Hip Protector Clinical Studies
Hip protectors have been subjected to a relatively large number of clinical studies over the past 20 years or so. Early study reports affirmed the benefit of hip protectors, most notably that published in the critically peer-reviewed New England Journal of Medicine in 20001 and endorsed by its accompanying editorial.2 These reports helped establish hip protectors as a central component of modern hip fracture prevention.
Several subsequent studies with various designs, different hip protectors and variable user compliance rates produced, not surprisingly, conflicting results. This resulted in several years of confusion and debate that temporarily slowed the wider adoption of hip protectors. More recently, an effort has been made to establish hip protector research standards3 for laboratory-controlled side-by-side comparisons of hip protector impact absorption capability as well as guidelines for future clinical studies concerning hip protector performance.4 The former provide a solid basis for directly comparing the various efficacy claims of individual manufacturers while the latter will hopefully improve the quality of future studies in a clinical setting.
In the meantime, the overall growing body of clinical evidence including several meta-analyses has continued to support the value of hip protectors in reducing the incidence of hip fractures.5-7 Notable in the discussion sections of many study reports has been the consistent call for improvements in shock absorption capability and better wearing comfort as a means to improve wearing compliance. It is these very appeals that have been central to Fall-Safe’s core design imperatives—to produce a hip protector that is not only significantly better in providing impact protection, but also better comfort, while also addressing shape and durability issues.
While no doubt future clinical studies may provide additional information, there is ample positive evidence to support the intuitively obvious concept of wearing hip protectors to diminish the risk of hip fractures occurring from falls sustained by people at risk, wherever and whenever the falls may occur. Indeed, they can be considered as a simple, relatively inexpensive insurance against what can be a devastating and life-altering injury with so many negative consequences.
As has been seen with other preventative endeavors that are challenging to confirm through formal prospective randomized clinical studies, such as the wearing of vehicle seatbelts—in many ways a good analogy to hip protectors—there is ample reason to believe that, in time, the benefit of an intuitively appropriate and relatively inexpensive intervention such as the wearing of hip protectors will cease to be a matter for debate.
In the upcoming Resources section of this website, we will, over time, include synopses of some of the more significant clinical trials in this field to help provide additional perspective.
References
- Kannus P, Parkkari J, Niemi S, et al. Prevention of Hip Fracture in Elderly People with Use of a Hip Protector. N Engl J Med 2000;343:1506-1513
- Rubenstein L. Editorial: Hip Protectors – A Breakthrough in Fracture Prevention. N Engl J Med 2000;343 (21)
- Robinovitch SN, Evans SL, Minns J, et al. Hip protectors: recommendations for biomechanical testing--an international consensus statement (part I). Osteoporos Int. 2009 Dec;20(12):1977-1988
- Cameron ID, Robinovitch S, Birge S et al. Hip protectors: recommendations for conducting clinical trials–an international consensus statement (part II). Osteoporos Int. 2010 Jan;21(1):1-10.
- Parker MJ, Gillespie WJ, Gillespie LD. Effectiveness of hip protectors for preventing hip fractures in elderly people: a systematic review. BMJ. 2006;332(7541):571-574.
- Oliver D, Connelly JB, Victor CR, et al. Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment: systematic review and meta-analyses. BMJ. 2007;334(7584):82-87.
- Sawka AM, Boulos P, Beattie K, et al. Hip protectors decrease hip fracture risk in elderly nursing home residents: a Bayesian meta-analysis. J Clin Epidemiol. 2007;60(4):336-344.