Potential Solutions for the Mitigation of Hip Injuries Caused by Falls in Older Adults: A Narrative Review

Abstract

Abstract Background Hip injuries caused by falling are common and often catastrophic for older adults. There is thus an urgent need to develop solutions designed to mitigate fall injuries to the hip by reducing the forces created on the body by ground impact. Methods The goal of this narrative review was to synthesize published literature on available products developed with the expressed goal of reducing fall-related hip injuries. Results Three categories were identified: passive wearables (eg, hip protectors), active wearables (eg, instrumented belts with deployable airbags), and compliant flooring. Laboratory studies indicate that each technology can reduce peak forces induced by simulated falls. Considerable preliminary data suggest that passive wearables and compliant flooring may reduce fall-related injuries within long-term care facilities. Controlled trials of specific types of these 2 technologies, however, have produced inconsistent results. While little is known about the effectiveness of active wearables, promising early data indicate the feasibility of an instrumented belt worn around the waist to effectively deploy an airbag to protect the hips prior to ground impact. Important challenges associated with one or more identified technologies included poor adherence to instructed wear as well as the potential for significant physical or time burden to caregivers or health care professionals. Conclusions Passive wearables, active wearables, and compliant flooring have shown promise in reducing fall-related hip injuries in older adults. Still, each type of product is accompanied by limited real-world data and/or significant challenges that must be overcome to maximize effectiveness and minimize unintended side effects.