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Muscle activation has been demonstrated to influence impact dynamics during scenarios including running, automotive impacts, and head impacts. This study investigated the effects of targeted muscle activation magnitude on impact dynamics during low energy falls on the hip with human volunteers. Fifteen university-aged participants (eight females, seven males) underwent 12 lateral pelvis release trials. Half of the trials were muscle-'relaxed'; in the remaining 'contracted' trials participants isometrically contracted their gluteus medius to 20-30% of maximal voluntary contraction before the drop was initiated onto a force plate. Peak force applied to the femur-pelvis complex averaged 9.3% higher in contracted compared to relaxed trials (F = 6.798, p = .022). Muscle activation effects were greater for females, resulting in (on average) an 18.5% increase in effective pelvic stiffness (F = 5.838, p = .046) and a 23.4% decrease in time-to-peak-force (F = 5.109, p = .042). In the relaxed trials, muscle activation naturally increased during the impact event, reaching levels of 12.8, 7.5, 11.1, and 19.1% MVC at the time of peak force for the gluteus medias, vastus lateralis, erector spinae, and external oblique, respectively. These findings demonstrated that contraction of trunk and hip musculature increased peak impact force across sexes. In females, increases in the magnitude and rate of loading were accompanied (and likely driven) by increases in system stiffness. Accordingly, incorporating muscle activation contributions into biomechanical models that investigate loading dynamics in the femur and/or pelvis during lateral impacts may improve estimate accuracy.

In-vivo fall simulations generally evaluate hip fracture risk through differences in impact force magnitude; however, the distribution of force over the hip likely modulates loading and subsequent injury risk of the underlying femur. The current study characterized impact force distribution over the hip during falls, and the influence of biological sex and trochanteric soft tissue thickness (TSTT). Forty young adults completed fall simulation protocols (FSP) including highly controlled vertical pelvis and more dynamic kneeling and squat releases. At the instant of peak force, percentage of impact force applied in a circular region (r = 5 cm) centered over the greater trochanter (FGT%) was determined to characterize force localization. To assess the need for anatomically aligned pressure analysis, this process was repeated utilizing peak pressure location as a surrogate for the greater trochanter (FPP%). FGT% was 10.8 and 21.9% greater in pelvis release than kneeling and squat releases respectively. FGT% was 19.1 and 30.4% greater in males and low-TSTT individuals compared to females and high-TSTT individuals. TSTT explained the most variance (43.7–55.3%) in FGT% across all protocols, while sex explained additional variance (5.3–19.0%) during dynamic releases. In all FSP, TSTT-groups and sexes, average peak pressure location was posterior and distal to the GT. FPP% overestimated FGT% by an average of 15.7%, highlighting the need for anatomically aligned pressure analysis. This overestimation was FSP and sex dependent, minimized during pelvis release and in males. The data have important implications from clinical and methodological perspectives, and for implementation in tissue-level computational models.

A wide variety of accelerometer systems, with differing sensor characteristics, are used to detect impact loading during physical activities. The study examined the effects of system characteristics on measured peak impact loading during a variety of activities by comparing outputs from three separate accelerometer systems, and by assessing the influence of simulated reductions in operating range and sampling rate. Twelve healthy young adults performed seven tasks (vertical jump, box drop, heel drop, and bilateral single leg and lateral jumps) while simultaneously wearing three tri-axial accelerometers including a criterion standard laboratory-grade unit (Endevco 7267A) and two systems primarily used for activity-monitoring (ActiGraph GT3X+, GCDC X6-2mini). Peak acceleration (gmax) was compared across accelerometers, and errors resulting from down-sampling (from 640 to 100 Hz) and range-limiting (to ±6 g) the criterion standard output were characterized. The Actigraph activity-monitoring accelerometer underestimated gmax by an average of 30.2%; underestimation by the X6-2mini was not significant. Underestimation error was greater for tasks with greater impact magnitudes. gmax was underestimated when the criterion standard signal was down-sampled (by an average of 11%), range limited (by 11%), and by combined down-sampling and range-limiting (by 18%). These effects explained 89% of the variance in gmax error for the Actigraph system. This study illustrates that both the type and intensity of activity should be considered when selecting an accelerometer for characterizing impact events. In addition, caution may be warranted when comparing impact magnitudes from studies that use different accelerometers, and when comparing accelerometer outputs to osteogenic impact thresholds proposed in literature.

While metrics of pelvis and femur geometry have been demonstrated to influence hip fracture risk, attempts at linking geometry to underlying mechanisms have focused on fracture strength. We investigated the potential effects of femur and pelvis geometry on applied loads during lateral falls on the hip. Fifteen female volunteers underwent DXA imaging to characterize two pelvis and six femur geometric features. Additionally, participants completed low-energy sideways falls on the hip; peak impact force and pressure, contact area, and moment of force applied to the proximal femur were extracted. No geometric feature was significantly associated with peak impact force. Peak moment of force was significantly associated with femur moment arm (p = 0.005). Peak pressure was positively correlated with pelvis width and femur moment arm (p 0.05), while contact area was negatively correlated with metrics of pelvis width and femur neck length (p 0.05). This is the first study to link experimental measures of impact loads during sideways falls with image-based skeletal geometry from human volunteers. The results suggest that while skeletal geometry has limited effects on overall peak impact force during sideways falls, it does influence how impact loads are distributed at the skin surface, in addition to the bending moment applied to the proximal femur. These findings have implications for the design of protective interventions (e.g. wearable hip protectors), and for models of fall-related lateral impacts that could incorporate the relationships between skeletal geometry, external load magnitude/distribution, and tissue-level femur loads.

Impact mechanics theory suggests that peak loads should decrease with increase in system energy absorption. In light of the reduced hip fracture risk for persons with high body mass index (BMI) and for falls on soft surfaces, the purpose of this study was to characterize the effects of participant BMI, gender, and flooring surface on system energy absorption during lateral falls on the hip with human volunteers. Twenty university-aged participants completed the study with five men and five women in both low BMI (22.5 kg/m(2)) and high BMI (27.5 kg/m(2)) groups. Participants underwent lateral pelvis release experiments from a height of 5 cm onto two common floors and four safety floors mounted on a force plate. A motion-capture system measured pelvic deflection. The energy absorbed during the initial compressive phase of impact was calculated as the area under the force-deflection curve. System energy absorption was (on average) 3-fold greater for high compared to low BMI participants, but no effects of gender were observed. Even after normalizing for body mass, high BMI participants absorbed 1.8-fold more energy per unit mass. Additionally, three of four safety floors demonstrated significantly increased energy absorption compared to a baseline resilient-rolled-sheeting system (% increases ranging from 20.7 to 28.3). Peak system deflection was larger for high BMI persons and for impacts on several safety floors. This study indicates that energy absorption may be a common mechanism underlying the reduced risk of hip fracture for persons with high BMI and for those who fall on soft surfaces.