Effects of shear-thickening polymer on force attenuation capacities in hip protectors

Many elderly people use hip protectors to prevent hip fractures from sideways falls. These hip protectors absorb or shunt away the energy applied to the greater trochanter. Herein, shear-thickening polymer (STP)-based hip protectors composed of STP and polyurethane foam are studied. The purpose of this study was to identify the main factor that reduces the impact force directly applied to the femoral neck region and to determine the optimal thickness of STP in hip protectors. Seven hip protectors of different thicknesses were prepared, and two sets of free-fall mechanical tests with a low impact energy of 25.1 J and moderate impact energy of 44.1 J were conducted for each hip protector. When the thickness of STP exceeded 8 mm, the resultant peak force tended to plateau under both impact conditions, and the force attenuation capacity decreased even under low impact energy conditions. Thus, a hip protector with a 6 mm or 8 mm STP and 5 mm foam was recommended. The STP was the key factor affecting force attenuation capacity, not the polyurethane foam. However, the foam also played an important role in helping the STP function and improving compliance for users.

Skilled nursing resident adherence with wearable technology to offer safer mobility and decreased fall injuries

Hip fractures are a debilitating event for thousands of older adults each year in our communities and in our care facilities. The outcomes of sustaining a hip fracture include disability, significant cost and increased mortality in a growing population of those at risk of falls and fracture. Traditional methods of injury prevention from falls for those at risk of hip fracture include the wearing of hip protector clothing with limited adherence. A smart wearable designed to overcome barriers to adherence and offer hip protection with fall-sensing technology is emerging in older adult resident facilities to capture the fall as it occurs and avoid injury. This hip protection device has been evaluated in older adult residential settings to decrease fall injuries and support a culture of mobility. Adherence to the wear of the motion sensing technology can be accomplished by embedding the program into the daily care for residents identified as at risk of hip fracture. Successful adherence and shared results are illustrated with specific insight articulated in a single user case study.

Development of hip protectors for snowboarding utilizing 3D modeling and 3D printing

The purpose of this study was to develop a highly comfortable 3D male hip protector using 3D modeling and printing technologies. The hip protector pads and patterns were devised using 3D human body shapes, and three types of pads were chosen in consideration of snowboarding motions. The three types of pads were as follows: first, the original type with no hole; second, an inner open type with an incision on the inside; and third, an outer open type, with an incision on the outside. Another variable of the protective pads was the material: 3D printed thermoplastic polyurethane (TPU) pad + ethylene–vinyl acetate (EVA) foam or only EVA foam. Six types of pad prototypes were 3D printed and evaluated for subjective wearing comfort. Subjective comfort, fit, activity comfort, and shock absorption were evaluated on an 11-point Likert scale. The study results showed that protectors printed using TPU material were not different from the results of 3D modeling. The evaluation results revealed that comfort, fit, and motion comfort were all negatively evaluated by subjects when wearing the original pad. While fit, comfort, and motion comfort were all positively evaluated by subjects when wearing the outer open-type pad, and comfort and motion comfort were positively evaluated by subjects when wearing the inner open-type pad. With respect to materials, pads made with the 3D printing (TPU) and EVA foam combination provided the best results in terms of overall comfort, buttocks comfort, and activity comfort.

Hip Protectors and their Role in Hip Fracture Prevention: A Review

Hip fractures cause severe worldwide morbidity and loss of independence, costing national healthcare systems millions of pounds each year. The incidence is increasing with the expanding elderly population common of many Western countries. Hip protectors have been progressively studied in recent years focussing upon their use in hip fracture prevention, and compliance levels. This review aims to determine the effectiveness of protectors, and also investigates compliance levels. A search for English language Randomised Controlled Trials (RCTs) testing effectiveness of hip protectors was performed on Medline and Embase. Nine articles fulfilling the search criteria were found. Each was reviewed for hip protector effectiveness and compliance rates within the study, with results and conclusions critically-appraised. Of the nine articles, six (66.6%) found hip protectors to be effective in preventing hip fractures in selective populations. However, poor compliance rates were found in all reviewed trials. Future research should therefore focus upon improving compliance rates in the studied population.

EVALUATION OF SMART BELT HIP PROTECTION IN A SKILLED NURSING FACILITY

Hip fractures impact > 300,000 US older adults yearly resulting in 70,000 deaths and are expected to gain in numbers with the rising population. Residents of skilled nursing facilities are among the highest at risk of sustaining hip fractures due to increased risk of falls and frailty. These most vulnerable stand to experience the most serious results of hip fracture with > 50% resulting in total dependency and/or death. Care providers are focused on providing an environment of safety with implementation of traditionally utilized fall prevention measures. Unfortunately, the maintenance of safety in this high-risk population often comes at the price of limiting independent mobility. The utilization of passive hip protector padding for those recognized as being at high risk of hip fracture can decrease the risk of hip fracture by 82%; however, challenges to adherence of hip protectors limit the effectiveness of this widely utilized measure. Emerging technology in the form of a smart belt was evaluated in a skilled nursing setting to offer insight into efficacy and user adherence. The smart belt is capable of sensing when the wearer is experiencing a motion that would likely result in a fall onto the hip, deploy an anatomically conforming airbag and alert caregivers that a fall has occurred. The embedding of the hip protection technology into care planning led to daily patient utilization totaling over 3000 hours. Specific findings of the user derived motion and experience will be articulated through case studies and illustration of the technology captured motion data.

Development of a stick-on hip protector: A multiple methods study to improve hip protector design for older adults in the acute care environment

Introduction Over 90% of hip fractures in older adults result from falls, and hospital patients are at especially high risk. Specific types of wearable hip protectors have been shown to reduce hip fracture risk during a fall by up to 80%, but user compliance has averaged less than 50%. We describe the development and evaluation of a “stick-on” hip protector (secured over the hip with a skin-friendly adhesive) for older patients in acute care. Methods An initial version of the product was evaluated with six female patients (aged 76–91) in a hospital ward, who were asked to wear it for one week. We subsequently refined the product through biomechanical testing and solicited feedback from 43 health professionals on a second prototype. Results The first prototype was worn by five of six patients for the full week or duration of their hospital stay. The second prototype (20 mm thick, surface area 19 × 15.5 cm) provided 36% force attenuation, more than common garment-based models (20–21%). Feedback from patients and health professionals highlighted usability, comfort, cost, and appearance. Conclusions Our results from biomechanical and user testing support the need for further work to determine the value of stick-on hip protectors in acute care.