Hip fracture is one of the most serious fall-related injuries in older adults, has a high rate of mortality and higher rate of disability. The incidence of hip fractures continues to increase as older adults become a larger proportion of the U.S. population. Within one-year post hip injury, 20% of elderly die and 30% of community dwellers are placed in nursing homes. Accordingly, hip injury prevention in the elderly is an increasingly important health concern. Hip fractures are expensive and are among the 20 most costly medical conditions. The average hospital cost for a hip fracture is $26,000 per episode and the projected annual cost of hip fracture in the U.S. is expected to reach $16B in 2020. As the U.S. population is aging, both the number of hip fractures and the costs of hip injury treatments are going to rise. Injury mitigation requires innovative approaches to minimize the probability of hip fracture occurrence. Use of hip protectors represents a potential strategy for reducing forces involved in a femoral impact. However, despite the need for hip protection in the elderly population, especially for people who are at risk of falls, adherence of hip protection use is low. Existing hip protectors are often bulky and uncomfortable and their effectiveness in reducing impact injury is limited by low rates of compliance and use. Design of comfortable and aesthetically pleasing protective wear with an advanced impact resisting material structure is one method that can increase usage. The protective system needs to be highly efficient in preventing injury and must consider two key determinants of when a fall results in a hip fracture: lateral direction and age- related changes in the stiffness and damping of the trochanteric soft tissues over the hip. The proposed Phase I research will build on novel engineering studies that demonstrated Alba-Technic's EVO2TM material system is highly effective in mitigating impact injury. A distinct advantage of EVO2 is that it can be tuned to both shunt and absorb impact energy simultaneously. This results in a very efficient design that can be made thinner, more comfortable and more appealing. Recent work by the Alba-Technic team has led to a process where the protector design can conform closely to a person's body shape and be made smooth and tapered to eliminate the stigmatizing appearance that comes with numerous protective devices currently on the market. The proposed new hip protector design acts as a secondary skin. Building upon these observations, we seek to assess the feasibility of using the EVO2 material for hip protection. In pursuit of this goal, we will apply rigorous approaches to develop a highly effective, non-stigmatizing, aesthetically pleasing hip protective wear product (called the Hip Defender) that elderly persons, susceptible to falls, will wear on a daily basis. The goals of the experiments outlined herein are to: Design a hip protector product with aesthetic appeal (Aim 1); Create a hip protection system using the optimized EVO2 material system (Aim 2); and Validate performance through impact testing and assessment of consumer preferences (Aim 3). The goal is the successful development of a hip protection device that is non-stigmatizing, highly effective with desirable appearance.
Public Health Relevance Statement: PROJECT NARRATIVE Hip injury prevention in older adults is of increasing public health concern due to several factors, the severe consequences, related costs and continued increase in the incidence of hip fractures. Hip protectors have not proven to be optimal solutions, primarily due to poor adherence, lack of acceptance aesthetically and discomfort among users wearing these devices. The proposed innovation presents an advanced technology that improves on the current state of the art. It combines injury-mitigating materials that simultaneously distribute and absorb the fall impact and can be molded into a form that is aesthetically appealing and comfortable to wear on a daily basis. Design and development of a highly effective, non-stigmatizing, aesthetically pleasing hip protective product could serve to overcome the known barriers to use among elderly persons susceptible to falls.
Project Terms: Address; Adherence; Adoption; Adult; age related; Aging; Appearance; Biomechanics; Cellular Structures; Centers for Disease Control and Prevention (U.S.); Cessation of life; Communities; comparative; Compliance behavior; Consumer Preferences; cost; Data; design; Development; Devices; disability; Doctor of Medicine; Doctor of Philosophy; Effectiveness; Elderly; Engineering; Environment; Esthetics; experience; experimental study; Fall prevention; fall risk; falls; Feedback; flexibility; Focus Groups; Goals; Health; Health Care Costs; Hip Fractures; Hip Injuries; Hip Joint; Hip region structure; Hospital Costs; improved; Incidence; Individual; Industrialization; Injury; injury prevention; innovation; Knowledge; Lateral; Legal patent; Maine; Medical; member; Methods; Molds; mortality; novel; Nursing Homes; Participant; Perception; Performance; performance tests; Persons; Phase; Population; prevent; Probability; Process; Protective Devices; prototype; Public Health; Quality of life; Rehabilitation therapy; Research; Research Methodology; Resistance; Risk; Shapes; Shunt Device; Skin; social stigma; soft tissue; Stigmatization; Structure; success; System; Target Populations; Technology; Testing; Thick; Time; Universities; wearable device; Work
