The Experts below are selected from a list of 270 Experts worldwide ranked by ideXlab platform
I Vuori - One of the best experts on this subject based on the ideXlab platform.
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energy shunting external hip Protector attenuates the peak femoral impact force below the theoretical fracture threshold an in vitro biomechanical study under falling conditions of thel elderly
Journal of Bone and Mineral Research, 2009Co-Authors: M Jari D Parkkari, Pekka Kannus, Jussi Heikkila, J Poutala, Harri Sievanen, I VuoriAbstract:The first objective of this study was to design a hip Protector that would effectively attenuate and shunt away from the greater trochanter the impact energies created in typical falls of the elderly. As the shock absorption material, the Protector included the 12 mm-thick Plastazote, which was found to be the most efficient energy-absorbing material in our previous in vitro biomechanical tests. With an anatomically designed semiflexible outer shield of the Protector (high density polyethylene), the impact surface was increased and the impact energy shunted away from the greater trochanter. In the second phase of the study, we determined the force attenuation capacity of this device in realistic (in vitro) falling conditions of the elderly. With the impact force of 6940 N used (a typical hip impact force measured in in vitro falling tests), the trochanteric soft tissue (25 mm-thick polyethylene foam) attenuated the peak femoral impact force to 5590 N and the tested Protector to 1040 N. In the second series of this experiment, the peak femoral impact force was set to be so high (13,130 N) that the Protector, if effective, should prevent the hip fracture in almost all cases. The trochanteric soft tissue attenuated this peak impact force to 10,400 N and the tested Protector to 1810 N. Thus, the force received by the proximal femur still remained clearly below 4170 N, the average force required to fracture in vitro the proximal femur of the elderly in a fall loading configuration. In conclusion, our test results suggest that an anatomically designed energy-shunting and energy-absorbing hip Protector can provide an effective impact force attenuation in typical falling conditions of the elderly. However, the efficacy of the Protector in the prevention of hip fractures can only be evaluated in randomized clinical trials. (J Bone Miner Res 1995 ;10 :1437-1442)
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prevention of hip fracture in elderly people with use of a hip Protector
The New England Journal of Medicine, 2000Co-Authors: Pekka Kannus, Jari Parkkari, Seppo Niemi, M Pasanen, Mika Palvanen, Markku Jarvinen, I VuoriAbstract:Background Hip fractures are common in frail elderly adults worldwide. We investigated the effect of an anatomically designed external hip Protector on the risk of these age-related fractures. Methods We randomly assigned 1801 ambulatory but frail elderly adults (1409 women and 392 men; mean age, 82 years), in a 1:2 ratio, either to a group that wore a hip Protector or to a control group. Fractures of the hip and all other fractures were recorded until the end of the first full month after 62 hip fractures had occurred in the control group. The risk of fracture in the two groups was compared, and in the hip-Protector group the risk of fracture was also analyzed according to whether the Protector had been in use at the time of a fall. Results During follow-up, 13 subjects in the hip-Protector group had a hip fracture, as compared with 67 subjects in the control group. The respective rates of hip fracture were 21.3 and 46.0 per 1000 person-years (relative hazard in the hip-Protector group, 0.4; 95 percent c...
I. D. Cameron - One of the best experts on this subject based on the ideXlab platform.
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Hip Protectors: recommendations for biomechanical testing—an international consensus statement (part I)
Osteoporosis International, 2009Co-Authors: S. Robinovitch, S. Birge, P. Kannus, J. Minns, S. L. Evans, A. C. Laing, P. A. Cripton, S. Derler, D. Plant, I. D. CameronAbstract: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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Hip Protectors: recommendations for conducting clinical trials—an international consensus statement (part II)
Osteoporosis International, 2009Co-Authors: I. D. Cameron, S. Robinovitch, S. Birge, P. Kannus, K. Khan, J. Lauritzen, J. Howland, S. Evans, J. Minns, A. LaingAbstract:Introduction While hip Protectors are effective in some clinical trials, many, including all in community settings, have been unable to demonstrate effectiveness. This is due partly to differences in the design and analysis. The aim of this report is to develop recommendations for subsequent clinical research. Methods In November of 2007, the International Hip Protector Research Group met to address barriers to the clinical effectiveness of hip Protectors. This paper represents a consensus statement from the group on recommended methods for conducting future clinical trials of hip Protectors. Results and conclusions Consensus recommendations include the following: the use of a hip Protector that has undergone adequate biomechanical testing, the use of sham hip Protectors, the conduct of clinical trials in populations with annual hip fracture incidence of at least 3%, a run-in period with demonstration of adequate adherence, surveillance of falls and adherence, and the inclusion of economic analyses. Larger and more costly clinical trials are required to definitively investigate effectiveness of hip Protectors.
A. Laing - One of the best experts on this subject based on the ideXlab platform.
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Hip Protectors: recommendations for conducting clinical trials—an international consensus statement (part II)
Osteoporosis International, 2009Co-Authors: I. D. Cameron, S. Robinovitch, S. Birge, P. Kannus, K. Khan, J. Lauritzen, J. Howland, S. Evans, J. Minns, A. LaingAbstract:Introduction While hip Protectors are effective in some clinical trials, many, including all in community settings, have been unable to demonstrate effectiveness. This is due partly to differences in the design and analysis. The aim of this report is to develop recommendations for subsequent clinical research. Methods In November of 2007, the International Hip Protector Research Group met to address barriers to the clinical effectiveness of hip Protectors. This paper represents a consensus statement from the group on recommended methods for conducting future clinical trials of hip Protectors. Results and conclusions Consensus recommendations include the following: the use of a hip Protector that has undergone adequate biomechanical testing, the use of sham hip Protectors, the conduct of clinical trials in populations with annual hip fracture incidence of at least 3%, a run-in period with demonstration of adequate adherence, surveillance of falls and adherence, and the inclusion of economic analyses. Larger and more costly clinical trials are required to definitively investigate effectiveness of hip Protectors.
Mike Langran - One of the best experts on this subject based on the ideXlab platform.
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White Paper: functionality and efficacy of wrist Protectors in snowboarding—towards a harmonized international standard
Sports Engineering, 2013Co-Authors: Frank I. Michel, Kai Uwe Schmitt, Frank I. Simpson, David Schulz, Richard M Greenwald, Kelly Russell, Mike LangranAbstract:The wrist is the most frequently injured body region among snowboarders. Studies have shown that the risk of sustaining a wrist injury can be reduced by wearing wrist protection. Currently, there are a wide variety of wrist protection products for snowboarding on the market that offer a range of protective features. However, there are no minimum performance standards for snowboarding wrist Protectors worldwide. The International Society for Skiing Safety convened a task force to develop a White Paper to evaluate the importance and necessity of a minimum performance for all wrist Protectors used in snowboarding. The White Paper outlines the need for a general framework for a harmonized international standard and reviews the existing evidence. Therefore, this White Paper may serve as a common base for future discussions. The broader goal of developing and implementing such a standard is to reduce the incidence and the severity of wrist injuries in snowboarding without increasing the risk of adverse events, such as upper arm or shoulder injury. The European standard for inline skating wrist Protectors (EN 14120) can serve as a starting point for efforts related to a standard for snowboard wrist Protectors, but certain modifications to the standard would be required. It is hypothesized that implementation of a snowboarding wrist Protector standard would result in fewer and less severe wrist injuries in the sport and could translate into more riding days for healthy snowboarders and significant health-care costs savings.
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White Paper: Functionality and efficacy of wrist Protectors in snowboarding-towards a harmonized international standard
Sports Engineering, 2013Co-Authors: Frank I. Michel, Kai Uwe Schmitt, Frank I. Simpson, David Schulz, Richard M Greenwald, Kelly Russell, Mike LangranAbstract:The wrist is the most frequently injured body region among snowboarders. Studies have shown that the risk of sustaining a wrist injury can be reduced by wearing wrist protection. Currently, there are a wide variety of wrist protection products for snowboarding on the market that offer a range of protective features. However, there are no minimum performance standards for snowboarding wrist Protectors worldwide. The International Society for Skiing Safety convened a task force to develop a White Paper to evaluate the importance and necessity of a minimum performance for all wrist Protectors used in snowboarding. The White Paper outlines the need for a general framework for a harmonized international standard and reviews the existing evidence. Therefore, this White Paper may serve as a common base for future discussions. The broader goal of developing and implementing such a standard is to reduce the incidence and the severity of wrist injuries in snowboarding without increasing the risk of adverse events, such as upper arm or shoulder injury. The European standard for inline skating wrist Protectors (EN 14120) can serve as a starting point for efforts related to a standard for snowboard wrist Protectors, but certain modifications to the standard would be required. It is hypothesized that implementation of a snowboarding wrist Protector standard would result in fewer and less severe wrist injuries in the sport and could translate into more riding days for healthy snowboarders and significant health-care costs savings. ABSTRACT FROM AUTHOR
Jonathan D. Adachi - One of the best experts on this subject based on the ideXlab platform.
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Do hip Protectors decrease the risk of hip fracture in institutional and community-dwelling elderly? A systematic review and meta-analysis of randomized controlled trials
Osteoporosis International, 2005Co-Authors: Anna M. Sawka, Pauline Boulos, Karen Beattie, Lehana Thabane, Alexandra Papaioannou, Amiram Gafni, Ann Cranney, Nicole Zytaruk, David A. Hanley, Jonathan D. AdachiAbstract:Hip fractures are an important cause of morbidity and mortality in the elderly. Hip Protectors are padded undergarments designed to decrease the impact of a fall on the hip. We systematically reviewed randomized controlled trials of hip Protectors to determine if they reduce hip fractures in the elderly. Analyses were pooled according to participant residence—community or institutional (the latter, included nursing homes, residential group homes or seniors’ hostels). We included individually randomized and statistically adjusted cluster randomized trials. Seven trials of 12- to 28-month duration were included. The Safehip brand of hip Protector was used in most studies. Compliance rates in the treatment groups varied from 31 to 68%. In four trials including a total of 5,696 community-dwelling seniors, the hip fracture rates in control groups ranged from 1.1 to 7.4%, and the pooled risk difference with hip Protector allocation was 0% [95% confidence intervals (CI), −1%, +1%), with a relative risk of 1.07 (0.81, 1.42). In three trials including 1,188 institutionalized elderly participants, hip fracture rates in the control groups varied from 8 to 19.4%, and the pooled risk difference for sustaining one or more hip fractures with hip Protector allocation was −3.7% (95% CI, −7.4%, 0.1%), with a relative risk of 0.56 (0.31, 1.01) (with statistically significant heterogeneity of treatment effect). In a post-hoc subgroup analysis of two trials comprised of exclusively nursing home residents, the risk difference with hip Protector allocation was −4.4% (−8.09, −0.76) with a relative risk of 0.50 (0.28, 0.91) ( n =1,014). Thus, there is little evidence to support the use of hip Protectors outside the nursing home setting. The potential benefit of hip Protectors in reducing hip fractures in nursing home residents requires further confirmation.
