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Seniors' Health: Jury remains out on hip protectors

New study suggests the devices won't prevent fractures, but a Canadian expert says more research is needed

Whether seniors with fragile bones should wear protective pads on their hips to reduce their risk of a fracture is still an open question, but a recent study in nursing homes suggests the devices won’t be of much use.

In the study, a team led by Dr. Douglas Kiel of the Institute for Aging Research in Boston randomly assigned 37 nursing homes to have residents wear a hip protector on the left or right hip. The hip protector consisted of a foam-and-plastic pad that could be worn in several types of undergarments.

The 1,042 nursing home residents who participated had an average age of 85 years and 79 per cent were women. After 20 months, the researchers stopped the study because protected and unprotected hips each sustained fractures at a rate of approximately three per cent, indicating the protective pads were not working.

However, a Canadian osteoporosis expert says this will not be the last word on this controversial issue. “I think it’s a good study, I just don’t think it’s definitive,” says Dr. Angela Cheung, director of the osteoporosis program for the University Health Network and Mount Sinai Hospital in Toronto. “Researchers need to look at this issue more, and test different models of hip protectors.”

Cheung, who is also a member of Osteoporosis Canada’s scientific advisory council, says there aren’t many patients in her practice who use hip protectors, but she does suggest them for people who are particularly prone to falling. She recommends hard-shell models that are contained in a form-fitting undergarment so the protective pads don’t shift out of position.

However, she adds that before resorting to hip protectors, seniors should consider fall prevention strategies, including exercises such as tai chi, the use of canes and walkers, the installation of hand bars in the bathroom and proper lighting throughout the home, and the removal of slippery rugs and clutter on the floor.

Overall, Cheung says there is more evidence to support the use of hip protectors by the higher-risk elderly in nursing homes than among community-dwelling seniors, but few facilities actually use the devices.