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Kim T, Yu X, Xiong S. A multifactorial fall risk assessment system for older people utilizing a low-cost, markerless Microsoft Kinect. ERGONOMICS 2024; 67:50-68. [PMID: 37079340 DOI: 10.1080/00140139.2023.2202845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/29/2023] [Indexed: 05/03/2023]
Abstract
Falls among older people are a major health concern. This study aims to develop a multifactorial fall risk assessment system for older people using a low-cost, markerless Microsoft Kinect. A Kinect-based test battery was designed to comprehensively assess major fall risk factors. A follow-up experiment was conducted with 102 older participants to assess their fall risks. Participants were divided into high and low fall risk groups based on their prospective falls over a 6-month period. Results showed that the high fall risk group performed significantly worse on the Kinect-based test battery. The developed random forest classification model achieved an average classification accuracy of 84.7%. In addition, the individual's performance was computed as the percentile value of a normative database to visualise deficiencies and targets for intervention. These findings indicate that the developed system can not only screen out 'at risk' older individuals with good accuracy, but also identify potential fall risk factors for effective fall intervention.Practitioner summary: Falls are the leading cause of injuries in older people. We newly developed a multifactorial fall risk assessment system for older people utilising a low-cost, markerless Kinect. Results showed that the developed system can screen out 'at risk' individuals and identify potential risk factors for effective fall intervention.
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Affiliation(s)
- Taekyoung Kim
- Human Factors and Ergonomics Laboratory, Department of Industrial and Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejoen, Republic of Korea
- KT R&D Center, Seoul, Republic of Korea
| | - Xiaoqun Yu
- Human Factors and Ergonomics Laboratory, Department of Industrial and Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejoen, Republic of Korea
| | - Shuping Xiong
- Human Factors and Ergonomics Laboratory, Department of Industrial and Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejoen, Republic of Korea
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Pérez-López JF, Cano-de-la-Cuerda R, Ortiz-Gutiérrez RM. Accelerometry in the Functional Assessment of Balance in People with Stroke: A Systematic Review. J Clin Med 2023; 12:7701. [PMID: 38137771 PMCID: PMC10743978 DOI: 10.3390/jcm12247701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/07/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023] Open
Abstract
Balance disturbances in people with lived experience of stroke affect activities of daily living and social participation, so assessing them is essential to know the level of functional independence. Accelerometers are electronic devices that allow kinematic variables of balance to be recorded and are a tool of great interest in the assessment of functional balance. To determine the validity and reliability of, as well as the most performed protocols using accelerometers in the functional assessment of balance in people with experience of stroke, a systematic search of articles published in the electronic databases PubMed, Scopus, the Web of Science, the Cochrane Library, the PEDro and the Virtual Health Library from Spain was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We used QUADAS-2 to assess the quality of the included studies. Eight studies met the inclusion criteria, two studied reliability and validity, two studied reliability and four studied the validity of accelerometers in the assessment of balance in people with stroke. All studies indicated the kind of accelerometer, localization on the body, tests and outcome variables. The results indicate that accelerometers show excellent reliability values in the assessment of balance in people who had a prior stroke and disparate results in terms of validity. Triaxial accelerometers were most used, and the 4th and 5th lumbar and 1st and 2nd sacral vertebrae were the body areas most used for their placement.
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Affiliation(s)
- Juan Francisco Pérez-López
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Universidad Rey Juan Carlos, 28922 Madrid, Spain;
| | - Roberto Cano-de-la-Cuerda
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Universidad Rey Juan Carlos, 28922 Madrid, Spain;
| | - Rosa María Ortiz-Gutiérrez
- Radiology, Rehabilitation and Physiotherapy Department, Nursing, Physiotherapy and Podiatry Faculty, Complutense of Madrid University, Plaza Ramón y Cajal 3, 28040 Madrid, Spain;
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Honvo G, Sabico S, Veronese N, Bruyère O, Rizzoli R, Amuthavalli Thiyagarajan J, Mikton C, Diaz T, Cooper C, Reginster JY. Measures of attributes of locomotor capacity in older people: a systematic literature review following the COSMIN methodology. Age Ageing 2023; 52:iv44-iv66. [PMID: 37902521 PMCID: PMC10615073 DOI: 10.1093/ageing/afad139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND Locomotor capacity (LC) is an important domain of intrinsic capacity and key determinant of functional ability and well-being in older age. The United Nations Decade of Healthy Ageing (2021-2030) calls for strengthening data and research on healthy ageing, including the measurement of older persons' LC. To advance the measurement and monitoring of LC, there is pressing need to identify valid and reliable measures. OBJECTIVE To identify all the available tools that were validated for measurement of LC or of its specific attributes in older people and to assess the methodological quality of the studies and measurement properties of the tools. DESIGN Systematic review. SETTING Anywhere (Community-dwelling; long-term care facility; etc.). SUBJECTS Older people. METHODS We used highly sensitive search strategies to search the following databases: Medline, Embase, Scopus, CINAHL and PsycINFO. The study was conducted following the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology for systematic review of outcome measurement instruments. RESULTS A total of 125 studies were included, which assessed tools for balance (n = 84), muscle power (n = 12), muscle strength (n = 32, including four studies about tools for balance and muscle power) and endurance (n = 1). No studies on tools for muscle function, joint function, or locomotor capacity overall, were retrieved. We identified 69 clinician-report or objective assessment tools for balance, 30 for muscle strength, 12 for muscle power and 1 endurance assessment tool. The GRADE assessment of quality of evidence showed that only a few tools have high quality evidence for both sufficient validity and reliability: The Balance Evaluation Systems Test (BESTest), the Mini-Balance Evaluation Systems Test (Mini-BESTest), the Berg Balance Scale (BBS) and the Timed Up and Go (TUG) test. CONCLUSIONS A few tools with high quality evidence for sufficient validity and reliability are currently available for balance assessment in older people that may be recommended for use in clinical and research settings. Further validation studies are required for muscle strength, muscle power and endurance assessment tools.
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Affiliation(s)
- Germain Honvo
- World Health Organization (WHO) Collaborating Center for Epidemiology of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
- Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Shaun Sabico
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Nicola Veronese
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Olivier Bruyère
- World Health Organization (WHO) Collaborating Center for Epidemiology of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
- Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - René Rizzoli
- World Health Organization (WHO) Collaborating Center for Epidemiology of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | | | - Christopher Mikton
- Demographic Change and Healthy Aging Unit, Social Determinants of Health, World Health Organization, Geneva, Switzerland
| | - Theresa Diaz
- Epidemiology, Monitoring and Evaluation Unit, Maternal, Newborn, Child, Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Cyrus Cooper
- World Health Organization (WHO) Collaborating Center for Epidemiology of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Jean-Yves Reginster
- World Health Organization (WHO) Collaborating Center for Epidemiology of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
- Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Bohlke K, Redfern MS, Rosso AL, Sejdic E. Accelerometry applications and methods to assess standing balance in older adults and mobility-limited patient populations: a narrative review. Aging Clin Exp Res 2023; 35:1991-2007. [PMID: 37526887 PMCID: PMC10881067 DOI: 10.1007/s40520-023-02503-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 07/11/2023] [Indexed: 08/02/2023]
Abstract
Accelerometers provide an opportunity to expand standing balance assessments outside of the laboratory. The purpose of this narrative review is to show that accelerometers are accurate, objective, and accessible tools for balance assessment. Accelerometry has been validated against current gold standard technology, such as optical motion capture systems and force plates. Many studies have been conducted to show how accelerometers can be useful for clinical examinations. Recent studies have begun to apply classification algorithms to accelerometry balance measures to discriminate populations at risk for falls. In addition to healthy older adults, accelerometry can monitor balance in patient populations such as Parkinson's disease, multiple sclerosis, and traumatic brain injury. The lack of software packages or easy-to-use applications have hindered the shift into the clinical space. Lack of consensus on outcome metrics has also slowed the clinical adoption of accelerometer-based balance assessments. Future studies should focus on metrics that are most helpful to evaluate balance in specific populations and protocols that are clinically efficacious.
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Affiliation(s)
- Kayla Bohlke
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA, 15260, USA
| | - Mark S Redfern
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA, 15260, USA
| | - Andrea L Rosso
- Department of Epidemiology, School of Public Health, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA, 15260, USA
| | - Ervin Sejdic
- The Edward S. Rogers Department of Electrical and Computer Engineering, Faculty of Applied Science and Engineering, University of Toronto, 27 King's College Cir, Toronto, ON, M5S, Canada.
- North York General Hospital, 4001 Leslie St., Toronto, ON, M2K, Canada.
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Lim ACY, Natarajan P, Fonseka RD, Maharaj M, Mobbs RJ. The application of artificial intelligence and custom algorithms with inertial wearable devices for gait analysis and detection of gait-altering pathologies in adults: A scoping review of literature. Digit Health 2022; 8:20552076221074128. [PMID: 35111331 PMCID: PMC8801637 DOI: 10.1177/20552076221074128] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/27/2021] [Indexed: 12/11/2022] Open
Abstract
Background The purpose of this scoping review was to explore the current applications of objective gait analysis using inertial measurement units, custom algorithms and artificial intelligence algorithms in detecting neurological and musculoskeletal gait altering pathologies from healthy gait patterns. Methods Literature searches were conducted of four electronic databases (Medline, PubMed, Embase and Web of Science) to identify studies that assessed the accuracy of these custom gait analysis models with inputs derived from wearable devices. Data was collected according to the preferred reporting items for systematic reviews and meta-analysis statement guidelines. Results A total of 23 eligible studies were identified for inclusion in the present review, including 10 custom algorithms articles and 13 artificial intelligence algorithms articles. Nine studies evaluated patients with Parkinson’s disease of varying severity and subtypes. Support vector machine was the commonest adopted artificial intelligence algorithm model, followed by random forest and neural networks. Overall classification accuracy was promising for articles that use artificial intelligence algorithms, with nine articles achieving more than 90% accuracy. Conclusions Current applications of artificial intelligence algorithms are reasonably effective discrimination between pathological and non-pathological gait. Of these, machine learning algorithms demonstrate the additional capacity to handle complicated data input, when compared to other custom algorithms. Notably, there has been increasing application of machine learning algorithms for conducting gait analysis. More studies are needed with unsupervised methods and in non-clinical settings to better reflect the community and home-based usage.
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Affiliation(s)
- Ashley Cha Yin Lim
- NeuroSpine Surgery Research Group (NSURG), Australia.,Faculty of Health and Medicine, The University of Newcastle, Australia
| | - Pragadesh Natarajan
- NeuroSpine Surgery Research Group (NSURG), Australia.,Neuro Spine Clinic, Prince of Wales Private Hospital, Australia.,Faculty of Medicine, University of New South Wales (UNSW), Australia
| | - R Dineth Fonseka
- NeuroSpine Surgery Research Group (NSURG), Australia.,Neuro Spine Clinic, Prince of Wales Private Hospital, Australia.,Faculty of Medicine, University of New South Wales (UNSW), Australia
| | - Monish Maharaj
- NeuroSpine Surgery Research Group (NSURG), Australia.,Neuro Spine Clinic, Prince of Wales Private Hospital, Australia.,Faculty of Medicine, University of New South Wales (UNSW), Australia
| | - Ralph J Mobbs
- NeuroSpine Surgery Research Group (NSURG), Australia.,Neuro Spine Clinic, Prince of Wales Private Hospital, Australia.,Faculty of Medicine, University of New South Wales (UNSW), Australia
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Gaspar AGM, Lapão LV. eHealth for Addressing Balance Disorders in the Elderly: Systematic Review. J Med Internet Res 2021; 23:e22215. [PMID: 33908890 PMCID: PMC8116987 DOI: 10.2196/22215] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 01/10/2021] [Accepted: 02/25/2021] [Indexed: 02/06/2023] Open
Abstract
Background The population is aging on a global scale, triggering vulnerability for chronic multimorbidity, balance disorders, and falls. Falls with injuries are the main cause of accidental death in the elderly population, representing a relevant public health problem. Balance disorder is a major risk factor for falling and represents one of the most frequent reasons for health care demand. The use of information and communication technologies to support distance healthcare (eHealth) represents an opportunity to improve the access and quality of health care services for the elderly. In recent years, several studies have addressed the potential of eHealth devices to assess the balance and risk of falling of elderly people. Remote rehabilitation has also been explored. However, the clinical applicability of these digital solutions for elderly people with balance disorders remains to be studied. Objective The aim of this review was to guide the clinical applicability of eHealth devices in providing the screening, assessment, and treatment of elderly people with balance disorders, but without neurological disease. Methods A systematic review was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statement. Data were obtained through searching the PubMed, Google Scholar, Embase, and SciELO databases. Only randomized controlled trials (RCTs) or quasiexperimental studies (QESs) published between January 2015 and December 2019 were included. The quality of the evidence to respond to the research question was assessed using Joanna Briggs Institute (JBI) Critical Appraisal for RCTs and the JBI Critical Appraisal Checklist for QESs. RCTs were assessed using the Cochrane risk of bias tool. We provide a narrative synthesis of the main outcomes from the included studies. Results Among 1030 unduplicated articles retrieved, 21 articles were included in this review. Twelve studies explored different technology devices to obtain data about balance and risk of falling. Nine studies focused on different types of balance exercise training. A wide range of clinical tests, functional scales, classifications of faller participants, sensor-based tasks, intervention protocols, and follow-up times were used. Only one study described the clinical conditions of the participants. Instrumental tests of the inner ear were neither used as the gold-standard test nor performed in pre and postrehabilitation assessments. Conclusions eHealth has potential for providing additional health care to elderly people with balance disorder and risk of falling. In the included literature, the heterogeneity of populations under study, methodologies, eHealth devices, and time of follow-up did not allow for clear comparison to guide proper clinical applicability. This suggests that more rigorous studies are needed.
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Affiliation(s)
- Andréa G Martins Gaspar
- Hospital Beatriz Ângelo, Lisbon, Portugal.,Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Luís Velez Lapão
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal
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Bet P, Castro PC, Ponti MA. Foreseeing future falls with accelerometer features in active community-dwelling older persons with no recent history of falls. Exp Gerontol 2020; 143:111139. [PMID: 33189837 DOI: 10.1016/j.exger.2020.111139] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/21/2020] [Accepted: 10/24/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Acceleration sensors are a viable option for monitoring gait patterns and its application on monitoring falls and risk of falling. However the literature still lacks prospective studies to investigate such risk before the occurrence of falls. OBJECTIVE To investigate features extracted from accelerometer signals with the purpose of predicting future falls in individuals with no recent history of falls. METHODS In this study we investigate the risk of fall in active and healthy community-dwelling living older persons with no recent history of falls, using a single accelerometer and variants of the Timed Up and Go (TUG) test. A prospective study was conducted with 74 healthy non-fallers older persons. After collecting acceleration data from the participants at the baseline, the occurrence of falls (outcome) was monitored quarterly during one year. A set of frequency features were extracted from the signal and their ability to predict falls was evaluated. RESULTS The best individual feature result shows an accuracy of 0.75, sensitivity of 0.71 and specificity of 0.76. A fusion of the three best features increases the sensitivity to 0.86. On the other hand, the cut-off points of the TUG seconds, often used to assess fall risk, did not demonstrate adequate sensitivity. CONCLUSION The results confirms previous evidence that accelerometer features can better estimate fall risk, and support potential applications that try to infer falls risk in less restricted scenarios, even in a sample stratified by age and gender composed of active and healthy community-dwelling living older persons.
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Affiliation(s)
- Patricia Bet
- Programa de Pós-Graduação Interunidades em Bioengenharia - Universidade de São Paulo, São Carlos, SP 13566-590, Brazil; DGero - Universidade Federal de São Carlos, São Carlos, SP, Brazil.
| | - Paula C Castro
- DGero - Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Moacir A Ponti
- ICMC - Universidade de São Paulo, São Carlos, SP 13566-590, Brazil
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Cruz-Montecinos C, Cuesta-Vargas A, Muñoz C, Flores D, Ellsworth J, De la Fuente C, Calatayud J, Rivera-Lillo G, Soto-Arellano V, Tapia C, García-Massó X. Impact of Visual Biofeedback of Trunk Sway Smoothness on Motor Learning during Unipedal Stance. SENSORS 2020; 20:s20092585. [PMID: 32370050 PMCID: PMC7248825 DOI: 10.3390/s20092585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 12/16/2022]
Abstract
The assessment of trunk sway smoothness using an accelerometer sensor embedded in a smartphone could be a biomarker for tracking motor learning. This study aimed to determine the reliability of trunk sway smoothness and the effect of visual biofeedback of sway smoothness on motor learning in healthy people during unipedal stance training using an iPhone 5 measurement system. In the first experiment, trunk sway smoothness in the reliability group (n = 11) was assessed on two days, separated by one week. In the second, the biofeedback group (n = 12) and no-biofeedback group (n = 12) were compared during 7 days of unipedal stance test training and one more day of retention (without biofeedback). The intraclass correlation coefficient score 0.98 (0.93–0.99) showed that this method has excellent test–retest reliability. Based on the power law of practice, the biofeedback group showed greater improvement during training days (p = 0.003). Two-way mixed analysis of variance indicates a significant difference between groups (p < 0.001) and between days (p < 0.001), as well as significant interaction (p < 0.001). Post hoc analysis shows better performance in the biofeedback group from training days 2 and 7, as well as on the retention day (p < 0.001). Motor learning objectification through visual biofeedback of trunk sway smoothness enhances postural control learning and is useful and reliable for assessing motor learning.
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Affiliation(s)
- Carlos Cruz-Montecinos
- Clinical Biomechanics Laboratory, Department of Physical Therapy, University of Chile, 8380453 Santiago, Chile; (C.C.-M.); (C.M.); (D.F.); (J.E.); (G.R.-L.)
- Biomechanics and Kinesiology Laboratory, Hospital San José, 8380419 Santiago, Chile
| | - Antonio Cuesta-Vargas
- Department of Physiotherapy, Faculty of Heath Sciences, University of Malaga, 29071 Málaga, Spain;
- Institute of Biomedical Research in Malaga (IBIMA), 29010 Málaga, Spain
- School of Clinical Science, Faculty of Health Science, Queensland University Technology, Brisbane, QLD 4000, Australia
| | - Cristian Muñoz
- Clinical Biomechanics Laboratory, Department of Physical Therapy, University of Chile, 8380453 Santiago, Chile; (C.C.-M.); (C.M.); (D.F.); (J.E.); (G.R.-L.)
| | - Dante Flores
- Clinical Biomechanics Laboratory, Department of Physical Therapy, University of Chile, 8380453 Santiago, Chile; (C.C.-M.); (C.M.); (D.F.); (J.E.); (G.R.-L.)
| | - Joseph Ellsworth
- Clinical Biomechanics Laboratory, Department of Physical Therapy, University of Chile, 8380453 Santiago, Chile; (C.C.-M.); (C.M.); (D.F.); (J.E.); (G.R.-L.)
| | - Carlos De la Fuente
- Carrera de Kinesiología, Departamento de Cs. de la Salud, Facultad de Medicina, Pontificia Universidad Católica, 7820436 Santiago, Chile;
- Laboratorio LIBFE, Escuela de Kinesiología, Universidad de los Andes, 7620086 Santiago, Chile
- Centro de Salud Deportiva, Clínica Santa María, 7520378 Santiago, Chile
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain;
| | - Gonzalo Rivera-Lillo
- Clinical Biomechanics Laboratory, Department of Physical Therapy, University of Chile, 8380453 Santiago, Chile; (C.C.-M.); (C.M.); (D.F.); (J.E.); (G.R.-L.)
- Neuroscience Department, University of Chile, 8380453 Santiago, Chile
- Research and Development Unit, Clínica Los Coihues, 9190025 Santiago, Chile
| | | | - Claudio Tapia
- Clinical Biomechanics Laboratory, Department of Physical Therapy, University of Chile, 8380453 Santiago, Chile; (C.C.-M.); (C.M.); (D.F.); (J.E.); (G.R.-L.)
- Universidad Tecnológica de Chile INACAP, Escuela Salud, 8340536 Santiago, Chile
- Correspondence:
| | - Xavier García-Massó
- Human Movement Analysis Group (HuMAG), University of Valencia, 46022 Valencia, Spain;
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Galán-Mercant A, Ortiz A, Herrera-Viedma E, Tomas MT, Fernandes B, Moral-Munoz JA. Assessing physical activity and functional fitness level using convolutional neural networks. Knowl Based Syst 2019. [DOI: 10.1016/j.knosys.2019.104939] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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10
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Bet P, Castro PC, Ponti MA. Fall detection and fall risk assessment in older person using wearable sensors: A systematic review. Int J Med Inform 2019; 130:103946. [PMID: 31450081 DOI: 10.1016/j.ijmedinf.2019.08.006] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/15/2019] [Accepted: 08/07/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND wearable sensors are often used to acquire data for gait analysis as a strategy to study fall events, due to greater availability of acquisition platforms, and advances in computational intelligence. However, there are no review papers addressing the three most common types of applications related to fall using sensors, namely: fall detection, fallers classification and fall risk screening. OBJECTIVE To identify the state of art of fall-related events detection in older person using wearable sensors, as well as the main characteristics of the studies in the literature, pointing gaps for future studies. METHODS A systematic review design was used to search peer-reviewed literature on fall detection and risk in elderly through inertial sensors, published in English, Portuguese, Spanish or French between August 2002 and June 2019. The following questions are investigated: the type of sensors and their sampling rate, the type of signal and data processing employed, the scales and tests used in the study and the type of application. RESULTS We identified 608 studies, from which 29 were included. The accelerometer, with sampling rate 50 or 100 Hz, allocated in the waist or lumbar was the most used sensor setting. Methods comparing features or variables extracted from the accelerometry signal are the most common, and fall risk screening the most observed application. CONCLUSION This review identifies the main elements to be addressed in studies on the detection of events related to falls in the elderly and may help in future studies on the subject. However, some aspects are still no reach consensus in the literature such as the size of the sample to be studied, the population under study and how to acquire data for each application.
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Affiliation(s)
- Patricia Bet
- DGero - Universidade Federal de São Carlos, São Carlos, SP, Brazil.
| | - Paula C Castro
- DGero - Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Moacir A Ponti
- ICMC - Universidade de São Paulo, São Carlos, 13566-590, SP, Brazil
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Immonen M, Simila H. Comparison of Accelerometry-Based Features for Fall Risk Assessment Measured From Two Sensor Locations. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2018:2076-2079. [PMID: 30440811 DOI: 10.1109/embc.2018.8512713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Falls are an unfortunate problem for older adults, their relatives and societies. Continuous gait monitoring for fall risk assessment during daily lives would allow early interventions to prevent injurious falls. Continuous gait monitoring is possible using technological solutions such as inertial sensors; for example accelerometers. Current solutions require attaching the sensor to a certain location on the body and many of them to the lower back, which is not convenient for the user. The objective of this study was to find out whether gait variables calculated from the acceleration signal measured during walk from two different locations on waist area differ from each other. Forty two older adult subjects were measured during walk test with a triaxial acceleration sensor worn on an elastic belt at the lower back and frontal hip area. Most of the analyzed gait features from the two locations have a strong correlation, indicating that these features are not sensitive to sensor location around waist level. A subsequent study is needed to confirm other locations for the sensors to allow analyzing gait during everyday lives.
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Simila H, Immonen M, Niemirepo T. Mobile Fall Risk Assessment Solution for Daily-Life Settings. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2018:1530-1533. [PMID: 30440684 DOI: 10.1109/embc.2018.8512589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Prevention of falls requires accurate means for fall risk assessment in order to identify persons at risk. This paper introduces a novel mobile fall risk assessment solution for daily-life settings. The solution contains an Android application that uses acceleration sensor data received via Bluetooth LE connection. The application guides through a simple walk test, analyzes the acceleration data measured from the acceleration sensor attached to the lower back and gives feedback about the fall risk for the user. Preliminary user tests with 12 healthy subjects were conducted to evaluate the feasibility of the solution. Each test subject performed three walks demonstrating normal, dragging and slow gait. The results showed that the acceleration features calculated by the application distinguish normal gait from dragging and slow gaits. Further collection of comprehensive data set with older adults is needed to adjust the application parameters appropriately for the target group.
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Qiu H, Rehman RZU, Yu X, Xiong S. Application of Wearable Inertial Sensors and A New Test Battery for Distinguishing Retrospective Fallers from Non-fallers among Community-dwelling Older People. Sci Rep 2018; 8:16349. [PMID: 30397282 PMCID: PMC6218502 DOI: 10.1038/s41598-018-34671-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 10/22/2018] [Indexed: 11/09/2022] Open
Abstract
Considering the challenge of population ageing and the substantial health problem among the elderly population from falls, the purpose of this study was to verify whether it is possible to distinguish accurately between older fallers and non-fallers, based on data from wearable inertial sensors collected during a specially designed test battery. A comprehensive but practical test battery using 5 wearable inertial sensors for multifactorial fall risk assessment was designed. This was followed by an experimental study on 196 community-dwelling Korean older women, categorized as fallers (N1 = 82) and non-fallers (N2 = 114) based on prior history of falls. Six machine learning models (logistic regression, naïve bayes, decision tree, random forest, boosted tree and support vector machine) were proposed for faller classification. Results indicated that compared with non-fallers, fallers performed significantly worse on the test battery. In addition, the application of sensor data and support vector machine for faller classification achieved an overall accuracy of 89.4% with 92.7% sensitivity and 84.9% specificity. These findings suggest that wearable inertial sensor based systems show promise for elderly fall risk assessment, which could be implemented in clinical practice to identify "at-risk" individuals reliably to promote proactive fall prevention.
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Affiliation(s)
- Hai Qiu
- Human Factors and Ergonomics Laboratory, Department of Industrial & Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
| | - Rana Zia Ur Rehman
- Human Factors and Ergonomics Laboratory, Department of Industrial & Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
| | - Xiaoqun Yu
- Human Factors and Ergonomics Laboratory, Department of Industrial & Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
| | - Shuping Xiong
- Human Factors and Ergonomics Laboratory, Department of Industrial & Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea.
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On-Body Sensor Positions Hierarchical Classification. SENSORS 2018; 18:s18113612. [PMID: 30356012 PMCID: PMC6263469 DOI: 10.3390/s18113612] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 10/21/2018] [Accepted: 10/22/2018] [Indexed: 01/23/2023]
Abstract
Many motion sensor-based applications have been developed in recent years because they provide useful information about daily activities and current health status of users. However, most of these applications require knowledge of sensor positions. Therefore, this research focused on the problem of detecting sensor positions. We collected standing-still and walking sensor data at various body positions from ten subjects. The offset values were removed by subtracting the sensor data of standing-still phase from the walking data for each axis of each sensor unit. Our hierarchical classification technique is based on optimizing local classifiers. Many common features are computed, and informative features are selected for specific classifications. In this approach, local classifiers such as arm-side and hand-side discriminations yielded F1-scores of 0.99 and 1.00, correspondingly. Overall, the proposed method achieved an F1-score of 0.81 and 0.84 using accelerometers and gyroscopes, respectively. Furthermore, we also discuss contributive features and parameter tuning in this analysis.
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Rucco R, Sorriso A, Liparoti M, Ferraioli G, Sorrentino P, Ambrosanio M, Baselice F. Type and Location of Wearable Sensors for Monitoring Falls during Static and Dynamic Tasks in Healthy Elderly: A Review. SENSORS (BASEL, SWITZERLAND) 2018; 18:E1613. [PMID: 29783647 PMCID: PMC5982638 DOI: 10.3390/s18051613] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 04/20/2018] [Accepted: 05/15/2018] [Indexed: 01/28/2023]
Abstract
In recent years, the meaning of successful living has moved from extending lifetime to improving the quality of aging, mainly in terms of high cognitive and physical functioning together with avoiding diseases. In healthy elderly, falls represent an alarming accident both in terms of number of events and the consequent decrease in the quality of life. Stability control is a key approach for studying the genesis of falls, for detecting the event and trying to develop methodologies to prevent it. Wearable sensors have proved to be very useful in monitoring and analyzing the stability of subjects. Within this manuscript, a review of the approaches proposed in the literature for fall risk assessment, fall prevention and fall detection in healthy elderly is provided. The review has been carried out by using the most adopted publication databases and by defining a search strategy based on keywords and boolean algebra constructs. The analysis aims at evaluating the state of the art of such kind of monitoring, both in terms of most adopted sensor technologies and of their location on the human body. The review has been extended to both dynamic and static analyses. In order to provide a useful tool for researchers involved in this field, the manuscript also focuses on the tests conducted in the analyzed studies, mainly in terms of characteristics of the population involved and of the tasks used. Finally, the main trends related to sensor typology, sensor location and tasks have been identified.
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Affiliation(s)
- Rosaria Rucco
- Department of Motor Sciences and Wellness, University of Naples "Parthenope", 80133 Naples, Italy.
- IDC Hermitage Capodimonte, 80133 Naples, Italy.
| | - Antonietta Sorriso
- Department of Engineering, University of Naples "Parthenope", 80133 Naples, Italy.
| | - Marianna Liparoti
- Department of Motor Sciences and Wellness, University of Naples "Parthenope", 80133 Naples, Italy.
- IDC Hermitage Capodimonte, 80133 Naples, Italy.
| | - Giampaolo Ferraioli
- Department of Science and Technologies, University of Naples "Parthenope", 80133 Naples, Italy.
| | - Pierpaolo Sorrentino
- IDC Hermitage Capodimonte, 80133 Naples, Italy.
- Department of Engineering, University of Naples "Parthenope", 80133 Naples, Italy.
| | - Michele Ambrosanio
- Department of Engineering, University of Naples "Parthenope", 80133 Naples, Italy.
| | - Fabio Baselice
- Department of Engineering, University of Naples "Parthenope", 80133 Naples, Italy.
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Jarchi D, Pope J, Lee TKM, Tamjidi L, Mirzaei A, Sanei S. A Review on Accelerometry-Based Gait Analysis and Emerging Clinical Applications. IEEE Rev Biomed Eng 2018; 11:177-194. [PMID: 29994786 DOI: 10.1109/rbme.2018.2807182] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Gait analysis continues to be an important technique for many clinical applications to diagnose and monitor certain diseases. Many mental and physical abnormalities cause measurable differences in a person's gait. Gait analysis has applications in sport, computer games, physical rehabilitation, clinical assessment, surveillance, human recognition, modeling, and many other fields. There are established methods using various sensors for gait analysis, of which accelerometers are one of the most often employed. Accelerometer sensors are generally more user friendly and less invasive. In this paper, we review research regarding accelerometer sensors used for gait analysis with particular focus on clinical applications. We provide a brief introduction to accelerometer theory followed by other popular sensing technologies. Commonly used gait phases and parameters are enumerated. The details of selecting the papers for review are provided. We also review several gait analysis software. Then we provide an extensive report of accelerometry-based gait analysis systems and applications, with additional emphasis on trunk accelerometry. We conclude this review with future research directions.
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