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A Few Minutes With Jake Sosnoff

College of Applied Health Sciences media relations specialist Vince Lara spends A Few Minutes With ... Jake Sosnoff, professor in the Kinesiology and Community Health department of AHS. Jake discusses what inspired his research into preventing falls, teaching people to fall safely, and his research with multiple sclerosis.

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VINCE LARA: Hello, this is Vince Lara, Media Relations Specialist at the College of Applied Health Sciences at the University of Illinois. Today I spend A Few Minutes With Jake Sosnoff, Professor in Kinesiology and Community Health at AHS, and we talk about Jake's research on falls prevention.

So Jake, what started your interest in falls prevention?

JAKE SOSNOFF: My interest in falls prevention really started with interacting with my grandfather. So my grandfather was a polio survivor. He had what was called post-polio syndrome. And it's essentially when you survive polio, it's the after-effects of that. Slightly more complicated than that, but for the most part, that's what we thought of it as. And because of polio, he had one leg that was weaker than the other. So he had a slight limp, and this made him at risk for falls. His walking was wobbly.

And because he was at risk for falls, as he was getting older, it became more and more problematic. And I remember, growing up as a teenager, I would literally walk two or three steps in front of him so that when he did lose his balance and fall, he would reach out and grab me. I liked my grandfather. He was someone from the greatest generation. He always had great stories-- and just being around him. So I've always been interested in understanding why people do or do not fall.

And added to that, I'm very lucky. I grew up in a family of orthotists/prosthetists, so people that made artificial limbs and braces. So I was always around people with mobility challenges. So that's just one of those topics that I've been interested in.

VINCE LARA: What motivated you to found the Illini Fall Prevention Clinic?

JAKE SOSNOFF: So falls are this huge problem, and I personally feel like we don't pay enough attention to them. It's just sort of thought like a problem of older people. So older people, their hair goes gray, they get wrinkles, and they fall. It's not that simple. Falls are a huge problem. 1 out of 4 older adults is going to fall in the next year. Somewhere up to 90% of all hip fractures are due to a fall. And then there's some data out there that suggests that upwards of 80% of traumatic brain injuries in older adults are due to falls, so huge public health implications.

Although if you look at the literature, we've been studying falls for 40-plus years. We know how to prevent them, but then if you look at death rates and injury rates due to falls, they're actually going up. To me, the issue is that we're not getting people who need preventive practices the preventive practices. We react to it.

So the goal of the Illini Fall Prevention Clinic is to use the research-grade equipment we have-- state of the art equipment-- and to essentially provide people with fall risk assessments. And arguably, these fall risk assessments are better than what they would get clinically because most clinics don't have this equipment. So my students and graduate students they run people through the tests of their walking, and their balance, and their thinking. And then based on the challenges we see, the difficulties we see, we then provide personalized prevention plans.

So we do that-- we run that out of the lab in Huff Hall. We also in the past have gone to different places. So we've done it at Clark-Lindsey. We're looking at doing it in some other retirement communities. So we really try to do this as a service to the community to give back.

VINCE LARA: Tell me a little bit about teaching people to fall safely.

JAKE SOSNOFF: So the other side of this is falls prevention, so let's try to stop people from falling. But my students and I joke, until we can get rid of gravity, which is really the reason people fall, people are going to fall. So your balance can be good. I know you're athletic. You're out there doing something, going for a run, and there's just some fluke. You fall to the ground.

So can we teach people to fall to the ground in such a way that they don't get hurt? Right? And in some sports, and martial arts, and judo, people are taught how to roll. Or in gymnastics, you're tumbling. You know how to do that. We learn that at-- we used to learn it all the time. Changes in physical education might move us away from learning how to tumble, but for the most part, we used to learn that. And the question is well, can we teach older adults to fall safely?

There's different approaches to try to have people fall safely. One idea-- and I think we're the same age that we started to wear bike helmets at some point because they realized that if you put a helmet on, you'll protect your head, which makes a lot of sense. So in the falls literature in the '90s, they started to have people wear hip protectors, which are wonderful, except nobody wants to wear a hip protector. So it's this question, can we teach people to fall safely?

And I had a graduate student that was incredibly gifted. She's now working at the Shirley Ryan AbilityLab up in Chicago doing wonderful work on spinal cord injury, but her dissertation was focusing on trying to teach older adults to fall. And we came up with a paradigm-- I guess I should say she really came up with the paradigm-- where we have people fall to the side in an experimental setup. We measure how hard they hit the ground.

And then we have a group of people that we taught them how to fall what we call correctly, the tuck and roll technique. And we had another group where we just dropped them over and over to see if they would figure it out. And perhaps not too surprisingly, but when you teach people how to fall correctly, they reduce the amount of impact forces by about a third.

And then another interesting finding, which we weren't targeting, but it just sort of was something we found out-- which oftentimes is the best way to have science happen-- is we found that people that we taught to fall actually hit their head less than people who didn't know how to fall. So it's very preliminary data. It's a fairly small sample size, but it's one of the first instances where we provide some empirical scientific evidence that we can teach people to fall safely.

A caveat to this, Vince, is that we were looking at really healthy older adults. So when I call them old, the average age was 62. And as I get closer to 62, I realized that's no longer old. So these were very fit middle aged adults or young old, depending on how we want to classify it. And the question we have and as we're trying to pursue now, is can we teach perhaps less fit older adults or adults with some neurological impairment? Can we teach them how to fall safely? So that's ongoing research although we're very excited about it.

VINCE LARA: Speaking of ongoing research, you've done some interesting research on fall prevention technology. Talk a little bit about that if you would.

JAKE SOSNOFF: Thank you. So again, it goes back to how can we prevent falls. And it's this notion that people don't know their own fall risk. So the idea I told you a little bit earlier is that 1 out of 4 older adults is going to fall in the next year. Well, if I went out to the mall or went out somewhere, and I asked a bunch of old people-- or seniors, excuse me-- how likely they are to fall, data suggests it would be about 1 in 10 would say that, yeah, they're likely to fall. People aren't aware of the risk. They don't understand. They have a very poor understanding of their perceived risk.

And where technology can come in is we can actually use technology. So we've developed an app that we use on a smartphone. We would actually be able to show people their own fall risk and start to inform it. And so people don't get involved in fall prevention because they don't think they need it. They think they're perfectly fine, and they wait, in some cases, until it's too late.

So using our smartphones-based app, we ask them self-reported health history, their experiences with fall, if they've got injured. And then we actually measure their movement and their perception of their ability to do some of these movements. And based on that, we run it through a fancy algorithm, and we give them a fall risk. And essentially, we can tell them, you're likely to fall this year. We really think you should go do some prevention activities. Worst case scenario, you really should probably contact your physician and talk to them about your fall risk because there seem to be some areas and issues.

We've had four or five different papers published on this idea, and it seems to be a lot of room for growth in that smartphones are out there. It's upwards of 82% of the population have a smartphone. Most of us are fortunate enough to have an older adult close to us, so we can help them with the smartphone if they don't know how to use it. And we're at this wonderful position where we can start using technology to minimize the barriers for people to do fall prevention and just health behavior change in general.

VINCE LARA: My thanks to Jake Sosnoff. This has been A Few Minutes With.

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