Dual-stiffness flooring: can it reduce fracture rates associated with falls?

J Am Med Dir Assoc. 2013 Apr;14(4):303-5. doi: 10.1016/j.jamda.2012.12.077. Epub 2013 Jan 30.


Objective: Falls cause significant morbidity and mortality in long term care facilities. Dual-stiffness flooring (DSF) has previously shown promise in reducing such morbidity in experimental models. This study set out to measure the impact of SmartCell flooring on falls-related morbidity in a nursing home.

Methods: All falls occurring at an Arizona nursing home between July 1, 2008, and December 31, 2010, were reviewed for age, sex, diagnosis of osteoporosis, number of medications, history of previous falls, type of flooring (normal vs DSF), time of day, type of injury, and resulting actions. Fall-related outcomes were compared across room types using chi-square and logistic regression methods.

Results: Eighty-two falls on the DSF were compared with 85 falls on the regular floor. There was a tendency for residents falling on DSF to have less bruising and abrasions, while having more redness and cuts. There were 2 fractures on regular flooring (2.4% fracture rate) and none on the DSF flooring (0% fracture rate).

Conclusions: The fracture rate of 2.4% of falls on the regular floor is consistent with previous reports in the literature, whereas a 0% rate found on the DSF floor is a clinically significant improvement. This suggests that DSF may be a practical approach for institutions and consumers to reduce fall-related injuries. A larger scale controlled study to confirm these encouraging preliminary findings is warranted.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls / prevention & control*
  • Accidental Falls / statistics & numerical data*
  • Aged
  • Aged, 80 and over
  • Arizona / epidemiology
  • Cohort Studies
  • Construction Materials / statistics & numerical data
  • Equipment Design
  • Female
  • Floors and Floorcoverings / methods*
  • Humans
  • Inpatients / statistics & numerical data
  • Male
  • Middle Aged
  • Protective Devices / statistics & numerical data
  • Safety Management / methods*
  • Safety Management / organization & administration*
  • Wounds and Injuries / epidemiology
  • Wounds and Injuries / prevention & control*