An analysis of the use of hip protectors in aged care facilities (institutional settings) and community-dwelling individuals.
Hip fractures are a significant contributor to morbidity and mortality in older adults. Studies have shown that people aged 65 and over who have suffered a hip fracture are up to 3.5 times more likely to die within a year of surgery. (1) 95% of hip fractures are caused by falls, usually sideways direction. (2) With the aging population, and prevalence of hip fractures globally, it is estimated that the incidence of hip fractures will rise to greater than 6 million worldwide by 2050. (3)
The most common form of hip fracture is a neck of femur fracture, which accounts for over half of hip fractures. (4) Hip protectors are designed to reduce the risk of hip fractures from falls.
Hip protectors are normally worn within specifically designed underwear. There are three different types of hip protectors:
There have been many studies over the years looking at the effectiveness of hip protectors in preventing fractures in older peoples. The current evidence is as follows:
However a new study has been released which provides evidence that hip protectors can reduce the risk of fracture three fold in residential aged care in residents who are compliant and meet certain criteria. (7) This study does have a number of limitations including who was included, what type of hip protectors were used and only evaluating those residents that were compliant however still has value in showing hip protectors can be effective in reducing fractures when used in residential care and following specific criteria.
There are a number or barriers around compliance and precautions which need to be considered on a case by case basis including:
Considering the evidence around fracture prevention and poor compliance, hip protectors should not be common practice for falls prevention, particularly in community dwelling individuals. However if all of the above barriers have been considered and the client is deemed likely to be compliant they may be considered as an adjunct to other falls prevention measures.
A person who has been prescribed hip protectors is often at a high risk of falls. Exercises would therefore focus on falls prevention.
This can be achieved through a program for the hip or lower limb. A combination of exercises would be put in place to improve strength, balance and stepping reactions, all of which work together to minimise someone’s falls risk.
When undertaking a comprehensive assessment of someone’s hip movements, or prescribing hip protectors, we will consider many factors including:
A comprehensive assessment by a Physiotherapist or Occupational Therapist is indicated to decrease someone’s risk of falls.
Extensive research suggests that the most effective approach to decreasing someone’s falls risk is a combination of:
There are also other factors to consider. Research indicates that someone’s vitamin D levels can impact their falls risk, as can their environment and the equipment they use (such as footwear or glasses).
Yes. Community Therapy has invested in several pieces of technology such as:
We also work on external perturbations. This involves the clinician moving someone to simulate a loss of balance in order to teach them how to correctly step and save themselves.
Our Physiotherapists also aim to improve someone’s ability to get down onto the ground and back up again.
All of these things in combination help someone to decrease their risk of falling and also decrease their risk of injury if they do fall.
Yes. When we partner with a residential aged care facility or a home care provider we usually engage in a falls committee as part of that partnership.
Committee meetings are weekly, fortnightly or monthly depending on the cohort of clients or residents that we are supporting. The meetings examine any trends in falls (such as time of day, location or mechanism involved) to determine strategies at a group level that can decrease fall rates. The committee will also look at any cases that need individualised strategies as well.
A hip fracture can occur in either of those ways.
Fractures can obviously occur through impact, either with the floor during a fall or with something else such as a motor vehicle.
Fractures that occur without a fall often indicate a pathology which could be weakening the bone, such as osteoporosis or cancer in the bone.
Theoretically, softer flooring can cushion the impact of a fall. However, careful consideration needs to be given to the other risks this can introduce. For example, a change in flooring can create a trip hazard.
A common strategy (particularly in residential aged care facilities or hospitals) is to place a falls mat next to someone’s bed if they are at a high risk of falls. While this may be suitable for someone who is bed bound and at risk of rolling out, in many cases it will not be suitable for someone who is still walking as the mat introduces a change of threshold that the person may not be able to navigate safely.
These factors need to be evaluated by an Occupational Therapist and decided on a case by case basis.
With high quality products and considerate service, we will work together with you to enhance your business and improve the efficiency. Please don't hesitate to contact us to get more details of Shoulder Protector.