Effects of Fall Training Program on Automatization of Safe Motor Responses during Backwards Falls in School-Age Children
Open accessAbstract
A significant number of children suffer injuries from falls. The current measures of prevention and education regarding falls are not sufficient, as falling is still the main cause of injury at this age. This study aimed to evaluate the risk of injury during a backward fall and assess the effect of the Safe Fall training program on this risk. 457 primary school children between the ages of 6 and 12 (mean age of 9) were enrolled in a 6-week randomized intervention. The program was carried out during physical education classes and consisted of an intervention group that followed the Safe Fall training program and a control group that was given equilibrium exercises. The risk of injury was assessed before and after the implementation using the Information Scale on Safe Ways of Falling observation scale, evaluating the responses of five different body parts (head, hip, knees, upper limbs and back). Students’ natural response to falls was associated with a high risk of injury in more than 90% of the cases. The implementation of the Safe Fall program resulted in a considerable decrease in this risk, with percentages lowered to levels between 8.7% and 18.3%.
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School-based prevention relies heavily on subjective observation rather than objective biomechanical assessment.
“While clinically valid, manual observation is subjective, labour-intensive, and unscalable for large student populations.”
From Safe Fall: Use of Predictive Modeling and Machine Vision Techniques for Fall Analysis and Fall Quality (2026) · cites this paper as [2]
Methods §2.5 describes an observer scoring children’s fall responses with an observation scale, so the paper supports the use of manual observation in this school-based study. It does not say that school-based prevention relies heavily on that approach or assess whether observation is subjective, labour-intensive, or unscalable compared with biomechanical assessment. (LLM, conf=0.78)
Experimental — accuracy not yet measuredCurrent validation relies on the INFOSECA observation scale, a clinical instrument that evaluates five biomechanical criteria.
“Current validation relies on the INFOSECA observation scale, a clinical instrument that evaluates five biomechanical criteria (e.g., head protection, trunk rolling) [2].”
From Safe Fall: Use of Predictive Modeling and Machine Vision Techniques for Fall Analysis and Fall Quality (2026) · cites this paper as [2]
Section 2.5 (page unavailable) says the study used an observation scale to score fall responses in five body parts, including head and back. It does not describe the scale as a clinical instrument or establish that current validation relies on it; its back criterion is landing on a flat back, not trunk rolling. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThis mechanism converts potentially injurious vertical energy into horizontal rotational motion, protecting the spine and head from direct impact.
“This mechanism converts potentially injurious vertical energy into horizontal rotational motion, protecting the spine and head from direct impact [2].”
From Safe Fall: Use of Predictive Modeling and Machine Vision Techniques for Fall Analysis and Fall Quality (2026) · cites this paper as [2]
The Discussion (page not provided) says that rolling over and other falling techniques reduce impact. Methods §2.5 (page not provided) identifies poor head control and landing on a flat back as potentially harmful. The paper does not describe converting vertical energy into horizontal rotational motion or establish that mechanism as the reason the head and spine avoid direct impact. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThese dramatic increases reflect the acquisition of a decisive and coordinated protective strategy: children learned to expand their body horizontally (rolling) and commit to the descent rapidly (squatting) to dissipate energy, rather than freezing in an upright position.
“These dramatic increases reflect the acquisition of a decisive and coordinated protective strategy: children learned to expand their body horizontally (rolling) and commit to the descent rapidly (squatting) to dissipate energy, rather than freezing in an upright position [2].”
From Safe Fall: Use of Predictive Modeling and Machine Vision Techniques for Fall Analysis and Fall Quality (2026) · cites this paper as [2]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredThese findings provide data-driven validation of the Safe Fall pedagogical approach: the intervention successfully overwrites the natural instinct to stiffen and resist gravity with a trained motor program characterised by decisive entry and spatial expansion.
“These findings provide data-driven validation of the Safe Fall pedagogical approach: the intervention successfully overwrites the natural instinct to stiffen and resist gravity with a trained motor program characterised by decisive entry and spatial expansion [2].”
From Safe Fall: Use of Predictive Modeling and Machine Vision Techniques for Fall Analysis and Fall Quality (2026) · cites this paper as [2]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured
This confirms the efficacy of the intervention in overwriting natural reflexes with the tuck-and-roll strategies advocated in the martial arts biomechanics literature.
“This confirms the efficacy of the intervention in overwriting natural reflexes with the “tuck-and-roll” strategies advocated in the martial arts biomechanics literature [2].”
From Safe Fall: Use of Predictive Modeling and Machine Vision Techniques for Fall Analysis and Fall Quality (2026) · cites this paper as [2]
Fear of falling leads to activity avoidance, reduced classroom participation, and long-term deconditioning, creating a vicious cycle of motor incompetence and increased injury risk.
“This acquired anxiety can lead to activity avoidance, reduced classroom participation, and long-term deconditioning, creating a vicious cycle of motor incompetence and increased injury risk [2].”
From Safe Fall: Use of Predictive Modeling and Machine Vision Techniques for Fall Analysis and Fall Quality (2026) · cites this paper as [2]
The Introduction and Discussion address children’s fall-related injury risk and unsafe motor responses, but do not link fear or anxiety to activity avoidance, classroom participation, or deconditioning. Searches for those terms and the proposed cycle found no passage addressing that causal chain. (LLM, conf=0.77)
Experimental — accuracy not yet measuredRepeated falls in children often precipitate a psychological 'fear of falling.'
“repeated falls in children often precipitate a psychological “fear of falling.””
From Safe Fall: Use of Predictive Modeling and Machine Vision Techniques for Fall Analysis and Fall Quality (2026) · cites this paper as [2]
The Introduction says children with medically attended injuries have a higher risk of recurrence, while the Discussion addresses injury risk and parents’ awareness. Neither section says repeated falls cause fear of falling in children; searches for fear, anxiety, and related psychological effects found no supporting passage. No page numbers were available in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measured
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References 24 · Cited by 8
- Authors
- DelCastillo-Andrés, Ó., Toronjo-Hornillo, L., & Toronjo-Urquiza, L.
- Affiliations
- Departamento de Educación Física y Deporte, Universidad de Sevilla, C/Pirotecnia s/n, 41013 Sevilla, Spain
- Universidad de Sevilla (ES)
- Department of Chemical and Biological Engineering, The University of Sheffield, Sheffield S10 2TN, UK
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2019-10-23
- Volume
- 16
- Issue
- 21
- Pages
- 4078
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC6862607
- OpenAlex
- W2981716566
- Cited by
- 8
- References
- 24
- Citations by year
- 2024: 2 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 1
- FWCI
- 1.15
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, cc-by-nc-nd)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Deposito de Investigacion Universidad de Sevilla (University of Seville) (submittedVersion, cc-by-nc-nd)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Injury Epidemiology and Prevention
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Social Sciences › Psychology › Developmental and Educational Psychology › Children's Physical and Motor Development
- Keywords
- backward falls, fall injury prevention, elementary school students, injury risk, physical education, traumatic brain injury, knee injury, injury prevention education
- MeSH terms
- Accident Prevention, Accidental Falls, Child, Female, Health Promotion, Humans, Male, Motor Skills, Physical Education and Training, Wounds and Injuries, Single-Blind Method, Outcome Assessment, Health Care
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