Hip protectors to reduce hip fractures

Conclusion: No indications for effectiveness

For elderly people living independently at home, provision of hip protectors is an ineffective intervention. There is an accumulating body of evidence that the use hip protectors in an institutional setting is ineffective. A problem is that hip protectors are not constantly worn, due to discomfort and practicality. However, the lack of favorable evidence can not be explained by the adherance issue. In a recent studie no protective effect of hip protectors was detected despite good adherence to protocol.

Recommendations (for research & practice)

Using non-clustered randomised designs in the future may avoid the apparent methodological biases in hip protector research.

Based on the results of research it is not recommended using hip protectors as a preventive measure in community and in institutions.

Review Date: 21/02/2007
Version: 1.0
Status: Publish

Procedure
Literature search (CSI catalogue; PUBMED; NHS EED; SafetyLit) was performed by the reviewer of CSI and later on by the documentalist of CSI. Results were compared and selected by two reviewers.
Two review articles were selected and six articles were added because of their relevant contribution to the subject.. The resulting evidence statements were subjected to expert review and if necessary adapted.

Background documents

Prevention of hip fractures by external hip protectors: a randomized controlled trial. (version 1)
Natasja M. van Schoor, Johannes H. Smit, Jos W. Twisk, ...[et al.] (2003)

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 (version 1)
Anna M. Sawka, Pauline Boulos, Karen Beattie ... [et al.] (2005)

Hip protectors for preventing hip fractures in older people (version 1)
M.J. Parker, W.J. Gillespie, L.D. Gillespie (2005)

Predictors of adherence with the recommended use of hip protectors (version 1)
S.E. Kurrle, I.D. Cameron, S. Quine (2004)

The Amsterdam Hip Protector Study: compliance and determinants of compliance (version 1)
N.M. van Schoor, G. Asma, J.H. Smit, ...[et al.] (2003)

Efficacy of a hip protector to prevent hip fracture in nursing home residents (version 1)
Douglas P. Kiel, Jay Magaziner, Sheryl Zimmerman, ...et.al (2007)

Hip protectors decrease hip fracture risk in elderly nursing home residents : a Bayesian meta-analysis (version 1)
A.M. Sawka, P. Boulos, K. Beattie ...[et al.] (2007)