Circumstances of Falls During Sit-to-Stand Transfers in Older People: A Cohort Study of Video-Captured Falls in Long-Term Care

Published:November 16, 2022DOI:



      To characterize the circumstances of falls during sit-to-stand transfers in long-term care (LTC), including the frequency, direction, stepping and grasping responses, and injury risk, based on video analysis of real-life falls.


      Cohort study.




      We analyzed video footage of 306 real-life falls by 183 LTC residents that occurred during sit-to-stand transfers, collected from 2007 to 2020. The mean age was 83.7 years (SD=9.0 years), and 93 were female (50.8%).


      Not applicable.

      Main Outcome Measures

      We used Generalized Estimating Equations to test for differences in the odds that a resident would fall at least once during the rising vs stabilization phases of sit-to-stand and to test the association between the phase of the transfer when the fall occurred (rising vs stabilization) and the following outcomes: (1) the initial fall direction; (2) the occurrence, number, and direction of stepping responses; (3) grasping of environmental supports; and (4) documented injury.


      Falls occurred twice as often in the rising phase than in the stabilization phase of the transfer (64.0% and 36.0%, respectively). Falls during rising were more often directed backward, while falls during stabilization were more likely to be sideways (odds ratio [OR]=1.95; 95% confidence interval [CI]=1.07-3.55). Falls during rising were more often accompanied by grasping responses, while falls during stabilization were more likely to elicit stepping responses (grasping: OR=0.30; 95% CI=0.14-0.64; stepping: OR=8.29; 95% CI=4.54-15.11). Injuries were more likely for falls during the stabilization phase than the rising phase of the transfer (OR=1.73; 95% CI=1.04-2.87).


      Most falls during sit-to-stand transfers occurred from imbalance during the rising phase of the transfer. However, falls during the subsequent stabilization phase were more likely to cause injury.


      List of abbreviations:

      BC (British Columbia), CI (confidence interval), COM (center of mass), GEE (Generalized Estimating Equations), LTC (long-term care), OR (odds ratio)
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