The "safe falls, safe schools" multicentre international project: Evaluation and analysis of backwards falling ability in Italian secondary schools

Problem statement: Different studies have reported on the epidemiology related to injuries resulting from falls, which are the most common causes of injury in Italy. The World Health Organization considers falls as the second leading cause of accidental or unintentional deaths worldwide. However, it has been demonstrated that the Safe Fall, Safe Schools Programme (SFSSP) based on 10-min warm-up sessions is able to teach techniques for falling backwards in safe way during physical education (PE) classes. Unfortunately, there are no studies that have analysed extensive warm-up and detraining effects related to the age. Aim: The aim of this study was to assess extensive specific warm-up (20 min) and detraining effects after five weeks on the SFSSP on Italian secondary school students according to age. Methods: Eighty-seven secondary school students took part in this investigation. Students were divided into two groups, equally distributed by age. The trial-control group (TC=39) and the control-trial group (CT=48) performed the same PE lesson for 10 weeks. In the first five weeks, two different 20-min warm-up exercises were performed (TC=SFSSP; CT=conventional warm-up); after five weeks, the warm-ups were inverted (TC=conventional warm-up; CT=SFSSP). The backwards falling ability test carried out among both groups was evaluated in relation to the position of the neck, trunk, knees, hips and hands, before and after five and 10 weeks. Results: McNemar’s test showed significant differences (between pre-and mid-time points, P<0.05) for the neck, trunk, hip and hands, while no significant differences were found in the knee value (P=0.581 in TC). No differences were found between the mid-and post-time points for TC. In CT, no differences were found in-between (pre-and mid-time points, P>0.05) for all variables studied. Significant differences (P<0.05) were found in-between the mid-and post- time points for CT in all variables studied. Analysis of the total scores for SFSSP showed significantly differences in TC and CT (P<0.0001). The Wilcoxon signed-rank test showed no significant differences (total scores: first year=1.68±1.05 AU; fifth year=1.47±0.86 AU; P=0.34) before the SFSSP intervention, while the SFSSP was able to improve the ability after intervention (total scores: first year=4.47±0.84 AU; fifth year=3.91±1.40 AU; P<0.01). Conclusions: The SFSSP was able to improve motor ability for both groups and the detraining effect was found to maintain the same ability level compared to that after the SFSSP intervention. Participants started with the same level of backwards falling ability and each group, after the intervention, significantly raised its score, confirming the efficacy of the intervention. Therefore, the SFSSP could be included in the standard national programme without changing the standard training lesson.