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. 2009 Dec;20(12):1977-88.
doi: 10.1007/s00198-009-1045-4. Epub 2009 Oct 6.

Hip protectors: recommendations for biomechanical testing--an international consensus statement (part I)

S N Robinovitch  1 , S L Evans, J Minns, A C Laing, P Kannus, P A Cripton, S Derler, S J Birge, D Plant, I D Cameron, D P Kiel, J Howland, K Khan, J B Lauritzen
Affiliations

Hip protectors: recommendations for biomechanical testing--an international consensus statement (part I)

S N Robinovitch et al. Osteoporos Int. 2009 Dec.

Abstract

Introduction: Hip protectors represent a promising strategy for preventing fall-related hip fractures. However, clinical trials have yielded conflicting results due, in part, to lack of agreement on techniques for measuring and optimizing the biomechanical performance of hip protectors as a prerequisite to clinical trials.

Methods: In November 2007, the International Hip Protector Research Group met in Copenhagen to address barriers to the clinical effectiveness of hip protectors. This paper represents an evidence-based consensus statement from the group on recommended methods for evaluating the biomechanical performance of hip protectors.

Results and conclusions: The primary outcome of testing should be the percent reduction (compared with the unpadded condition) in peak value of the axial compressive force applied to the femoral neck during a simulated fall on the greater trochanter. To provide reasonable results, the test system should accurately simulate the pelvic anatomy, and the impact velocity (3.4 m/s), pelvic stiffness (acceptable range: 39-55 kN/m), and effective mass of the body (acceptable range: 22-33 kg) during impact. Given the current lack of clear evidence regarding the clinical efficacy of specific hip protectors, the primary value of biomechanical testing at present is to compare the protective value of different products, as opposed to rejecting or accepting specific devices for market use.

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Conflict of interest statement

Conflicts of interest S.N. Robinovitch is a consultant to Tytex A/S, manufacturer of the Safehip line of wearable hip protectors. S.L. Evans was a consultant to the Ascent Group on hip protector design and testing and is currently a consultant to Dow Corning on impact protection materials and testing. A.C. Laing has received funding for conference travel from Tytex A/S. D.P. Kiel has received grants, served on advisory boards, or served on speakers’ bureaus for Eli Lilly, Novartis, Merck, Procter and Gamble, Amgen, GSK, Pfizer, Lifeline, and Hologic. P. Kannus has received grant funding, lecturing fees, or consulting fees from Aventis, MSD, Novartis, Pfizer, Respecta, and Roche. S.J. Birge has served on speakers’ bureaus for Merck, Novartis, Wyeth and as a consultant to Glaxo-Smith Kline and Pfizer. J.B. Lauritzen was a consultant to Tytex A/S until 2006. R.J. Minns received financial assistance from WinHealth (the European distributors of HipSaver hip protectors) for the construction of the test rig in his laboratory.

Figures

Fig. 1
Fig. 1
a Drop tower and b pendulum-based systems for measuring the capacity of hip protectors to attenuate the peak compressive force applied to the proximal femur during a simulated sideways fall from standing height
Fig. 2
Fig. 2
Effect of filtering on measured impact force. The raw force trace (solid line) has a secondary frequency artifact superimposed on the main waveform. A fourth order, low-pass, recursive Butterworth filter with a cut-off frequency of 50 Hz (dotted line) removes the secondary frequency arefact, without fundamentally affecting the primary waveform. In contrast, a filter with a 200 Hz cut-off frequency (dashed line) has little effect
See this image and copyright information in PMC

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