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The Influence of Body Mass Index, Sex, & Muscle Activation on Pressure Distribution During Lateral Falls on the Hip

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Abstract

Hip fracture incidence rates are influenced by body mass index (BMI) and sex, likely through mechanistic pathways that influence dynamics of the pelvis-femur system during fall-related impacts. The goal of this study was to extend our understanding of these impact dynamics by investigating the effects of BMI, sex, and local muscle activation on pressure distribution over the hip region during lateral impacts. Twenty participants underwent “pelvis-release experiments” (which simulate a lateral fall onto the hip), including muscle-‘relaxed’ and ‘contracted’ trials. Males and low-BMI individuals exhibited 44 and 55% greater peak pressure, as well as 66 and 56% lower peripheral hip force, compared to females and high-BMI individuals, respectively. Local muscle activation increased peak force by 10%, contact area by 17%, and peripheral hip force by 11% compared to relaxed trials. In summary, males and low-BMI individuals exhibited more concentrated loading over the greater trochanter. Muscle activation increased peak force, but this force was distributed over a larger area, preventing increased localized loading over the greater trochanter. These findings suggest potential value in incorporating sex, gender, and muscle activation-specific force distributions as inputs into computational tissue-level models, and have implications for the design of personalized protective devices including wearable hip protectors.

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Abbreviations

BMI:

Body mass index

GT:

Greater trochanter

MVC:

Maximal voluntary contraction

SENIAM:

Surface electromyography for non-invasive assessment of muscles

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Acknowledgments

This research was funded in part by an operating grant from the Natural Sciences and Engineering Research Council of Canada (RGPIN-2015-03636), and infrastructure grants from the Canadian Foundation for Innovation (Grant # 25351) and the Ontario Ministry of Research and Innovation (Grant # 25351).

Conflict of interest

The authors have no conflicts of interest to declare. No persons other than the authors had input into any aspect of the study including research question development, study design, data analysis, interpretation of results, or manuscript writing.

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Authors and Affiliations

  1. Injury Biomechanics and Aging Laboratory, Department of Kinesiology, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada

    Steven P. Pretty, Daniel R. Martel & Andrew C. Laing

Authors
  1. Steven P. Pretty
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  2. Daniel R. Martel
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  3. Andrew C. Laing
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Correspondence to Andrew C. Laing.

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Associate Editor Jane Grande-Allen oversaw the review of this article.

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Pretty, S.P., Martel, D.R. & Laing, A.C. The Influence of Body Mass Index, Sex, & Muscle Activation on Pressure Distribution During Lateral Falls on the Hip. Ann Biomed Eng 45, 2775–2783 (2017). https://doi.org/10.1007/s10439-017-1928-z

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  • DOI: https://doi.org/10.1007/s10439-017-1928-z

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