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Mechanical and compliance study of a modified hip protector for old age home residents in Hong Kong. / Mechanical & compliance study of a modified hip protector for old age home residents in Hong Kong

Sze Pan Ching. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (leaves 162-178). / Abstracts in English and Chinese. / ABSTRACT --- p.i / ABSTRACT (IN CHINESE) --- p.iv / ACKNOWLEGEMENT --- p.vi / TABLE OF CONTENTS --- p.viii / LIST OF FIGURES --- p.xv / LIST OF TABLES --- p.xviii / LIST OF APPENDIX --- p.xx / LIST OF ABBREVIATIONS --- p.xxi / LIST OF DEFINITIONS OF TERMS --- p.xxii / Chapter I. --- INTRODUCTION --- p.1 / Chapter 1.1 --- Epidemiology of hip fracture among elderly worldwide --- p.1 / Chapter 1.2 --- Impact of hip fractures --- p.3 / Chapter 1.2.1 --- Mortality --- p.3 / Chapter 1.2.2 --- Hospitalization and institutionalization --- p.4 / Chapter 1.2.3 --- Morbidity --- p.4 / Chapter 1.2.4 --- Psychological impact and quality of life --- p.5 / Chapter 1.2.5 --- Financial burden --- p.6 / Chapter 1.3 --- Causes of hip fracture --- p.6 / Chapter 1.3.1 --- Mechanisms of hip fracture --- p.7 / Chapter 1.3.2 --- Degenerated protective mechanism --- p.8 / Chapter 1.3.3 --- Poor hip strength indices --- p.9 / Chapter 1.4 --- Prevention of hip fractures --- p.10 / Chapter 1.4.1 --- Reduction of the chance of lateral fall --- p.10 / Chapter 1.4.2 --- Increase hip strength indices --- p.11 / Chapter 1.4.3 --- Limitations of current strategies --- p.12 / Chapter 1.5 --- Hip protectors for prevention of hip fractures --- p.12 / Chapter 1.6 --- Effectiveness of hip protector --- p.14 / Chapter 1.6.1 --- Laboratory studies on effectiveness in force attenuation --- p.14 / Chapter 1.6.2 --- Clinical studies on prevention of hip fractures --- p.16 / Chapter 1.6.3 --- Cost-effectiveness study --- p.17 / Chapter 1.7 --- Problems on the use of hip protectors --- p.19 / Chapter 1.7.1 --- Discomfort --- p.19 / Chapter 1.7.2 --- Extra effort in wearing --- p.20 / Chapter 1.7.3 --- Appearance after wearing --- p.21 / Chapter 1.7.4 --- Urinary incontinence --- p.22 / Chapter 1.7.5 --- Oth er problems --- p.23 / Chapter 1.8 --- Acceptance and Compliance of hip protectors --- p.23 / Chapter 1.8.1 --- Acceptance --- p.23 / Chapter 1.8.2 --- Compliance --- p.24 / Chapter 1.9 --- Strategies to improve compliance of hip protector --- p.25 / Chapter 1.9.1 --- Better design of hip protector --- p.25 / Chapter 1.9.2 --- Encouragement/support to the user --- p.26 / Chapter 1.9.3 --- Support from nursing staff/carer --- p.27 / Chapter 1.10 --- Rationale and objectives of present study --- p.28 / Chapter II. --- METHODOLOGY --- p.36 / Chapter 2.1 --- Development of hip protector --- p.36 / Chapter 2.1.1 --- Design of the pads --- p.36 / Chapter 2.1.2 --- Design of the pants --- p.38 / Chapter 2.1.2.1 --- Fabric materials --- p.38 / Chapter 2.1.2.2 --- Anthropometric measurement --- p.42 / Chapter 2.1.2.3 --- Pattern design --- p.43 / Chapter 2.1.3 --- Trial use of hip protector --- p.43 / Chapter 2.1.4 --- Calculation and statistical method --- p.43 / Chapter 2.2 --- Mechanical test on force attenuation properties --- p.44 / Chapter 2.2.1 --- Testing system --- p.44 / Chapter 2.2.2 --- Simulation of impact force and identification of dropping height --- p.45 / Chapter 2.2.3 --- Testing method --- p.46 / Chapter 2.2.4 --- Calculation and statistical method --- p.47 / Chapter 2.3 --- Compliance study --- p.47 / Chapter 2.3.1 --- Setting --- p.47 / Chapter 2.3.2 --- Subjects --- p.48 / Chapter 2.3.3 --- Study design --- p.49 / Chapter 2.3.4 --- Implementation procedure and intervening Program --- p.49 / Chapter 2.3.4.1 --- Liaison with the heads and responsible staff in the elderly hostels --- p.49 / Chapter 2.3.4.2 --- Education program for hostel staff --- p.50 / Chapter 2.3.4.3 --- Education program for elderly subjects --- p.50 / Chapter 2.3.4.4 --- Fall and fracture risk counseling --- p.51 / Chapter 2.3.4.5 --- Consent and Ethical approval --- p.51 / Chapter 2.3.4.5 --- Provision of hip protector and training program on wearing hip protector --- p.51 / Chapter 2.3.4.6 --- Follow up and encouragement on the use of hip protector --- p.52 / Chapter 2.3.5 --- Outcome measures --- p.52 / Chapter 2.3.5.1 --- Primary outcome --- p.52 / Chapter 2.3.5.2 --- Secondary outcomes --- p.53 / Chapter 2.3.6 --- Measurement method --- p.55 / Chapter 2.3.6.1 --- Compliance --- p.55 / Chapter 2.3.6.2 --- Falls and fractures incidence --- p.56 / Chapter 2.3.6.3 --- Adverse effect and feedback after wearing hip protector --- p.56 / Chapter 2.3.6.4 --- Fear of fall --- p.57 / Chapter 2.3.6.5 --- Fall and fracture history --- p.57 / Chapter 2.3.6.6 --- Medical co-morbidities --- p.58 / Chapter 2.3.6.7 --- Presence of urinary incontinence --- p.58 / Chapter 2.3.6.8 --- Functional level --- p.58 / Chapter 2.3.6.9 --- Hand function --- p.58 / Chapter 2.3.6.10 --- Mobility --- p.59 / Chapter 2.3.6.11 --- Cognitive function --- p.59 / Chapter 2.3.7 --- Sample size calculation --- p.59 / Chapter 2.3.8 --- Calculation and Statistical method --- p.60 / Chapter III. --- RESULTS --- p.73 / Chapter 3.1 --- Design of hip protector --- p.73 / Chapter 3.1.1 --- The design of pants --- p.73 / Chapter 3.1.1.1 --- The fabric materials --- p.73 / Chapter 3.1.1.2 --- The size of the pants --- p.74 / Chapter 3.1.2 --- The design of pads --- p.75 / Chapter 3.1.2.1 --- Thickness of silicon padding --- p.75 / Chapter 3.1.1.2 --- Dimension of the hard shield --- p.75 / Chapter 3.2 --- Mechanical test on force attenuation properties of the pads --- p.76 / Chapter 3.2.1 --- Impact force --- p.76 / Chapter 3.2.2 --- Impact duration --- p.78 / Chapter 3.2.3 --- Selection of th e prototype --- p.78 / Chapter 3.3 --- Compliance study --- p.79 / Chapter 3.3.1 --- Demograph ics --- p.79 / Chapter 3.3.2 --- Primary outcome --- p.79 / Chapter 3.3.2.1 --- Initial acceptance rate --- p.79 / Chapter 3.3.2.2 --- Compliance rate --- p.79 / Chapter 3.3.2.3 --- Percentage of people wearing hip protector across the study period --- p.81 / Chapter 3.3.2.4 --- Percentage of protected fall --- p.81 / Chapter 3.3.3 --- Secondary outcomes --- p.81 / Chapter 3.3.3.1 --- Fall and related injury among the subjects in the study period --- p.81 / Chapter 3.3.3.2 --- Reasons for non-acceptance --- p.82 / Chapter 3.3.3.3 --- Feedback in using hip protector --- p.84 / Chapter 3.3.3.4 --- Factors associated with compliance and non-compliance (feedback in wearing hip protector) --- p.84 / Chapter 3.3.3.5 --- Factors associated with compliance and non-compliance (subject characteristics) --- p.85 / Chapter 3.3.3.6 --- Effect on mobility after wearing hip protector --- p.85 / Chapter 3.3.3.7 --- Fear of fall after wearing hip protector --- p.85 / Chapter IV. --- DISCUSSION --- p.123 / Chapter 4.1 --- Development of a hip protector for Chinese elderly --- p.124 / Chapter 4.1.1 --- Successful modifications made to the pads --- p.124 / Chapter 4.1.1.1 --- More comfort to wear with silicon cushioning materials added --- p.124 / Chapter 4.1.1.2 --- Better mechanical properties with semi-flexible plastic and silicon pad --- p.125 / Chapter 4.1.1.3 --- Smaller in dimension of the present model might improve appearance after wearing --- p.127 / Chapter 4.1.2 --- No significant improvement on compliance with modification of the pants --- p.128 / Chapter 4.2 --- Sufficient mechanical properties of hip protector demonstrated --- p.129 / Chapter 4.2.1 --- Mechanical test set up --- p.130 / Chapter 4.2.2 --- Mechanism of force attenuation --- p.132 / Chapter 4.3 --- No significant improvement on compliance shown --- p.134 / Chapter 4.4 --- Compliance at night time better than other studies --- p.136 / Chapter 4.5 --- Determinants of compliance mostly related to subjects' feedback of using hip protector rather than on their characteristics --- p.137 / Chapter 4.6 --- Better compliance observed in hostel with higher staff-to-subject ration and with occupational therapist as contact person --- p.138 / Chapter 4.7 --- Better acceptance rate of hip protector shown in the present study --- p.139 / Chapter 4.8 --- Identification of factors influencing acceptance --- p.139 / Chapter 4.9 --- Percentage of protected fall was higher than mean compliance --- p.141 / Chapter 4.10 --- No hip fracture occurred while subjects wearing hip protector --- p.141 / Chapter 4.11 --- Decreased fear of falling after wearing hip protector --- p.142 / Chapter 4.12 --- Limitation --- p.142 / Chapter 4.13 --- Recommendation --- p.143 / Chapter V. --- CONCLUSION --- p.146 / Chapter VI. --- APPENDIX --- p.148 / Chapter VII. --- BIBLIOGRAPHY --- p.162 / Chapter VIII. --- PUBLICATIONS --- p.179

Identiferoai:union.ndltd.org:cuhk.edu.hk/oai:cuhk-dr:cuhk_325751
Date January 2006
ContributorsSze, Pan Ching., Chinese University of Hong Kong Graduate School. Division of Orthopaedics and Traumatology.
Source SetsThe Chinese University of Hong Kong
LanguageEnglish, Chinese
Detected LanguageEnglish
TypeText, bibliography
Formatprint, xxii, 181, [22] leaves : ill. (some col.) ; 30 cm.
CoverageChina, Hong Kong, Hong Kong, Hong Kong
RightsUse of this resource is governed by the terms and conditions of the Creative Commons “Attribution-NonCommercial-NoDerivatives 4.0 International” License (http://creativecommons.org/licenses/by-nc-nd/4.0/)

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