The effect of positioning on the biomechanical performance of soft shell hip protectors

Choi, Woochol Joseph; Hoffer, J. A.; Robinovitch, Stephen N.

doi:10.1016/j.jbiomech.2009.11.023

Cited by 31 publications

(8 citation statements)

References 28 publications

(35 reference statements)

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“…Generally, the point of application of the fall load in cadaveric fracture experiments is assumed to be directly at the GT (Courtney et al, 1994). In our study the point of application was consistently found to be located distal and posterior to the GT, which corroborates the results of Choi et al (2010). Displacing the point of application might result in changed femoral fracture forces, which should be taken into account in future experimental and finite element fracture studies.…”

Section: Discussionsupporting

confidence: 84%

Can martial arts techniques reduce fall severity? An in vivo study of femoral loading configurations in sideways falls

Zijden

Groen

Tanck

et al. 2012

Journal of Biomechanics

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Section: Discussionsupporting

confidence: 84%

Can martial arts techniques reduce fall severity? An in vivo study of femoral loading configurations in sideways falls

Zijden

Groen

Tanck

et al. 2012

Journal of Biomechanics

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“…Our results for the Hipsaver protector (a commonly sold and tested hip protector) also compared favourably with two studies by Laing et al, whereby our study reports 20.26% (Test I) and 18.07% (Test II) compared to 20.9% and 23.5% by Laing et al [20,21]. Other studies which tested the Hipsaver protector, for example, Choi et al, 2010 and van Schoor et al, 2006 report much greater force attenuation of 45% and 45.6 -57.8% [17][18][19]. The impact velocity used in these studies were lower at 1.98 m/s and 1.25 m/s respectively.…”

Section: Discussionsupporting

confidence: 70%

“…A biomechanical study by Derler et al found that the peak force at the femoral neck is increased by up to 23% when the pad is displaced by 30mm in the anterior direction [15]. Several other studies have reported significant differences between individual hip protectors in their effectiveness to reduce the impact force on the femur when displaced up to 50mm in the superior, posterior, inferior, and anterior directions [16,17]. This further highlights the importance of a well-designed hip protector and well-fitting garments.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical testing of hip protectors following the Canadian Standards Association express document

Keenan

Evans

2019

Osteoporos Int

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A variety of hip protectors are available, but it is not clear which is the most effective and there is no standard test to evaluate their performance. This is the first study that uses a standard mechanical test on hip protectors. Some protectors perform well but others are almost ineffective, providing little to no protection to the wearer during a fall. Introduction: Each year, over 70,000 patients are admitted to hospital in the UK with hip fractures. There are a variety of commercial hip protectors currently available. However, it is not explicitly clear which is the most effective with regard to maximum force attenuation, whilst still being both comfortable for the user and providing reasonable force reduction if misplaced from the intended position. The numerous test methods reported in the literature have given conflicting results, making objective comparison difficult for users, researchers, and manufacturers alike. The Canadian Standards Association (CSA) has therefore published an express document (EXP-08-17) with a draft standard test method. This paper presents initial results for a range of hip protectors. Methods: Eighteen commercially available hip protectors were tested according to EXP-08-17. Each hip protector was impacted five times in correct anatomical alignment over the greater trochanter and once at 50 mm displacements in the anterior, posterior, and lateral directions. Results: Considerable differences were identified between individual hip protectors in their ability to reduce impact forces on the femur (between 3% and 36% reduction in peak force). The performance was reduced when misplaced in many cases (maximum reduction only 20%). Conclusions: This is the first study that uses a standard mechanical test on hip protectors. Previous studies have used a variety of methods, making it difficult to interpret results. We hope that these results using a standard test method will facilitate the effective comparison of results, as well as providing useful data for clinicians, users, and purchasers.

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“…Although hip protectors substantially reduce risk of hip fracture if worn during a fall, they cannot prevent hip fracture on every occasion, including cases of spontaneous fracture without any obvious external impact (e.g., [69]), when the hip breaks from impact to the buttocks during of a backwards landed fall or a fall to the knees (e.g., [22, 70]), or when the hip protector is not positioned correctly over the greater trochanter (e.g., [71, 72]). Forsen et al [73] reported that it became increasingly difficult to convince residents of the benefits of hip protectors after each time a hip fracture occurred while wearing a hip protector.…”

Section: Methodsmentioning

confidence: 99%

Validation and psychometric properties of the commitment to hip protectors (C-HiP) index in long-term care providers of British Columbia, Canada: a cross-sectional survey

et al. 2017

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BackgroundIf worn during a fall, hip protectors substantially reduce risk for hip fracture. However, a major barrier to their clinical efficacy is poor user adherence. In long-term care, adherence likely depends on how committed care providers are to hip protectors, but empirical evidence is lacking due to the absence of a psychometrically valid assessment tool.MethodsWe conducted a cross-sectional survey in a convenience sample of 529 paid care providers. We developed the 15-item C-HiP Index to measure commitment, comprised of three subscales: affective, cognitive and behavioural. Responses were subjected to hierarchical factor analysis and internal consistency testing. Eleven experts rated the relevance and clarity of items on 4-point Likert scales. We performed simple linear regression to determine whether C-HiP Index scores were positively related to the question, “Do you think of yourself as a champion of hip protectors”, rated on a 5-point Likert scale. We examined whether the C-HiP Index could differentiate respondents: (i) who were aware of a protected fall causing hip fracture from those who were unaware; (ii) who agreed in the existence of a champion of hip protectors within their home from those who didn’t.ResultsHierarchical factor analysis yielded two lower-order factors and a single higher-order factor, representing the overarching concept of commitment to hip protectors. Items from affective and cognitive subscales loaded highest on the first lower-order factor, while items from the behavioural subscale loaded highest on the second. We eliminated one item due to low factor matrix coefficients, and poor expert evaluation. The C-HiP Index had a Cronbach’s alpha of 0.96. A one-unit increase in championing was associated with a 5.2-point (p < 0.01) increase in C-HiP Index score. Median C-HiP Index scores were 4.3-points lower (p < 0.01) among respondents aware of a protected fall causing hip fracture, and 7.0-points higher (p < 0.01) among respondents who agreed in the existence of a champion of hip protectors within their home.ConclusionsWe offer evidence of the psychometric properties of the C-HiP Index. The development of a valid and reliable assessment tool is crucial to understanding the factors that govern adherence to hip protectors in long-term care.

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The effect of positioning on the biomechanical performance of soft shell hip protectors

Cited by 31 publications

References 28 publications

Can martial arts techniques reduce fall severity? An in vivo study of femoral loading configurations in sideways falls

Can martial arts techniques reduce fall severity? An in vivo study of femoral loading configurations in sideways falls

Biomechanical testing of hip protectors following the Canadian Standards Association express document

Validation and psychometric properties of the commitment to hip protectors (C-HiP) index in long-term care providers of British Columbia, Canada: a cross-sectional survey

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