Can flooring and underlay materials reduce hip fractures in older people?

The underlay, and its role in reducing the energy and peak forces transmitted to the hip from a lateral fall onto the greater trochanter, provides a more permanent solution and because it is hidden from view; aspects of texture and color are not considerations for purchasers of floor coverings. Fabrication of the PVC foam into a flexible workable form may be difficult, as it is a rigid form that does not stretch or bend easily during laying and positioning. A quicker immediate solution to provide protection with existing materials could be to use two or even three layers of the rubber crumb underlay, as the reduction of peak force under the carpet may be below the level that may be expected to fracture the hip. The ideal underlay/floor covering should have the following features:Sufficient firmness to reduce the energy level experienced at the hip to fracture the hip (<20J); 20J is considered the maximum that would fracture most hips in osteoporotic older people (i.e., at least a 50-per cent reduction in impact energy). Most foam rubber underlays only provide 10-30 percent reduction in energy.Reduction in peak force to below 2kN, which is the minimum threshold at which most osteoporotic patients are unlikely to fracture their hipsSufficient thickness and softness to prevent possible rucking or tripping on the carpet/vinyl that will be lying over the underlay; maximum thickness of the floor covering materials, including the underlay, should be 20mm.Good compression set properties, that is, return to its original thickness after both short-term (less than one second) and long-term loading (greater than five weeks)Anti-static characteristics to reduce attraction of dirt and minimize static buildup on the carpet/vinyl overlay due to relative movement between the twoMoisture-resistance on both the upper and lower surfacesSuitably flexible for ease of laying down and fixing. Some of the firm PU and PVC foams are difficult to roll and lay flat during cutting and shaping.Minimum aging effects: must not shrink or distort with time and temperatureEasy to cut by knife/scissors and lay for the carpet fittersComparable costs to the current conventional underlays (£7 to £8 per square meter)Compliance with the fire and building regulations (such as noise reduction) pertinent to flooring covers