issues and experts

Special flooring may be the future in preventing fall-related injuries at care facilities

July 03, 2019

Dawn Mackey, Biomedical Physiology and Kinesiology (BPK), 778-782-9330,

Ian Bryce, University Communications and Marketing, 236-880-2187,




A Simon Fraser University team of scientists and patient safety experts from the Fraser Health Authority have released a new study on the role of compliant flooring—low-stiffness flooring designed to reduce the impact of falls—that showed early promise in preventing fall-related injuries in laboratory and clinical settings.

Published in PLOS Medicine, the Flooring for Injury Prevention (FLIP) Study saw 150 resident bedrooms at a long-term care home in Burnaby randomly assigned to renovation and installation of either one-inch thick compliant flooring or one-inch thick rigid flooring, both covered with identical hospital-grade vinyl.

The compliant flooring had been shown to reduce impact forces to the hip by about 35 per cent and to the head by about 70 per cent during simulated falls in the laboratory.

Yet, the results of the four-year randomized trial revealed that the flooring, in its current implementation, did not have a significant impact in preventing fall-related injuries for long-term care residents.

“The results were not what we were hoping for, or expecting,” says lead investigator Dawn Mackey, a professor in SFU’s Department of Biomedical Physiology and Kinesiology (BPK). “While the flooring did not increase the rate of falls, and thus did not cause harm to residents, it also had no effect on the injuries we were able to measure, and thus no detectable benefits.”

Mackey says the explanation may in part be related to the high use of hip protectors at the long-term care home. Hip protectors protect against hip fracture and were observed to be worn in approximately 40 per cent of falls in the study.

Another part of the story may relate to the challenge of identifying concussions in long-term care residents. Mackey notes that it is difficult to separate the neural consequences of falls involving head impact from baseline dementia.

The research team remains convinced that a softer landing surface has merit for reducing injuries from falls. “In the long-term care setting, we need to see further innovation in flooring products with superior impact force attenuation properties,” says Mackey.

“We also need to explore the feasibility and effectiveness of other intervention strategies such as wearable protective head gear and padding applied to other areas of resident bedrooms, such as walls and edges of furniture. This study reminds us that solving the problem of falls in older adults is difficult, but worthwhile.”