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Test systems for the biomechanical evaluation of hip protectors: a systematic review

Yahaya SA, Ripin ZM, Ridzwan MIZ

Osteoporos Int, 2020 Jan;31(1):43-58.
PMID: 31446442 DOI: 10.1007/s00198-019-05128-x

Various mechanical and biomechanical test systems to evaluate the effectiveness of hip protectors designed to prevent hip fracture as a result of falls were examined in this review. The articles considered were selected systematically. The effect of differences in design criteria was demonstrated, and it was observed that the impact energy employed during testing dramatically affects the performance of the hip protector. Over the past three decades, researchers have continuously experimented with various systems to determine the efficacy of various hip protectors. The primary aim has been to make informed decisions in optimizing hip protector design. This article provides a systematic review of various test systems employed in the determination of the biomechanical efficacy of hip protectors. A systematic literature search was carried out, and 28 relevant articles were included to demonstrate the effect of test systems in the evaluation of the biomechanical effectiveness of hip protectors. Methodological studies illustrated the appropriate use of impact testing systems for the simulation of hip anatomy and fall dynamics in evaluating the effectiveness of hip protectors in preventing a hip fracture. This systematic review has demonstrated the effect of the variability of test systems on the evaluation of impact attenuation by various hip protectors. The lack of standardized test systems accounts for the inconsistencies in the test results of the efficacy of hip protectors. This has been a major challenge in the efforts of researchers to optimize the interventions. The standardization of test systems may require needed improvements immediately as opposed to the development of new interventions in order to ensure that only hip protectors with adequately proven efficacies are deployed for clinical trials or for the protection of the hips of vulnerable individuals from sideways impact.
Optimization of the Impact Attenuation Capability of Three-Dimensional Printed Hip Protector Produced by Fused Deposition Modeling Using Response Surface Methodology

Yahaya SA, Ripin ZM, Ridzwan MIZ

3D Print Addit Manuf, 2023 Oct 01;10(5):971-983.
PMID: 37886404 DOI: 10.1089/3dp.2021.0014

Fused deposition modeling has provided a cheap and effective method for the rapid production of prototypes and functional products in many spheres of life. In this study, three-dimensional (3D) printing techniques to produce and optimize a hip protector that will assure clinical efficacy are presented. The I-Optimal design was used to optimize the hip protector's significant parameters (infill density, shell thickness, and material shore hardness) to obtain maximum femoral neck force attenuation of the 3D-printed hip protector. A drop impact tower device simulates the impact force at the hip's parasagittal plane during a fall. The results show that the infill density has the most significant influence on attenuation properties, followed by the infill density combined with the material shore hardness. By maximizing all the parameters, it is demonstrated that using an additive manufacturing technique to print hip protectors could be an effective strategy in curbing hip fractures.
Fulltext Superlubricity of Materials: Progress, Potential, and Challenges

Ramezani M, Ripin ZM, Jiang CP, Pasang T

Materials (Basel), 2023 Jul 21;16(14).
PMID: 37512418 DOI: 10.3390/ma16145145

This review paper provides a comprehensive overview of the phenomenon of superlubricity, its associated material characteristics, and its potential applications. Superlubricity, the state of near-zero friction between two surfaces, presents significant potential for enhancing the efficiency of mechanical systems, thus attracting significant attention in both academic and industrial realms. We explore the atomic/molecular structures that enable this characteristic and discuss notable superlubric materials, including graphite, diamond-like carbon, and advanced engineering composites. The review further elaborates on the methods of achieving superlubricity at both nanoscale and macroscale levels, highlighting the influence of environmental conditions. We also discuss superlubricity's applications, ranging from mechanical systems to energy conservation and biomedical applications. Despite the promising potential, the realization of superlubricity is laden with challenges. We address these technical difficulties, specifically those related to achieving and maintaining superlubricity, and the issues encountered in scaling up for industrial applications. The paper also underscores the sustainability concerns associated with superlubricity and proposes potential solutions. We conclude with a discussion of the possible future research directions and the impact of technological innovations in this field. This review thus provides a valuable resource for researchers and industry professionals engaged in the development and application of superlubric materials.
Effects of patient transfer devices on the risk of work-related musculoskeletal disorders: a systematic review

Abdul Halim NSS, Ripin ZM, Ridzwan MIZ

Int J Occup Saf Ergon, 2023 Jun;29(2):494-514.
PMID: 35306979 DOI: 10.1080/10803548.2022.2055908

Objectives. This study aimed to evaluate the efficacy of patient transfer assistive devices in reducing the risk of work-related musculoskeletal disorders (WMSDs) among nurses. Methods. PubMed, Scopus, Google Scholar and the Cochrane Database of Systematic Reviews were searched to identify studies with a quantitative assessment of the efficacy of patient transfer assistive devices on the incidence and injury claims of WMSDs as compared to the manual lifting of patients. A health impact analysis of the pre-post intervention of assistive device implementation was performed. The percentage of the reduction of forces, incidence of WMSDs, number of missed workdays and injury compensation claims were calculated, pooled and presented as boxplots. Results. A total of 25 studies met the inclusion criteria. The best post-intervention outcomes of assistive devices deployment in the healthcare setting included a reduction in WMSD incidence by 59.8%, missed workdays by 90.0% and workers' compensation claims by 95.0%. Additionally, hand force declined by 71% (p
Fulltext Prevalence of hand-arm vibration syndrome among tyre shop workers in Kelantan, Malaysia

Qamruddin AA, Nik Husain NR, Sidek MY, Hanafi MH, Ripin ZM, Ali N

J Occup Health, 2019 Nov;61(6):498-507.
PMID: 31364246 DOI: 10.1002/1348-9585.12078

BACKGROUND: Prolonged exposure to hand-arm vibration is associated with a disorder of the vascular, neurological, and musculoskeletal systems of the upper limb known as hand-arm vibration syndrome (HAVS). Currently, the evidence of HAVS in tropical environments is limited.
OBJECTIVES: To determine the prevalence and severity of HAVS among tyre shop workers in Kelantan, Malaysia.
METHODS: A cross-sectional study involving 200 tyre shop workers from two districts in Kelantan was performed. Part one data were collected at the field using questionnaire, and hand-arm vibration was measured. Part two involved a set of hand clinical examinations. The workers were divided into high (≥5 m s-2 ) and low/moderate (<5 m s-2 ) exposure group according to their 8-hr time weighted average [A(8)] of vibration exposure. The differences between the two exposure group were then compared.
RESULTS: The prevalence of the vascular, neurological, and musculoskeletal symptoms was 12.5% (95% CI 10.16 to 14.84), 37.0% (95% CI 30.31 to 43.69), and 44.5% (95% CI 37.61 to 51.38) respectively. When divided according to their exposure statuses, there was a significant difference in the prevalence of HAVS for all three components of vascular, neurological, and musculoskeletal (22.68% vs 2.91%, 62.89% vs 12.62% and 50.52% and 38.83%) respectively. All the clinical examinations findings also significantly differed between the two groups with the high exposure group having a higher abnormal result.
CONCLUSION: Exposure to high A(8) of vibration exposure was associated with a higher prevalence of all three component of HAVS. There is a need for better control of vibration exposure in Malaysia.
Lifetime vibration dose correlates with severity of the neurological component of hand-arm vibration syndrome among tyre shop workers in Kelantan, Malaysia

Qamruddin AA, Husain NRN, Sidek MY, Hanafi MH, Ripin ZM, Ali N

Int J Occup Saf Ergon, 2021 Jun;27(2):410-415.
PMID: 30940001 DOI: 10.1080/10803548.2019.1600872

Introduction. Cumulative lifetime exposure to vibration is believed to contribute to more severe complications of hand-arm vibration syndrome (HAVS). Objectives. To determine prevalence of the neurological component of HAVS and the correlation between lifetime vibration dose (LVD) and neurological severity of HAVS among tyre shop workers in Kelantan. Methods. The cross-sectional study involved 200 tyre shop workers from two districts in Kelantan. Part one data were collected in the field using a questionnaire and hand-arm vibration was measured. Part two involved a set of hand clinical examinations (Purdue pegboard, Semmes-Weinstein monofilament and two-point discrimination tests) carried out for neurological component severity staging. LVD for each worker was calculated from data gathered in part one. For workers who had neurological symptoms, staging according to Stockholm workshop scales was done according to part two data. The strength of correlation between LVD and neurological stages was then determined using Spearman correlation. Results. Prevalence of neurological component was 37%. Spearman correlation between LVD and the neurological stages showed a moderate positive correlation. Conclusion. Cumulative lifetime exposure to hand-transmitted vibration is likely to be related to neurological severity of HAVS and therefore must be considered when assessing workers' exposure to hand-arm vibration.
Musculoskeletal complications of hand-arm vibration syndrome among tyre shop workers in Kelantan, Malaysia

Qamruddin AA, Husain NRN, Sidek MY, Hanafi MH, Ripin ZM, Ali N

Int J Occup Saf Ergon, 2020 Dec 03.
PMID: 33148113 DOI: 10.1080/10803548.2020.1846924

Objectives. Exposure to hand-arm vibration (HAV) is associated with hand-arm vascular syndrome (HAVS), which is characterized by musculoskeletal complications. However, evidence on this matter has been inconclusive. Therefore, this study aimed to determine and compare the prevalence of musculoskeletal complications of HAVS between a high-exposure (≥5 m·s-2) group and a low-moderate-exposure (<5 m·s-2) group and to explore the factors associated with the musculoskeletal complications of HAVS among tyre shop workers in Kelantan, Malaysia. Methods. A cross-sectional study involving 200 tyre shop workers was carried out. HAV was measured by a vibration meter. The workers were divided into two exposure groups - according to their 8-h time-weighted average, A(8), of vibration exposure - and compared. Results. Almost half of the workers reported musculoskeletal complications of the upper limbs and neck. Only the lifetime vibration dose (LVD) was significantly associated with the development of musculoskeletal complications. Conclusion. The high-exposure group had a higher prevalence of musculoskeletal complications. Only the LVD was significantly associated with complications. However, all factors of the work system, such as ergonomics, handgrip force and posture, might contribute to the development of musculoskeletal complications of HAVS and should be included in assessments.
Evaluation of a motorised patient transfer device based on perceived workload, technology acceptance, and emotional states

Law MJJ, Ridzwan MIZ, Ripin ZM, Abd Hamid IJ, Law KS, Karunagaran J, et al.

Disabil Rehabil Assist Technol, 2024 Apr;19(3):938-950.
PMID: 36334271 DOI: 10.1080/17483107.2022.2134472

PURPOSE: The high prevalence of musculoskeletal disorders (MSDs) among healthcare workers is partly attributed to the low adoption of patient transfer assistive devices. This study aimed to evaluate the nurses' perceived workload, technology acceptance, and emotional states during the use of the sliding board (SB) and mechanical intervention in the form of a Motorised Patient Transfer Device (MPTD).
METHODS: The SB and MPTD activities were performed by seven nurses on a simulated patient. The nurses' facial expressions were recorded during the trial. The NASA Task Load Index and technology acceptance questionnaire were also assessed.
RESULTS: The MPTD significantly reduced the mean overall NASA-TLX score by 68.7% (p = 0.004) and increased the overall acceptance score (median = 8.30) by 21.2% (p = 0.016) when compared to the SB (median = 6.85). All the subjects reported positive feelings towards MPTD. However, facial expression analysis showed that the nurses had a significantly higher peak density of fear while using MPTD (p = 0.016). Besides, there was no improvement in the negative valence and contempt emotion compared to the SB.
CONCLUSION: Overall, nurses showed positive perceptions and acceptance of MPTD even when they experienced negative emotions.IMPLICATIONS FOR REHABILITATIONThe Motorised Patient Transfer Device (MPTD) reduced the perceived workload of nurses and showed a higher acceptance level compared to the commonly used baseline device (SB).Factors that attributed to the nurses' negative emotions can be used to improve technology and patient transfer processes.More training should be given to familiarise the health practitioners with the new assistive device to reduce their fear of technology.