Skip to main content
Erschienen in: Osteoporosis International 6/2019

02.04.2019 | Original Article

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

verfasst von: B. E. Keenan, S. L. Evans

Erschienen in: Osteoporosis International | Ausgabe 6/2019

Einloggen, um Zugang zu erhalten

Abstract

Summary

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.
Literatur
2.
Zurück zum Zitat Nevitt MC, Cummings SR (1993) Type of fall and risk of hip and wrist fractures: the study of osteoporotic fractures. The Study of Osteoporotic Fractures Research Group. J Am Geriatr Soc 41:1226–1234CrossRefPubMed Nevitt MC, Cummings SR (1993) Type of fall and risk of hip and wrist fractures: the study of osteoporotic fractures. The Study of Osteoporotic Fractures Research Group. J Am Geriatr Soc 41:1226–1234CrossRefPubMed
3.
Zurück zum Zitat Kannus P, Leiponen P, Parkkari J, Palvanen M, Jarvinen M (2006) A sideways fall and hip fracture. Bone 39:383–384CrossRefPubMed Kannus P, Leiponen P, Parkkari J, Palvanen M, Jarvinen M (2006) A sideways fall and hip fracture. Bone 39:383–384CrossRefPubMed
4.
Zurück zum Zitat Parkkari J, Kannus P, Palvanen M, Natri A, Vainio J, Aho H, Vuori I, Jarvinen M (1999) Majority of hip fractures occur as a result of a fall and impact on the greater trochanter of the femur: a prospective controlled hip fracture study with 206 consecutive patients. Calcif Tissue Int 65:183–187CrossRefPubMed Parkkari J, Kannus P, Palvanen M, Natri A, Vainio J, Aho H, Vuori I, Jarvinen M (1999) Majority of hip fractures occur as a result of a fall and impact on the greater trochanter of the femur: a prospective controlled hip fracture study with 206 consecutive patients. Calcif Tissue Int 65:183–187CrossRefPubMed
5.
Zurück zum Zitat Kanis JA, Johnell O, Oden A, Jonsson B, De Laet C, Dawson A (2000) Risk of hip fracture according to the World Health Organization criteria for osteopenia and osteoporosis. Bone 27:585–590CrossRefPubMed Kanis JA, Johnell O, Oden A, Jonsson B, De Laet C, Dawson A (2000) Risk of hip fracture according to the World Health Organization criteria for osteopenia and osteoporosis. Bone 27:585–590CrossRefPubMed
6.
Zurück zum Zitat Hernlund E, Svedbom A, Ivergard M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jonsson B, Kanis JA (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8:136CrossRefPubMedPubMedCentral Hernlund E, Svedbom A, Ivergard M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jonsson B, Kanis JA (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8:136CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733CrossRefPubMed Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733CrossRefPubMed
8.
Zurück zum Zitat Jordan KM, Cooper C (2002) Epidemiology of osteoporosis. Best Pract Res Clin Rheumatol 16:795–806CrossRefPubMed Jordan KM, Cooper C (2002) Epidemiology of osteoporosis. Best Pract Res Clin Rheumatol 16:795–806CrossRefPubMed
10.
Zurück zum Zitat Baker PN, Salar O, Ollivere BJ, Forward DP, Weerasuriya N, Moppett IK, Moran CG (2014) Evolution of the hip fracture population: time to consider the future? A retrospective observational analysis. BMJ Open 4:e004405CrossRefPubMedPubMedCentral Baker PN, Salar O, Ollivere BJ, Forward DP, Weerasuriya N, Moppett IK, Moran CG (2014) Evolution of the hip fracture population: time to consider the future? A retrospective observational analysis. BMJ Open 4:e004405CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat White SM, Griffiths R (2011) Projected incidence of proximal femoral fracture in England: a report from the NHS Hip Fracture Anaesthesia Network (HIPFAN). Injury 42:1230–1233CrossRefPubMed White SM, Griffiths R (2011) Projected incidence of proximal femoral fracture in England: a report from the NHS Hip Fracture Anaesthesia Network (HIPFAN). Injury 42:1230–1233CrossRefPubMed
12.
Zurück zum Zitat Holt G, Smith R, Duncan K, Hutchison JD, Reid D (2009) Changes in population demographics and the future incidence of hip fracture. Injury 40:722–726CrossRefPubMed Holt G, Smith R, Duncan K, Hutchison JD, Reid D (2009) Changes in population demographics and the future incidence of hip fracture. Injury 40:722–726CrossRefPubMed
13.
Zurück zum Zitat Parker MJ, Gillespie WJ, Gillespie LD (2006) Effectiveness of hip protectors for preventing hip fractures in elderly people: systematic review. BMJ 332:571–574CrossRefPubMedPubMedCentral Parker MJ, Gillespie WJ, Gillespie LD (2006) Effectiveness of hip protectors for preventing hip fractures in elderly people: systematic review. BMJ 332:571–574CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Santesso N, Carrasco-Labra A, Brignardello-Petersen R (2014) Hip protectors for preventing hip fractures in older people. Cochrane Database Syst Rev:CD001255 Santesso N, Carrasco-Labra A, Brignardello-Petersen R (2014) Hip protectors for preventing hip fractures in older people. Cochrane Database Syst Rev:CD001255
15.
Zurück zum Zitat Derler S, Spierings AB, Schmitt KU (2005) Anatomical hip model for the mechanical testing of hip protectors. Med Eng Phys 27:475–485CrossRefPubMed Derler S, Spierings AB, Schmitt KU (2005) Anatomical hip model for the mechanical testing of hip protectors. Med Eng Phys 27:475–485CrossRefPubMed
16.
Zurück zum Zitat Minns J, Dodd C, Gardner R, Bamford J, Nabhani F (2004) Assessing the safety and effectiveness of hip protectors. Nurs Stand 18:33–38CrossRefPubMed Minns J, Dodd C, Gardner R, Bamford J, Nabhani F (2004) Assessing the safety and effectiveness of hip protectors. Nurs Stand 18:33–38CrossRefPubMed
17.
Zurück zum Zitat Choi WJ, Hoffer JA, Robinovitch SN (2010) The effect of positioning on the biomechanical performance of soft shell hip protectors. J Biomech 43:818–825CrossRefPubMed Choi WJ, Hoffer JA, Robinovitch SN (2010) The effect of positioning on the biomechanical performance of soft shell hip protectors. J Biomech 43:818–825CrossRefPubMed
18.
Zurück zum Zitat Kannus P, Parkkari J, Poutala J (1999) Comparison of force attenuation properties of four different hip protectors under simulated falling conditions in the elderly: an in vitro biomechanical study. Bone 25:229–235CrossRefPubMed Kannus P, Parkkari J, Poutala J (1999) Comparison of force attenuation properties of four different hip protectors under simulated falling conditions in the elderly: an in vitro biomechanical study. Bone 25:229–235CrossRefPubMed
19.
Zurück zum Zitat van Schoor NM, van der Veen AJ, Schaap LA, Smit TH, Lips P (2006) Biomechanical comparison of hard and soft hip protectors, and the influence of soft tissue. Bone 39:401–407CrossRefPubMed van Schoor NM, van der Veen AJ, Schaap LA, Smit TH, Lips P (2006) Biomechanical comparison of hard and soft hip protectors, and the influence of soft tissue. Bone 39:401–407CrossRefPubMed
20.
Zurück zum Zitat Laing AC, Feldman F, Jalili M, Tsai CM, Robinovitch SN (2011) The effects of pad geometry and material properties on the biomechanical effectiveness of 26 commercially available hip protectors. J Biomech 44:2627–2635CrossRefPubMedPubMedCentral Laing AC, Feldman F, Jalili M, Tsai CM, Robinovitch SN (2011) The effects of pad geometry and material properties on the biomechanical effectiveness of 26 commercially available hip protectors. J Biomech 44:2627–2635CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Laing AC, Robinovitch SN (2008) The force attenuation provided by hip protectors depends on impact velocity, pelvic size, and soft tissue stiffness. J Biomech Eng 130:061005CrossRefPubMed Laing AC, Robinovitch SN (2008) The force attenuation provided by hip protectors depends on impact velocity, pelvic size, and soft tissue stiffness. J Biomech Eng 130:061005CrossRefPubMed
22.
Zurück zum Zitat Laing AC, Robinovitch SN (2008) Effect of soft shell hip protectors on pressure distribution to the hip during sideways falls. Osteoporos Int 19:1067–1075CrossRefPubMed Laing AC, Robinovitch SN (2008) Effect of soft shell hip protectors on pressure distribution to the hip during sideways falls. Osteoporos Int 19:1067–1075CrossRefPubMed
23.
Zurück zum Zitat Parkkari J, Kannus P, Poutala J, Vuori I (1994) Force attenuation properties of various trochanteric padding materials under typical falling conditions of the elderly. J Bone Miner Res 9:1391–1396CrossRefPubMed Parkkari J, Kannus P, Poutala J, Vuori I (1994) Force attenuation properties of various trochanteric padding materials under typical falling conditions of the elderly. J Bone Miner Res 9:1391–1396CrossRefPubMed
24.
Zurück zum Zitat Li N, Tsushima E, Tsushima H (2013) Comparison of impact force attenuation by various combinations of hip protector and flooring material using a simplified fall-impact simulation device. J Biomech 46:1140–1146CrossRefPubMed Li N, Tsushima E, Tsushima H (2013) Comparison of impact force attenuation by various combinations of hip protector and flooring material using a simplified fall-impact simulation device. J Biomech 46:1140–1146CrossRefPubMed
25.
Zurück zum Zitat Wiener SL, Andersson GBJ, Nyhus LM, Czech J (2002) Force reduction by an external hip protector on the human hip after falls. Clin Orthop Relat Res (1976–2007) 398:157–168 Wiener SL, Andersson GBJ, Nyhus LM, Czech J (2002) Force reduction by an external hip protector on the human hip after falls. Clin Orthop Relat Res (1976–2007) 398:157–168
26.
Zurück zum Zitat Mills NJ (1996) The biomechanics of hip protectors. Proc Inst Mech Eng H J Eng Med 210:259–266CrossRef Mills NJ (1996) The biomechanics of hip protectors. Proc Inst Mech Eng H J Eng Med 210:259–266CrossRef
27.
Zurück zum Zitat Robinovitch SN, Evans SL, Minns J, Laing AC, Kannus P, Cripton PA, Derler S, Birge SJ, Plant D, Cameron ID, Kiel DP, Howland J, Khan K, Lauritzen JB (2009) Hip protectors: recommendations for biomechanical testing—an international consensus statement (part I). Osteoporos Int 20:1977–1988CrossRefPubMedPubMedCentral Robinovitch SN, Evans SL, Minns J, Laing AC, Kannus P, Cripton PA, Derler S, Birge SJ, Plant D, Cameron ID, Kiel DP, Howland J, Khan K, Lauritzen JB (2009) Hip protectors: recommendations for biomechanical testing—an international consensus statement (part I). Osteoporos Int 20:1977–1988CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Cameron ID, Robinovitch S, Birge S, Kannus P, Khan K, Lauritzen J, Howland J, Evans S, Minns J, Laing A, Cripton P, Derler S, Plant D, Kiel DP (2010) Hip protectors: recommendations for conducting clinical trials—an international consensus statement (part II). Osteoporos Int 21:1–10CrossRefPubMedPubMedCentral Cameron ID, Robinovitch S, Birge S, Kannus P, Khan K, Lauritzen J, Howland J, Evans S, Minns J, Laing A, Cripton P, Derler S, Plant D, Kiel DP (2010) Hip protectors: recommendations for conducting clinical trials—an international consensus statement (part II). Osteoporos Int 21:1–10CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Robinovitch SN, Hayes WC, McMahon TA (1991) Prediction of femoral impact forces in falls on the hip. J Biomech Eng 113:366–374CrossRefPubMed Robinovitch SN, Hayes WC, McMahon TA (1991) Prediction of femoral impact forces in falls on the hip. J Biomech Eng 113:366–374CrossRefPubMed
31.
Zurück zum Zitat European Committee for Standardization. EN 1621-1:1997 Motorcyclists’ protective clothing against mechanical impact. Part 1: requirements and test methods for impact protectors European Committee for Standardization. EN 1621-1:1997 Motorcyclists’ protective clothing against mechanical impact. Part 1: requirements and test methods for impact protectors
Metadaten
Titel
Biomechanical testing of hip protectors following the Canadian Standards Association express document
verfasst von
B. E. Keenan
S. L. Evans
Publikationsdatum
02.04.2019
Verlag
Springer London
Erschienen in
Osteoporosis International / Ausgabe 6/2019
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-019-04914-x

Weitere Artikel der Ausgabe 6/2019

Osteoporosis International 6/2019 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.