I wonder what is the experience of our colleagues with the use of Hip Protectors. These have emerged about ten years ago and provide a mechanical protection to the vulnerable part of the hip bone. It is a simple device ( several models ) that absorbs part of the energy directed to the hip when falling. It atenuates the blow and may diminish the risk of fracture.
Hi Mohammed - Thank you for indicating this paper. Along the years it has become clear that hip protectors are not a remedy for all, However selected patients like people with Parkinson, Alzheimer and those defined as Frail may benefit from hip protectors when exposed to ADL activities with high risk of falls ( bathing for instance)
NICE quidelines include hip protectors in the armatorium for the protection of hip fracture in the elderly population. They state that "Hip protectors may be most useful for people who are confused or have dementia, are falling often or for those frailer individuals in residential care whose bones are very fragile, especially if they have previously had broken bones."
However they continue that "The biggest issue with hip protectors has been comfort and fit. Correct fitting of the underpants and positioning of the pads will ensure they are comfortable and more likely to be worn whenever the person is at risk of falling, even at night. Some of the modern types of pads have ventilation channels for temperature regulation and only a small part of their surface is in contact with the skin helping to reduce heat formation and sweating. These might be more comfortable when worn for a longer time, even throughout the day and night".
The evidence for NICE is limited and they write "A recent large review of hip protector studies, suggested that frail older people who wore hip protectors in nursing homes had a modest reduction in hip fracture. However there was no evidence of this reduction in people who used hip protectors in their own homes. The reason for these findings is uncertain but it is possible that some individuals did not wear the hip protectors all the time or that they were not fitted properly. People in nursing homes may have benefited more because staff had been trained to fit the hip protectors and to encourage residents to wear them".
In other words it is obviously reasonable to prescribe them on the frail patients as already mentioned by Arthur and potentially in a controlled environment which will make sure that they will be worn.
Hi George - one of the recomendations is to wear them mainly during activities with risk of falls. Another point - there is a line of underwears ecquiped not with pads but with a semi-soft material which make them more confortable.
Dear Arthur I completely agree with you. In the hospital prior to my retirement we developed a service for prevention of falls with the community and we were supplying such equipment to our elderly. Some designs were uncomfortable and we opted for more flexible materials. People were happy to wear them. All people who were at risk they had them for, as you said, protecting them during their "risky" activities
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