The Impact of Specifically Adapted Judo-based Training Program on Risk Factors for Falls Among Adults
Condition: Accidental Fall; Fall Injury; Work-related Injury; Work Accident
MeSH terms: Wounds and Injuries
Study type: Interventional

Summary: 
      This is a control study with a 2-group pretest-posttest design investigating the effects of a
      10-week judo-inspired exercise program (Judo4Balance) for physical functions, self-efficacy,
      activity level, and fall techniques among working adults & part-time working retired people.

      Falls constitute a common and severe threat to older men and women's health worldwide.
      However, falls are not just a problem of advanced age, studies have been reporting that falls
      are a problem at all ages. Nevertheless, falls are under-studied, particularly among young
      and middle-aged adults (working age adults). For all fall-related injuries among adults, the
      proportions have been reported to be 32.3% among older adults, 35.3% among middle-aged
      adults, and 32.3% among younger adults in the United States. This indicates that falls and
      fall related injuries represent a significant threat to public health at all ages. Therefore,
      new innovative ways of prevention is much needed and needs to be studied.
    

Detailed description: 
      The aim of this study is to evaluate and document whether a ten week standardized judo
      inspired exercise program (Judo4Balance) which include both training the physical qualities
      such as strength and balance as well as the "break fall" technique can influence the risk of
      falling as well as reduce the negative consequences of an accidental fall.

      Questions asked:

        -  Can a ten week standardized judo based exercise program improve the "break fall"
           competence among adults ?

        -  Can a ten week standardized judo based exercise program improve the fall-efficacy at
           home and at work among adults ?

        -  Can a ten week standardized judo based exercise program improve the physical status with
           regards to the risks for falls among adults ?

        -  Can a ten week standardized judo based exercise program improve the balance among adults
           ?

        -  Could a ten week standardized judo based exercise program be a useful tool in an
           organisation's preventive Health and Safety work.

      The study included two groups with ethical approval to recruit up to 100 individuals in the
      intervention group and up to 100 individuals in a control group. (control participants are
      selected mainly the same workplace where the group exercises are being performed and consists
      of a similar sample of age, sex and physical status ).

      The study is conducted in accordance with the Declaration of Helsinki. This study was
      approved by the Ethical Committee of the Uppsala Region (Dnr 2018/239). Each participant
      voluntarily provided a written informed consent before participating. Participants were
      informed that they could withdraw from participation at any time for any reason without any
      consequences. The participants received no compensation for participating in the study.

      A total of seven different workplaces from different parts of Sweden participate in the study
      of the judo-inspired exercise program (construction and steel industry, healthcare,
      pre-school, insurance office, advertising, and health and safety consultants). Judo Clubs
      from different locations in Sweden as well as an insurance company offered the program as
      part of their preventive Health and Safety at the workplace program. Workplaces report an
      interest in participating and view their participation as part of their systematic work to
      promote Health and Safety among employees. Information and an invitation to participate in
      the 10-week program were provided to employees at the workplace setting.

      After an acceptance to participate, written consent is obtained. Measurements were performed
      at the workplace by a qualified judo instructor.

      A total of three qualified Judo instructors, familiar with the physical tests performed the
      pre- and post-assessments. A total of 14 qualified judo instructors provide instructions in
      the different groups (on average, 2 instructors per group of 10-18 persons). The instructors
      teaching the special exercise program are required to have at least a blue belt in judo
      (which means a minimum of 5 years of regular judo and break fall training). All the
      instructors teaching the classes in the study have black belts. To teach the program, there
      are also a requirement to have a coaching license from the Swedish Judo Federation and to
      have undergone a specific weekend course in the Judo4Balance program, with a focus on
      teaching judo-related exercises and fall techniques to adult beginners.

      The program is delivered in a 45-50-minute session once a week for ten weeks at the
      respective workplace or other suitable location for the group exercise. The 10 week program
      is divided into three blocks and taught by experienced and especially trained judo
      instructors.

      Block 1: Good technique during break fall training and strength training, accustomed the body
      to regular training, find the right level of training for the group, build up load resistance
      in muscles, tendons and bones. Challenge the balance through new movements not used everyday.
      Flexibility training for stiff joints such as neck and upper back.

      Block 2: Improve "break fall" technique and strength exercises, increase the loads and
      further challenge the balance and coordination, increase range of motion and introduce "power
      training".

      Block 3: Train the skill of explosive power during strength exercises and break falls.
      Challenge the balance with increased complexity and difficulty.

      The participants both in the intervention group and control group are tested before and after
      the 10 week period. After the tests have been carried out a questionnaire is to be sent out
      to the instructors to get their evaluation of the suitability and effectiveness of the
      program at the work place. A similar questionnaire will be sent out to the participants to
      evaluate their experience of this preventive program from a Health and Safety at work
      perspective.

      There is strong evidence that exercise can reduce the risk of falling. Nevertheless, judo
      based training has not to the investigators knowledge been scientifically investigated for
      working adults with the aim of reducing falls at the workplace and elsewhere. Neither has it
      been studied if this type of group training is motivational for continuing physical activity
      after the intervention or for improving the health and safety among employees.
    

Intervention name(s): Active Comparator: Participants in 10 week Judo Inspired Exercise program
Intervention type(s): Behavioral
Intervention description(s): The intervention included 10 sessions, using a 10-week (45-50 minutes /week) pre-established program called Judo4Balance, a structured exercise program. Each session consisting of warm-up, balance, strength, power and break fall exercises. There is clear a progression within the 10 week program in three main blocks. Block 1: learning the exercises and principle movements, Block 2 more resistance and advance falling techniques, Block 3 Power training and falling strategies from stand up positions.
Other intervention name(s): Judo4Balance: Fall-Preventive Exercise Group
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Intervention model description: An intervention group which will be training the 10-week judo4 balance
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: Fall prevention; Physical training; judo; judo4Balance; Break falls; Health and Safety; Falling at work