Sub-Project D:  Compliant Flooring to Reduce Fall-Related Fractures

Research Team: Fabio Feldman (co-leader), Dawn Mackey (co-leader), Andrew Laing (co-leader), Karim Khan, Stephen Robinovitch

This project will test the effect of force-attenuating compliant flooring (similar to the rubber tile found in some playgrounds) on mobility, falls, and fall-related injuries in the LTC environment. We will start by extending our previous research to determine the most appropriate type of compliant flooring for installation. Our decision will be based on three criteria: (1) the amount of cushioning (or force reduction) provided by the flooring at impact from a fall; (2) the effect of the floor on the mobility and balance of older adults; and (3) the effect of the floor on the push-pull forces required to move equipment such as wheelchairs, beds, and carts. These results will be presented to various stakeholders, including care providers and administrators in our partnering LTC facilities and in the Fraser Health Authority, who will actively participate in decisions on material selection and installation.

Figure 4. Installation of SmartCells compliant flooring at Delta View long-term care facility (in Delta, BC), a major partner in the TIPS research program.


Simultaneous with these efforts, we will begin to collect data to evaluate the clinical utility of compliant flooring in reducing fall-related injuries in the high-risk long-term care environment. We will start by carefully monitoring falls and injuries in our partnering long-term care facilities, for a 12 month period prior to installation of compliant floor. This will allow us to calculate the baseline “injury-per-fall” rate. We will then install the best of our “laboratory-tested” compliant flooring systems in a high-risk area of a LTC facility, and compare the subsequent injury-per-fall rate with the value determined for the same wing in the previous 12 months (pre-post comparison) as well as in a comparison wing of similar size and resident population (contemporaneous comparison). Our aim is to systematically detail total and fall-related health care resource utilization (and associated costs) for each LTC resident in the wings that have, and do not have, compliant flooring. Through focus groups and interviews, we will also describe the experience of staff, residents’ and family members related to the novel compliant flooring.