AAP report urges physicians to proscribe home trampoline use


From such great heights, we fall the farthest.

An updated American Academy of Pediatrics (AAP) report — ever-cognizant of such physics — has jumpstarted once more a movement to keep feet on the ground, adamantly cautioning against use of home trampolines. Less than a hop, skip and bounce away from the AAP’s previous 1999 policy regarding recreational trampoline play (which was later reaffirmed in 2006), the current guidelines include information about patterns of injury, the efficacy of current safety measures and the unique injuries typically attributed to time spent, without trepidation, on a trampoline.  

Titled "Trampoline Safety in Childhood and Adolescence" — co-authored by Susannah Briskin, MD, of the University Hospitals Rainbow Babies & Children's Hospital — the report also provides key recommendations for physicians to use in their dialogues with patients who have known predilections for getting spring-mat high.

“Physicians should strongly discourage all home trampoline use,” Briskin told PhysBizTech. But “if families are going to continue to use trampolines,” she continued, “they should abide by the following rules: (1) Only a single jumper should be allowed on the mat; (2) no somersaulting/flipping should be allowed; (3) an adult should monitor the behavior on the trampoline; (4) all equipment should be thoroughly inspected on a regular basis.”

The trampoline was patented by gymnast George Nissen as a “tumbling device” in 1945. The AAP report insists that home-use of trampolines was not intended at the mechanism’s inception and therefore should not be employed, ideally, at such locales: “Nissen initially designed the trampoline as a training tool for acrobats and gymnasts and subsequently promoted it for military aviator training. Recreational use of trampolines is a more recent phenomenon, driven primarily by the increased availability of relatively inexpensive trampolines marketed for home use.”

And although trampoline injury rates have decreased at a consistent rate since 2004 [Figure 1] and product sales have gone down, the U.S. Consumer Produce Safety Commission’s National Electronic Injury Surveillance System (NEISS) shows uncomfortably lofty injury estimates even in 2009, when approximately 98,000 trampoline-perpetrated grievances were expected, 3,100 of which were estimated to result in hospitalization [Figure 2].

Figure 1:

Figure 2:

 

Information provided by: "Trampoline Safety in Childhood and Adolescence" COUNCIL ON SPORTS MEDICINE AND FITNESS; Pediatrics; originally published online September 24, 2012; Table 1; pg. 775. Graphs produced by: PhysBizTech. 

"We believe the risk of using the trampoline and suffering an injury is still high, despite safety measures which the industry has put into place," Briskin said in a news release.

According to Briskin, 1 in 200 injuries that occur on trampolines result in permanent neurological damage — devastating odds that should serve to strike the spring. Briskin included the following as other key aspects in the report that should cause jumpers and physicians pause:

  • Fractures, contusions, scrapes, sprains, head and neck injuries are common (for home trampoline users).
  • Somersaults/flips place an individual at high risk of a catastrophic injury, such as paralysis.
  • 75 percent of all injuries occur when multiple users are on the mat.
  • When multiple jumpers are on the mat, the smallest jumper is 14 times more likely to be injured.
  • 48 percent of all injuries to kids under the age of 5 are fractures.
  • Around 1/4 of all injuries occur from a fall from the trampoline; safety netting has not significantly improved that number.
  • One-third to one-half of all injuries occur with an adult is supervising.

"Many parents and supervising adults do not appear to be aware of key components of trampoline safety such as limited the trampoline to one user at a time, and this may contribute significantly to current injury rates," Briskin noted. As such, it’s important for physicians to establish the gravity of the home trampoline situation with patient families in an effective manner.

Consider it part of a standard safety discussion that typically includes seat belt use, pool safety guidelines, bike helmet use. Physicians should assess whether families allow their kids to use trampolines recreationally, and advise against their use, Briskin suggested.

The AAP also provided the below recommendations for physicians to consider:

  • Pediatricians should advise parents and children against recreational trampoline use.
  • Current data on netting and other safety equipment indicates no reduction in injury rates.
  • Homeowners with a trampoline should be directed to verify that their insurance covers trampoline injury-related claims
  • Rules and regulations for trampoline parks may not be consistent with the AAP guidelines.
  • Trampolines used for a structured sports training program should always have appropriate supervision, coaching, and safety measures in place.

“Unfortunately, the very forces that make trampoline use fun for many children also lead to unique injury mechanisms and patterns of injury. The trampoline industry has attempted to address the safety concerns with implementation of voluntary safety standards,” concluded the report.

For the trampoline industry and the glee of backyard bounders everywhere, voluntary safety standards simply aren’t enough — an unfortunate truth, indeed, but hardly surprising. After all, Icarus was never meant to bounce back.

Find the full AAP report, published in the October 2012 issue of the journal Pediatrics, here.

 

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