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Greenberg JK, Frumkin M, Xu Z, Zhang J, Javeed S, Zhang JK, Benedict B, Botterbush K, Yakdan S, Molina CA, Pennicooke BH, Hafez D, Ogunlade JI, Pallotta N, Gupta MC, Buchowski JM, Neuman B, Steinmetz M, Ghogawala Z, Kelly MP, Goodin BR, Piccirillo JF, Rodebaugh TL, Lu C, Ray WZ. Preoperative Mobile Health Data Improve Predictions of Recovery From Lumbar Spine Surgery. Neurosurgery 2024; 95:617-626. [PMID: 38551340 DOI: 10.1227/neu.0000000000002911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 01/24/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Neurosurgeons and hospitals devote tremendous resources to improving recovery from lumbar spine surgery. Current efforts to predict surgical recovery rely on one-time patient report and health record information. However, longitudinal mobile health (mHealth) assessments integrating symptom dynamics from ecological momentary assessment (EMA) and wearable biometric data may capture important influences on recovery. Our objective was to evaluate whether a preoperative mHealth assessment integrating EMA with Fitbit monitoring improved predictions of spine surgery recovery. METHODS Patients age 21-85 years undergoing lumbar surgery for degenerative disease between 2021 and 2023 were recruited. For up to 3 weeks preoperatively, participants completed EMAs up to 5 times daily asking about momentary pain, disability, depression, and catastrophizing. At the same time, they were passively monitored using Fitbit trackers. Study outcomes were good/excellent recovery on the Quality of Recovery-15 (QOR-15) and a clinically important change in Patient-Reported Outcomes Measurement Information System Pain Interference 1 month postoperatively. After feature engineering, several machine learning prediction models were tested. Prediction performance was measured using the c-statistic. RESULTS A total of 133 participants were included, with a median (IQR) age of 62 (53, 68) years, and 56% were female. The median (IQR) number of preoperative EMAs completed was 78 (61, 95), and the median (IQR) number of days with usable Fitbit data was 17 (12, 21). 63 patients (48%) achieved a clinically meaningful improvement in Patient-Reported Outcomes Measurement Information System pain interference. Compared with traditional evaluations alone, mHealth evaluations led to a 34% improvement in predictions for pain interference (c = 0.82 vs c = 0.61). 49 patients (40%) had a good or excellent recovery based on the QOR-15. Including preoperative mHealth data led to a 30% improvement in predictions of QOR-15 (c = 0.70 vs c = 0.54). CONCLUSION Multimodal mHealth evaluations improve predictions of lumbar surgery outcomes. These methods may be useful for informing patient selection and perioperative recovery strategies.
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Affiliation(s)
- Jacob K Greenberg
- Department of Neurological Surgery, Washington University, St. Louis , Missouri , USA
| | - Madelyn Frumkin
- Department of Psychology and Brain Sciences, Washington University, St. Louis , Missouri , USA
| | - Ziqi Xu
- Department of Computer Science & Engineering, Washington University in St. Louis, St. Louis , Missouri , USA
| | - Jingwen Zhang
- Department of Computer Science & Engineering, Washington University in St. Louis, St. Louis , Missouri , USA
| | - Saad Javeed
- Department of Neurological Surgery, Washington University, St. Louis , Missouri , USA
| | - Justin K Zhang
- Department of Neurological Surgery, Washington University, St. Louis , Missouri , USA
- Department of Neurosurgery, University of Utah, Salt Lake City , Utah , USA
| | - Braeden Benedict
- Department of Neurological Surgery, Washington University, St. Louis , Missouri , USA
| | - Kathleen Botterbush
- Department of Neurological Surgery, Washington University, St. Louis , Missouri , USA
| | - Salim Yakdan
- Department of Neurological Surgery, Washington University, St. Louis , Missouri , USA
| | - Camilo A Molina
- Department of Neurological Surgery, Washington University, St. Louis , Missouri , USA
| | - Brenton H Pennicooke
- Department of Neurological Surgery, Washington University, St. Louis , Missouri , USA
| | - Daniel Hafez
- Department of Neurological Surgery, Washington University, St. Louis , Missouri , USA
| | - John I Ogunlade
- Department of Neurological Surgery, Washington University, St. Louis , Missouri , USA
| | - Nicholas Pallotta
- Department of Orthopedic Surgery, Washington University, St. Louis , Missouri , USA
| | - Munish C Gupta
- Department of Orthopedic Surgery, Washington University, St. Louis , Missouri , USA
| | - Jacob M Buchowski
- Department of Orthopedic Surgery, Washington University, St. Louis , Missouri , USA
| | - Brian Neuman
- Department of Orthopedic Surgery, Washington University, St. Louis , Missouri , USA
| | - Michael Steinmetz
- Department of Neurosurgery, Center for Spine Health, Neurological Institute, Cleveland Clinic Foundation, Cleveland , Ohio , USA
| | - Zoher Ghogawala
- Department of Neurosurgery, Lahey Hospital and Medical Center, Burlington , Massachusetts , USA
| | - Michael P Kelly
- Department of Orthopedic Surgery, Washington University, St. Louis , Missouri , USA
| | - Burel R Goodin
- Department of Anesthesiology, Washington University, St. Louis , Missouri , USA
| | - Jay F Piccirillo
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis , Missouri , USA
| | - Thomas L Rodebaugh
- Department of Psychology and Brain Sciences, Washington University, St. Louis , Missouri , USA
| | - Chenyang Lu
- Department of Computer Science & Engineering, Washington University in St. Louis, St. Louis , Missouri , USA
| | - Wilson Z Ray
- Department of Neurological Surgery, Washington University, St. Louis , Missouri , USA
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Vogel C, Grimm B, Marmor MT, Sivananthan S, Richter PH, Yarboro S, Hanflik AM, Histing T, Braun BJ. Wearable Sensors in Other Medical Domains with Application Potential for Orthopedic Trauma Surgery-A Narrative Review. J Clin Med 2024; 13:3134. [PMID: 38892844 PMCID: PMC11172495 DOI: 10.3390/jcm13113134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 05/01/2024] [Accepted: 05/09/2024] [Indexed: 06/21/2024] Open
Abstract
The use of wearable technology is steadily increasing. In orthopedic trauma surgery, where the musculoskeletal system is directly affected, focus has been directed towards assessing aspects of physical functioning, activity behavior, and mobility/disability. This includes sensors and algorithms to monitor real-world walking speed, daily step counts, ground reaction forces, or range of motion. Several specific reviews have focused on this domain. In other medical fields, wearable sensors and algorithms to monitor digital biometrics have been used with a focus on domain-specific health aspects such as heart rate, sleep, blood oxygen saturation, or fall risk. This review explores the most common clinical and research use cases of wearable sensors in other medical domains and, from it, derives suggestions for the meaningful transfer and application in an orthopedic trauma context.
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Affiliation(s)
- Carolina Vogel
- University Hospital Tuebingen on Behalf of the Eberhard-Karls-University Tuebingen, BG Unfallklinik, Schnarrenbergstr. 95, 72076 Tuebingen, Germany; (C.V.); (T.H.)
| | - Bernd Grimm
- Luxembourg Institute of Health, Department of Precision Health, Human Motion, Orthopaedics, Sports Medicine and Digital Methods Group, 1445 Strassen, Luxembourg;
| | - Meir T. Marmor
- Orthopaedic Trauma Institute (OTI), San Francisco General Hospital, University of California, San Francisco, CA 94158, USA;
| | | | - Peter H. Richter
- Department of Trauma and Orthopaedic Surgery, Esslingen Hospotal, 73730 Esslingen, Germany;
| | - Seth Yarboro
- Deptartment Orthopaedic Surgery, University of Virginia, Charlottesville, VA 22908, USA;
| | - Andrew M. Hanflik
- Department of Orthopaedic Surgery, Southern California Permanente Medical Group, Downey Medical Center, Kaiser Permanente, Downey, CA 90027, USA;
| | - Tina Histing
- University Hospital Tuebingen on Behalf of the Eberhard-Karls-University Tuebingen, BG Unfallklinik, Schnarrenbergstr. 95, 72076 Tuebingen, Germany; (C.V.); (T.H.)
| | - Benedikt J. Braun
- University Hospital Tuebingen on Behalf of the Eberhard-Karls-University Tuebingen, BG Unfallklinik, Schnarrenbergstr. 95, 72076 Tuebingen, Germany; (C.V.); (T.H.)
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Gaffney BMM, Davis-Wilson HC, Awad ME, Tracy J, Melton DH, Lev G, Stoneback JW, Christiansen CL. Daily steps and stepping cadence increase one-year following prosthesis osseointegration in people with lower-limb amputation. Disabil Rehabil 2024; 46:1432-1437. [PMID: 37073780 PMCID: PMC10584988 DOI: 10.1080/09638288.2023.2200036] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/26/2023] [Accepted: 04/01/2023] [Indexed: 04/20/2023]
Abstract
PURPOSE People with lower-limb loss participate in less physical activity than able-bodied individuals, which increases the mortality risk and incidence of metabolic syndromes. This study evaluated the effect of lower-limb prosthesis osseointegration on physical activity, including daily steps and stepping cadence. METHODS Free-living walking activity was assessed from 14 patients scheduled to undergo prosthesis osseointegration at two time points (within 2 weeks prior to osseointegration surgery and 12-months following). Daily step count, stepping time, number of walking bouts, average step cadence per bout, maximum step cadence per bout, and time spent in bands of step cadence were compared before and after osseointegration. RESULTS Twelve months after prosthesis osseointegration, participants increased daily steps, daily stepping time, average step cadence, and maximum cadence per walking bout compared to pre-osseointegration. CONCLUSIONS Participants engaged in more daily steps, higher stepping cadence, and longer bouts at higher cadence one year following osseointegration compared to when using a socket prosthesis. As a novel intervention that is becoming more common, it is important to understand walking activity outcomes as these are critical for long-term health.
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Affiliation(s)
- Brecca M. M. Gaffney
- Department of Mechanical Engineering, University of Colorado Denver, Denver CO, USA
- Center for Bioengineering, University of Colorado Denver, Aurora, CO, USA
| | - Hope C. Davis-Wilson
- Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, USA
- Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, CO, USA
| | - Mohamed E. Awad
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
| | - James Tracy
- Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, USA
- Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, CO, USA
| | - Danielle H. Melton
- Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, USA
| | - Guy Lev
- University of Colorado Hospital, Aurora, CO, USA
| | - Jason W. Stoneback
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Cory L. Christiansen
- Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, USA
- Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, CO, USA
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Low CA, Bartel C, Fedor J, Durica KC, Marchetti G, Rosso AL, Campbell G. Associations between performance-based and patient-reported physical functioning and real-world mobile sensor metrics in older cancer survivors: A pilot study. J Geriatr Oncol 2024; 15:101708. [PMID: 38277879 PMCID: PMC10923123 DOI: 10.1016/j.jgo.2024.101708] [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: 09/29/2023] [Revised: 01/08/2024] [Accepted: 01/19/2024] [Indexed: 01/28/2024]
Abstract
INTRODUCTION Older cancer survivors are at increased risk for impaired physical functioning, but current assessments of function are difficult to implement in busy oncology clinics. Mobile devices measuring continuous activity and mobility in daily life may be useful for estimating physical functioning. The goal of this pilot study was to examine the associations between consumer wearable device (a wrist-worn activity tracker) and smartphone sensor data and commonly used clinical measures of physical function in cancer survivors aged 65 and older. MATERIALS AND METHODS Older adults within five years of completing primary treatment for any cancer completed standardized questionnaires and performance-based tests to measure physical functioning. Continuous passive data from smartphones and consumer wearable devices were collected for four weeks and linked to patient-reported and performance-based physical functioning as well as patient-reported falls or near falls at the end of the four-week monitoring period. To examine associations between sensor variables and physical functioning, we conducted bivariate Pearson correlations as well as multivariable linear regression analyses. To examine associations between sensor variables and falls, we conducted exploratory receiver operating characteristic curve and multivariable logistic regression analyses. RESULTS We enrolled 40 participants (mean age 73 years old, range 65-83; 98% White; 50% female). In bivariate analyses, consumer wearable device features reflecting greater amount and speed and lower fragmentation of walking in daily life were significantly related to better patient-reported function (r= 0.43-0.65) and performance-based physical function (r = 0.56-0.72), while smartphone features reflecting more geographic mobility were related to better performance-based physical function (r = 0.40-0.42) but not patient-reported function. After adjusting for age and comorbidities, only consumer wearable device features remained associated with performance-based physical functioning. In exploratory analyses, peak gait cadence was associated with fall risk even after covariate adjustment. DISCUSSION This study provides preliminary evidence that real-world data from consumer devices may be useful for estimating functional performance among older cancer survivors and potentially for remotely and longitudinally monitoring functioning in older patients during and after cancer treatment.
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Affiliation(s)
- Carissa A Low
- University of Pittsburgh, 3347 Forbes Avenue, Suite 200, Pittsburgh, PA 15213, USA.
| | - Christianna Bartel
- University of Pittsburgh, 3347 Forbes Avenue, Suite 200, Pittsburgh, PA 15213, USA
| | - Jennifer Fedor
- University of Pittsburgh, 3347 Forbes Avenue, Suite 200, Pittsburgh, PA 15213, USA
| | - Krina C Durica
- University of Pittsburgh, 3347 Forbes Avenue, Suite 200, Pittsburgh, PA 15213, USA
| | | | - Andrea L Rosso
- University of Pittsburgh, 3347 Forbes Avenue, Suite 200, Pittsburgh, PA 15213, USA
| | - Grace Campbell
- University of Pittsburgh, 3347 Forbes Avenue, Suite 200, Pittsburgh, PA 15213, USA; Duquesne University, 600 Forbes Avenue, Pittsburgh, PA 15282, USA
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Mehdipour A, Malouka S, Beauchamp M, Richardson J, Kuspinar A. Measurement properties of the usual and fast gait speed tests in community-dwelling older adults: a COSMIN-based systematic review. Age Ageing 2024; 53:afae055. [PMID: 38517125 PMCID: PMC10958613 DOI: 10.1093/ageing/afae055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVE The gait speed test is one of the most widely used mobility assessments for older adults. We conducted a systematic review to evaluate and compare the measurement properties of the usual and fast gait speed tests in community-dwelling older adults. METHODS Three databases were searched: MEDLINE, EMBASE and CINAHL. Peer-reviewed articles evaluating the gait speed test's measurement properties or interpretability in community-dwelling older adults were included. The Consensus-based Standards for the selection of health Measurement Instruments guidelines were followed for data synthesis and quality assessment. RESULTS Ninety-five articles met our inclusion criteria, with 79 evaluating a measurement property and 16 reporting on interpretability. There was sufficient reliability for both tests, with intraclass correlation coefficients (ICC) generally ranging from 0.72 to 0.98, but overall quality of evidence was low. For convergent/discriminant validity, an overall sufficient rating with moderate quality of evidence was found for both tests. Concurrent validity of the usual gait speed test was sufficient (ICCs = 0.79-0.93 with longer distances) with moderate quality of evidence; however, there were insufficient results for the fast gait speed test (e.g. low agreement with longer distances) supported by high-quality studies. Responsiveness was only evaluated in three articles, with low quality of evidence. CONCLUSION Findings from this review demonstrated evidence in support of the reliability and validity of the usual and fast gait speed tests in community-dwelling older adults. However, future validation studies should employ rigorous methodology and evaluate the tests' responsiveness.
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Affiliation(s)
- Ava Mehdipour
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Selina Malouka
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Marla Beauchamp
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Ayse Kuspinar
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
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6
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Micó-Amigo ME, Bonci T, Paraschiv-Ionescu A, Ullrich M, Kirk C, Soltani A, Küderle A, Gazit E, Salis F, Alcock L, Aminian K, Becker C, Bertuletti S, Brown P, Buckley E, Cantu A, Carsin AE, Caruso M, Caulfield B, Cereatti A, Chiari L, D'Ascanio I, Eskofier B, Fernstad S, Froehlich M, Garcia-Aymerich J, Hansen C, Hausdorff JM, Hiden H, Hume E, Keogh A, Kluge F, Koch S, Maetzler W, Megaritis D, Mueller A, Niessen M, Palmerini L, Schwickert L, Scott K, Sharrack B, Sillén H, Singleton D, Vereijken B, Vogiatzis I, Yarnall AJ, Rochester L, Mazzà C, Del Din S. Assessing real-world gait with digital technology? Validation, insights and recommendations from the Mobilise-D consortium. J Neuroeng Rehabil 2023; 20:78. [PMID: 37316858 PMCID: PMC10265910 DOI: 10.1186/s12984-023-01198-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 05/26/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Although digital mobility outcomes (DMOs) can be readily calculated from real-world data collected with wearable devices and ad-hoc algorithms, technical validation is still required. The aim of this paper is to comparatively assess and validate DMOs estimated using real-world gait data from six different cohorts, focusing on gait sequence detection, foot initial contact detection (ICD), cadence (CAD) and stride length (SL) estimates. METHODS Twenty healthy older adults, 20 people with Parkinson's disease, 20 with multiple sclerosis, 19 with proximal femoral fracture, 17 with chronic obstructive pulmonary disease and 12 with congestive heart failure were monitored for 2.5 h in the real-world, using a single wearable device worn on the lower back. A reference system combining inertial modules with distance sensors and pressure insoles was used for comparison of DMOs from the single wearable device. We assessed and validated three algorithms for gait sequence detection, four for ICD, three for CAD and four for SL by concurrently comparing their performances (e.g., accuracy, specificity, sensitivity, absolute and relative errors). Additionally, the effects of walking bout (WB) speed and duration on algorithm performance were investigated. RESULTS We identified two cohort-specific top performing algorithms for gait sequence detection and CAD, and a single best for ICD and SL. Best gait sequence detection algorithms showed good performances (sensitivity > 0.73, positive predictive values > 0.75, specificity > 0.95, accuracy > 0.94). ICD and CAD algorithms presented excellent results, with sensitivity > 0.79, positive predictive values > 0.89 and relative errors < 11% for ICD and < 8.5% for CAD. The best identified SL algorithm showed lower performances than other DMOs (absolute error < 0.21 m). Lower performances across all DMOs were found for the cohort with most severe gait impairments (proximal femoral fracture). Algorithms' performances were lower for short walking bouts; slower gait speeds (< 0.5 m/s) resulted in reduced performance of the CAD and SL algorithms. CONCLUSIONS Overall, the identified algorithms enabled a robust estimation of key DMOs. Our findings showed that the choice of algorithm for estimation of gait sequence detection and CAD should be cohort-specific (e.g., slow walkers and with gait impairments). Short walking bout length and slow walking speed worsened algorithms' performances. Trial registration ISRCTN - 12246987.
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Affiliation(s)
- M Encarna Micó-Amigo
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Tecla Bonci
- Department of Mechanical Engineering and Insigneo Institute for in Silico Medicine, The University of Sheffield, Sheffield, UK
| | - Anisoara Paraschiv-Ionescu
- Laboratory of Movement Analysis and Measurement, Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland
| | - Martin Ullrich
- Machine Learning and Data Analytics Lab, Department of Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Cameron Kirk
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Abolfazl Soltani
- Laboratory of Movement Analysis and Measurement, Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland
| | - Arne Küderle
- Machine Learning and Data Analytics Lab, Department of Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Eran Gazit
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Francesca Salis
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
- Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Lisa Alcock
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC), Newcastle University and The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Kamiar Aminian
- Laboratory of Movement Analysis and Measurement, Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland
| | - Clemens Becker
- Robert Bosch Gesellschaft für Medizinische Forschung, Stuttgart, Germany
| | - Stefano Bertuletti
- Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Philip Brown
- The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Ellen Buckley
- Department of Mechanical Engineering and Insigneo Institute for in Silico Medicine, The University of Sheffield, Sheffield, UK
| | - Alma Cantu
- School of Computing, Newcastle University, Newcastle upon Tyne, UK
| | - Anne-Elie Carsin
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Marco Caruso
- Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Brian Caulfield
- Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Andrea Cereatti
- Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Lorenzo Chiari
- Department of Electrical, Electronic and Information Engineering «Guglielmo Marconi», University of Bologna, Bologna, Italy
- Health Sciences and Technologies-Interdepartmental Center for Industrial Research (CIRI-SDV), University of Bologna, Bologna, Italy
| | - Ilaria D'Ascanio
- Department of Electrical, Electronic and Information Engineering «Guglielmo Marconi», University of Bologna, Bologna, Italy
| | - Bjoern Eskofier
- Machine Learning and Data Analytics Lab, Department of Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sara Fernstad
- School of Computing, Newcastle University, Newcastle upon Tyne, UK
| | | | - Judith Garcia-Aymerich
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Clint Hansen
- Department of Neurology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Jeffrey M Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sagol School of Neuroscience and Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Hugo Hiden
- School of Computing, Newcastle University, Newcastle upon Tyne, UK
| | - Emily Hume
- Department of Sport, Exercise and Rehabilitation, Northumbria University Newcastle, Newcastle upon Tyne, UK
| | - Alison Keogh
- Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Felix Kluge
- Machine Learning and Data Analytics Lab, Department of Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Novartis Institutes of Biomedical Research, Novartis Pharma AG, Basel, Switzerland
| | - Sarah Koch
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Walter Maetzler
- Department of Neurology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Dimitrios Megaritis
- Department of Sport, Exercise and Rehabilitation, Northumbria University Newcastle, Newcastle upon Tyne, UK
| | - Arne Mueller
- Novartis Institutes of Biomedical Research, Novartis Pharma AG, Basel, Switzerland
| | | | - Luca Palmerini
- Department of Electrical, Electronic and Information Engineering «Guglielmo Marconi», University of Bologna, Bologna, Italy
- Health Sciences and Technologies-Interdepartmental Center for Industrial Research (CIRI-SDV), University of Bologna, Bologna, Italy
| | - Lars Schwickert
- Robert Bosch Gesellschaft für Medizinische Forschung, Stuttgart, Germany
| | - Kirsty Scott
- Department of Mechanical Engineering and Insigneo Institute for in Silico Medicine, The University of Sheffield, Sheffield, UK
| | - Basil Sharrack
- Department of Neuroscience and Sheffield NIHR Translational Neuroscience BRC, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | | | - David Singleton
- Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Beatrix Vereijken
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ioannis Vogiatzis
- Department of Sport, Exercise and Rehabilitation, Northumbria University Newcastle, Newcastle upon Tyne, UK
| | - Alison J Yarnall
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC), Newcastle University and The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Lynn Rochester
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC), Newcastle University and The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Claudia Mazzà
- Department of Mechanical Engineering and Insigneo Institute for in Silico Medicine, The University of Sheffield, Sheffield, UK
| | - Silvia Del Din
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
- National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC), Newcastle University and The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
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Manor B, Zhou J, Lo OY. Novel Technology-driven Approaches to Enhance Mobility and Reduce Falls in Older Adults. J Gerontol A Biol Sci Med Sci 2023; 78:800-801. [PMID: 37165950 PMCID: PMC10172977 DOI: 10.1093/gerona/glad043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Affiliation(s)
- Brad Manor
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, Massachusetts, USA
- Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Junhong Zhou
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, Massachusetts, USA
- Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - On-Yee Lo
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, Massachusetts, USA
- Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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Brand YE, Schwartz D, Gazit E, Buchman AS, Gilad-Bachrach R, Hausdorff JM. Gait Detection from a Wrist-Worn Sensor Using Machine Learning Methods: A Daily Living Study in Older Adults and People with Parkinson's Disease. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22187094. [PMID: 36146441 PMCID: PMC9502704 DOI: 10.3390/s22187094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/31/2022] [Accepted: 09/12/2022] [Indexed: 05/14/2023]
Abstract
Remote assessment of the gait of older adults (OAs) during daily living using wrist-worn sensors has the potential to augment clinical care and mobility research. However, hand movements can degrade gait detection from wrist-sensor recordings. To address this challenge, we developed an anomaly detection algorithm and compared its performance to four previously published gait detection algorithms. Multiday accelerometer recordings from a wrist-worn and lower-back sensor (i.e., the “gold-standard” reference) were obtained in 30 OAs, 60% with Parkinson’s disease (PD). The area under the receiver operator curve (AUC) and the area under the precision−recall curve (AUPRC) were used to evaluate the performance of the algorithms. The anomaly detection algorithm obtained AUCs of 0.80 and 0.74 for OAs and PD, respectively, but AUPRCs of 0.23 and 0.31 for OAs and PD, respectively. The best performing detection algorithm, a deep convolutional neural network (DCNN), exhibited high AUCs (i.e., 0.94 for OAs and 0.89 for PD) but lower AUPRCs (i.e., 0.66 for OAs and 0.60 for PD), indicating trade-offs between precision and recall. When choosing a classification threshold of 0.9 (i.e., opting for high precision) for the DCNN algorithm, strong correlations (r > 0.8) were observed between daily living walking time estimates based on the lower-back (reference) sensor and the wrist sensor. Further, gait quality measures were significantly different in OAs and PD compared to healthy adults. These results demonstrate that daily living gait can be quantified using a wrist-worn sensor.
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Affiliation(s)
- Yonatan E. Brand
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6492416, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Dafna Schwartz
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6492416, Israel
- Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Eran Gazit
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6492416, Israel
| | - Aron S. Buchman
- Rush Alzheimer’s Disease Center, Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA
| | - Ran Gilad-Bachrach
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
- Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv 6997801, Israel
- Edmond J. Safra Center for Bioinformatics, Tel-Aviv University, Tel Aviv 6997801, Israel
| | - Jeffrey M. Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6492416, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
- Rush Alzheimer’s Disease Center and Department of Orthopedic Surgery, Rush University, Chicago, IL 60612, USA
- Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Correspondence:
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