Grab Bar Use Influences Fall Hazard During Bathtub Exit

Abstract

Objective This study evaluated the hazard (risk of unrecovered balance loss and hazardous fall) and strategies associated with grab bar use, compared to no grab bar use, during unexpected balance loss initiated whilst exiting a bathtub. Background While independent bathing is critical for maintaining self-sufficiency, injurious falls during bathing transfer tasks are common. Grab bars are recommended to support bathing tasks, but no evidence exists regarding fall prevention efficacy. Method Sixty-three adults completed a hazardous bathtub transfer task, experiencing an unpredictable external balance perturbation while stepping from a slippery bathtub to a dry surface. Thirty-two were provided a grab bar, while 31 had no grab bar available. Slips and grab bar use were recorded via four video cameras. Slip occurrence and strategy were identified by two independent video coders. Results Participants who had a grab bar were 75.8% more likely to recover their balance during the task than those who did not have a grab bar. Successful grab bar grasp was associated with balance recovery in all cases. Attempts to stabilize using other environmental elements, or using internal strategies only, were less successful balance recovery strategies. Grab bar presence appeared to cue use of the environment for stability. Proactive grasp and other strategies modified grasping success. Conclusion Grab bars appear to provide effective support for recovery from unexpected balance loss. Grab bar presence may instigate development of fall prevention strategies prior to loss of balance. Application Bathroom designs with grab bars may reduce frequency of fall-related injuries during bathing transfer tasks.