean (p < 0.001; r = 0.89). The relationship between trunk lean and COP was stronger than that between maximum reach and COP, denoting the importance of body positioning on ladder tipping risk. For this experimental setup, regression estimates indicate reaching and lean distance of 113 cm and 29 cm from the ladder midline, respectively, would lead to ladder tipping on average. These findings assist with developing thresholds of unsafe reaching and leaning on a ladder, which can aid in reducing ladder falls.

Friction performance of resilient flooring under contaminant conditions relevant to healthcare settings.

Flooring is among the factors known to influence slip and fall risk. Slips are common in the healthcare industry, where resilient flooring is prevalent. This study assessed coefficient of friction (COF) across resilient flooring products specific to conditions relevant to healthcare. The COF for eleven resilient flooring surfaces were tested in their dry condition and under six contaminant conditions. Data was analyzed using ANOVA and principal component analysis. The COF was strongly influenced by the contaminant condition (p < 0.001) with hand sanitizer and canola oil having the lowest COF values. COF was also influenced by the flooring product (p < 0.001) although to a lesser extent than the contaminant condition. The contaminants differentially affected the friction performance across the flooring products (interaction effect p < 0.001). These effects were described by the first two principal components. This study reveals high slipping potential for certain contaminants on resilient flooring and that flooring influences friction performance in contaminant-specific ways.

Validating the ability of a portable shoe-floor friction testing device, NextSTEPS, to predict human slips.

Measuring shoe-floor friction is critical for assessing the safety of footwear products. Portable devices for measuring coefficient of friction (COF) are needed. This study introduces such a device and evaluates its ability to predict human slip events across shoe designs. A portable device (18 kg) was utilized to measure 66 unique shoe-floor-fluid coefficients of friction (COF). Consistent with the shoes, flooring, and fluid contaminants from the COF tests, participants (n = 66) were unexpectedly exposed to the fluid while walking. Slip predictions were made based on a separate training data set. Slip predictions were made prospectively and using logistic regression analyses. The slip predictions were valid (p < 0.001), 91% sensitive, and 64% specific. The logistic regression fit also revealed that the COF values predicted slip outcomes (p = 0.006). This device is expected to expand the capacity of researchers, product developers, forensic engineers, and safety professionals to prevent slips and enhance human safety.

Situational factors that influence overreaching on a ladder during a gutter clearing task among older adults.

Ladder falls from overreaching are a problem in older adults. Evidence suggests ladder use behavior to be dependent on interfacing user and environmental circumstances (i.e. situational factors). This study investigates the effects of situational factors (remaining debris, ladder position, time into task, hand dominant reach, reaching disposition) on reaching during a gutter clearing task on a ladder in 104 older adults. Reaching was quantified as the maximum lateral center of pressure (COP) displacement from the ladder's center. A reach was classified as an overreach when the COP displaced outside the ladder width, indicative of a ladder tip. Reaching disposition, remaining debris, ladder position, and the interaction of reaching disposition and remaining debris predicted 20% of the reaching variability during the ladder task. Overreaching was observed in 40% of participants accounting for 13% of all extended reaches (beyond ladder). This work can guide interventions on mitigating overreaching and improving ladder safety.

Shoe Tread Wear Occurs Primarily during Early Stance and Precedes the Peak Required Coefficient of Friction.

Worn shoes contribute to injuries caused by slip-and-fall accidents. The peak required coefficient of friction (RCOF) has been associated with tread wear rate. However, the temporal relationship between RCOF and shoe wear is unknown. The purpose of this study was to determine whether the contact region at the time of peak RCOF is consistent with the region of shoe wear. The shoe contact region at peak RCOF was imaged by frustrated total internal reflection. Images of worn tread after months of use were captured. The worn tread region was more posterior than the contact region at RCOF and did not correlate with the contact region at the time of RCOF. The contact regions observed during earlier stance (within 83 ms of heel contact) were more consistent with the worn region, suggesting that RCOF may not directly cause tread wear. These results serve to motivate future studies to identify early-stance gait parameters associated with tread wear development.

In contrast to slip-resistant shoes, fluid drainage capacity explains friction performance across shoes that are not slip-resistant.

Slip and fall injuries can be prevented through footwear with good friction performance. The factors that contribute to friction in non-slip-resistant (NSR) shoes are not well understood. The purpose of this study was to determine whether predictive models for slip-resistant (SR) shoes also apply to NSR shoes. This study also quantified the contributions of under-shoe fluid drainage to friction in NSR shoes. The coefficient of friction (ACOF) and under-shoe fluid pressures of fifteen NSR shoes were measured. A previously developed ACOF prediction model based on measurable outsole features was applied to the NSR shoes. The previously developed model did not apply well (in trends, as indicated by interaction effects involving SR/NSR classification, or in magnitude, p < 0.001) to NSR shoes. Instead, an increase in the fluid pressures were associated with a reduction in ACOF (p < 0.001). This study demonstrates that fluid pressures dominate performance in NSR shoes in contrast to SR shoes.

Investigating the Influence of Spatiotemporal Gait Characteristics on Shoe Wear Rate.

OCCUPATIONAL APPLICATIONSWe investigated the association between shoe wear rate and several metrics describing an individual's spatiotemporal gait characteristics (cadence, step length, and preferred walking speed). No associations were found, indicating that alternative metrics should be investigated to predict the individualized rate at which workers wear down shoe tread.

TECHNICAL ABSTRACTBackground Shoe wear has been associated with increased slips and falls in the workplace. People wear down shoe tread at different rates; therefore, individualized shoe replacement timelines could improve resource targeting for organizations that use time as a basis for shoe replacement. Previous work has found that the shoe-floor kinetics, such as the friction requirements of walking, correlate with shoe wear rate. The use of easily measured metrics such as cadence, step length, or preferred walking speed to predict wear has not yet been investigated despite their relationship with friction requirements.Purpose This study seeks to determine the association between shoe wear rate and gait spatiotemporal characteristics.Methods Thirteen participants completed a longitudinal shoe wear study that consisted of a gait assessment followed by prolonged shoe wear in two pairs of slip-resistant shoes. The gait assessment was comprised of dry level-ground walking trials; kinematic and kinetic data were collected through optical motion capture and force plates. The participants' mean cadence, step length, and preferred walking speed were calculated. The participants then wore their shoes at work; the shoe wear rate was determined by measuring the periodic volumetric tread loss during this wear-at-work portion of the study.Results Three linear regression models found no significant association between the chosen gait metrics and the shoe wear rate.Conclusions The lack of an association between the spatiotemporal gait characteristics and shoe wear rate indicates that these factors may not explain the differences in wear rate between participants. This negative finding suggests that other measures such as the required coefficient of friction are better for individualizing footwear replacement guidelines.

Gait kinetics impact shoe tread wear rate.

BACKGROUND: Adequate footwear is an important factor for reducing the risk of slipping; as shoe outsoles wear down, friction decreases, and slip and fall risk increases. Wear theory suggests that gait kinetics may influence rate of tread wear. RESEARCH QUESTION: Do the kinetics of walking (i.e., the shoe-floor force interactions) affect wear rate? METHODS: Fourteen participants completed dry walking trials during which ground reaction forces were recorded across different types of shoes. The peak normal force, shear force, and required coefficient of friction (RCOF) were calculated. Participants then wore alternating pairs of shoes in the workplace each month for up to 24 months. A pedometer was used to track the distance each pair of shoes was worn and tread loss was measured. The wear rate was calculated as the volumetric tread loss divided by the distance walked in the shoes. Three, mixed linear regression models were used to assess the impact of peak normal force, shear force, and RCOF on wear rate. RESULTS: Wear rate was positively associated with peak RCOF and with peak shear force, but was not significantly related to peak normal forces. SIGNIFICANCE: The finding that shear forces and particularly the peak RCOF are related to wear suggests that a person's gait characteristics can influence wear. Therefore, individual gait kinetics may be used to predict wear rate based on the fatigue failure shoe wear mechanism.

Foot joint coupling variability differences between habitual rearfoot and forefoot runners prior to and following an exhaustive run.

As joint coupling variability has been associated with running-related lower extremity injury, the purpose of this study was to identify how variability within the foot may be different between forefoot (FFS) and rearfoot strike (RFS) runners. Identifying typical variability in uninjured runners may contribute to understanding of ideal coordination associated with running foot strike patterns. Fifteen FFS and 15 RFS runners performed a maximal-effort 5 km treadmill run. A 7-segment foot model identified 6 functional articulations (rearfoot, medial and lateral midfoot and forefoot, and 1st metatarsophalangeal) for analysis. Beginning and end of the run motion capture data were analyzed. Vector coding was used to calculate 6 joint couples. Standard deviations of the coupling angles were used to identify variability within subphases of stance (loading, mid-stance, terminal, and pre-swing). Mixed between-within subjects ANOVAs compared differences between the foot strikes, pre and post run. Increased variability was identified within medial foot coupling for FFS and within lateral foot coupling for RFS during loading and mid-stance. The exhaustive run increased variability during mid-stance for both groups. Interpretation. Joint coupling variability profiles for FFS and RFS runners suggest different foot regions have varying coordination needs which should be considered when comparing the strike patterns.

Effects of Student Interests on Engagement and Performance in Biomechanics.

There is a need for pedagogical techniques that increase student engagement among underrepresented groups in engineering. Relating engineering content to student interests, particularly through biomechanics applications, shows promise toward engaging a diverse group of students. This study investigates the effects of student interests on engagement and performance in 10th grade students enrolled in a summer program for students underrepresented in the science, technology, engineering, and mathematics fields. The authors assessed the effects of interest-tailored lectures on student engagement and performance in a 5-week program with bioengineering workshops, focusing on the delivery of biomechanics content. A total of 31 students received interest-tailored lectures (intervention) and 23 students received only generic lectures (control) in biomechanics. In addition, the authors assessed the effects of teaching method (lecture, classroom activities, and laboratory tours) on student engagement. The authors found interest-tailored lectures to significantly increase student engagement in lecture compared with generic lectures. Students that received interest-tailored lectures had an insignificant, but meaningful 5% increase in student performance. Students rated laboratory tours higher in engagement than other teaching methods. This study provides detailed examples that can directly assist student teaching and outreach in biomechanics. Furthermore, the pedagogical techniques in this study can be used to increase engagement of underrepresented students in engineering.

Traction performance across the life of slip-resistant footwear: Preliminary results from a longitudinal study.

INTRODUCTION: Slips, trips, and falls are a major cause of injury in the workplace. Footwear is an important factor in preventing slips. Furthermore, traction performance (friction and under-shoe fluid drainage) are believed to change throughout the life of footwear. However, a paucity of data is available for how traction performance changes for naturally worn, slip-resistant footwear. METHOD: The presented research is a preliminary analysis from an ongoing, larger study. Participants wore slip-resistant footwear while their distance walked was monitored. Friction and under-shoe fluid pressures were measured using a robotic slip tester under a diluted glycerol contaminant condition after each month of wear for the left and right shoes. The size of the worn region was also measured. RESULTS: Friction initially increased and then steadily decreased as the distance walked and the size of the worn region increased. Fluid pressures increased as the shoes were worn and were associated with increased walking distance and size of the worn region. DISCUSSION: Consistent with previous research, increases in the size of the worn region are associated with increased under-shoe fluid pressures and decreased traction. These trends are presumably due to reduced fluid drainage between the shoe-floor interface when the shoe becomes worn. CONCLUSIONS: Traction performance changes with natural wear. The distance walked in the shoe and the size of the worn region may be valuable indicators for assessing loss of traction performance. Practical Applications: Current shoe replacement recommendations for slip-resistant shoes are based upon age and tread depth. This study suggests that tools measuring the size of the worn region and/or distance traveled in the shoes are appropriate alternatives for tracking traction performance loss due to shoe wear.

Predicting Hydrodynamic Conditions under Worn Shoes using the Tapered-Wedge Solution of Reynolds Equation.

Slips and falls are a leading cause of injuries in the workplace. The risk of slipping increases as shoe tread wears. Knowledge of the mechanics relating shoe wear to slip risk is needed to develop fall-prevention strategies. This research applies a rectangular, tapered-wedge bearing solution to worn shoes and compares the results to experimentally measured under-shoe fluid pressure results. Changes in the size of the shoe outsole worn region and fluid dispersion capabilities were recorded for four, slip-resistant shoes which were systematically abraded. The film thickness predicted by the solution correlated well with the measured force supported by the fluid. The results provide support that the tapered-wedge solution can be used to assess slip risk in worn shoes.

Contact Pressures Between the Rearfoot and a Novel Offloading Insole: Results From a Finite Element Analysis Study.

Pressure offloading is critical to diabetic foot ulcer healing and prevention. A novel product has been proposed to achieve this offloading with an insole that can be easily modified for each user. This insole consists of pressurized bubbles that can be selectively perforated and depressurized to redistribute weight to the nonulcer region of the foot. However, the effect of the insole design parameters, for example, bubble height and stiffness, on offloading effectiveness is unknown. To this end, a 3-dimensional finite element model was developed to simulate contact between the rearfoot and insole. The geometry of the calcaneus bone and soft tissue was based on the medical images of an average male patient, and material properties and loading conditions based on the values reported in the literature were used. The model predicts that increasing bubble height and stiffness leads to a more effectively offloaded region. However, the model also predicts that increasing stiffness leads to increasing contact pressures on the surrounding soft tissue. Thus, a combination of insole design parameters was determined, which completely offloads the desired region, while simultaneously reducing the contact pressure on the surrounding soft tissue. This design is expected to aid in diabetic foot ulcer healing and prevention.

An observational ergonomic tool for assessing the worn condition of slip-resistant shoes.

Worn shoes are known to contribute to slip-and-fall risk, a common cause of workplace injuries. However, guidelines for replacing shoes are not well developed. Recent experiments and lubrication theory suggest that the size of the worn region is an important contributor to the shoe tread's ability to drain fluid and therefore the under-shoe friction. This study evaluated a simple test for comparing the size of the worn region relative to a common object (AAA and AA battery) as a means of determining shoe replacement. This study consisted of three components involving slip-resistant shoes: Experiment #1: a longitudinal, mechanical, accelerated wear experiment; Experiment #2: a longitudinal experiment where the same shoes were tested after each month of worker use; and Experiment #3: a cross-sectional experiment that exposed participants to a slippery condition, while donning their own worn shoes. The COF (Experiments #1 and #2); under-shoe fluid pressure (all experiments); and slip severity (Experiment #3) were compared across outcomes (fail/pass) of the battery tests. Larger fluid pressures, lower coefficient of friction, and more severe slips were observed for shoes that failed the battery tests compared with those passing the tests. This method offers promise for assessing loss in friction and an increase in slip risk for slip-resistant shoes.

Hand-rung forces after a ladder climbing perturbation.

The hands are believed to be important for arresting falls from ladders. Yet, there is a paucity of kinetic data for the hand-handhold interface during recovery from a ladder climbing perturbation. This study quantified the hand-rung forces utilized after ladder climbing perturbations and the factors (upper body strength, fall severity, reestablished foot placement) contributing to hand-rung force. A ladder rung was released under the foot of the participants to simulate a climbing misstep perturbation. Hand-rung forces after the perturbation were quantified from load cells connected to two ladder rungs. Mean peak hand-rung force magnitudes were found to range between 46% and 84% of the climber's body weight. These magnitudes approached and, in some cases, exceeded individuals' grasping capacity. Individual upper body strength was not found to consistently contribute to hand-rung force, but increased hand-rung force was clearly linked with greater fall severity after an ascending perturbation. Individuals that reestablished foot placement after an ascending perturbation utilized lower hand-rung forces. Therefore, this study suggests hand-rung force to be dependent on circumstances of the falling event (fall severity, reestablished foot placement) as opposed to the climber's capability of producing upper body force. This knowledge highlights the importance of handhold and ladder designs for arresting a falling event, and is critical to inform ladder fall interventions such as designing handholds that resist high forces and permitting steps that enable reestablished foot placement.

Worn region size of shoe outsole impacts human slips: Testing a mechanistic model.

Shoe outsole tread wear has been shown to increase slip risk by reducing the tread's ability to channel fluid away from the shoe-floor interface. This study establishes a connection between geometric features of the worn region size and slipping. A mechanistic pathway that describes the relationship between the worn region size and slip risk is assessed. Specifically, it is hypothesized that an increased worn region size leads to an increase in under-shoe fluid pressure, which reduces friction, and subsequently increases slipping. The worn region size, fluid pressure, and slip outcome were recorded for 57 participants, who were exposed to an unexpected slip condition. Shoes were collected from each participant and the available coefficient of friction (ACOF) was measured using a tribometer. A greater shoe worn region size was associated with increased slip occurrence. Specifically, a 1 mm increase in the characteristic length of the worn region (geometric mean of its width and length) was associated with an increase in slip risk of ~10%. Fluid pressure and ACOF results supported the mechanistic model: an increase in worn region size correlated with an increase in peak fluid pressure; peak fluid pressures negatively correlated with ACOF; and increased ACOF correlated with decreased slip risk. This finding supports the use of worn region size as a metric to assess the risk of slipping.