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Koh V, Xuan LW, Zhe TK, Singh N, B Matchar D, Chan A. Performance of digital technologies in assessing fall risks among older adults with cognitive impairment: a systematic review. GeroScience 2024; 46:2951-2975. [PMID: 38436792 PMCID: PMC11009180 DOI: 10.1007/s11357-024-01098-z] [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: 08/11/2023] [Accepted: 02/09/2024] [Indexed: 03/05/2024] Open
Abstract
Older adults with cognitive impairment (CI) are twice as likely to fall compared to the general older adult population. Traditional fall risk assessments may not be suitable for older adults with CI due to their reliance on attention and recall. Hence, there is an interest in using objective technology-based fall risk assessment tools to assess falls within this population. This systematic review aims to evaluate the features and performance of technology-based fall risk assessment tools for older adults with CI. A systematic search was conducted across several databases such as PubMed and IEEE Xplore, resulting in the inclusion of 22 studies. Most studies focused on participants with dementia. The technologies included sensors, mobile applications, motion capture, and virtual reality. Fall risk assessments were conducted in the community, laboratory, and institutional settings; with studies incorporating continuous monitoring of older adults in everyday environments. Studies used a combination of technology-based inputs of gait parameters, socio-demographic indicators, and clinical assessments. However, many missed the opportunity to include cognitive performance inputs as predictors to fall risk. The findings of this review support the use of technology-based fall risk assessment tools for older adults with CI. Further advancements incorporating cognitive measures and additional longitudinal studies are needed to improve the effectiveness and clinical applications of these assessment tools. Additional work is also required to compare the performance of existing methods for fall risk assessment, technology-based fall risk assessments, and the combination of these approaches.
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Affiliation(s)
- Vanessa Koh
- Programme in Health Services and Systems Research (HSSR), Duke-NUS Medical School, Singapore, Singapore.
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
| | - Lai Wei Xuan
- Programme in Health Services and Systems Research (HSSR), Duke-NUS Medical School, Singapore, Singapore
| | - Tan Kai Zhe
- Future Health Technologies Programme, Singapore-ETH Centre, Singapore, Singapore
| | - Navrag Singh
- Future Health Technologies Programme, Singapore-ETH Centre, Singapore, Singapore
- Laboratory for Movement Biomechanics, Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - David B Matchar
- Programme in Health Services and Systems Research (HSSR), Duke-NUS Medical School, Singapore, Singapore
- Future Health Technologies Programme, Singapore-ETH Centre, Singapore, Singapore
- Department of Medicine (General Internal Medicine), Duke University Medical Center, Durham, NC, USA
| | - Angelique Chan
- Programme in Health Services and Systems Research (HSSR), Duke-NUS Medical School, Singapore, Singapore
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Future Health Technologies Programme, Singapore-ETH Centre, Singapore, Singapore
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Mao Q, Zhang J, Yu L, Zhao Y, Luximon Y, Wang H. Effectiveness of sensor-based interventions in improving gait and balance performance in older adults: systematic review and meta-analysis of randomized controlled trials. J Neuroeng Rehabil 2024; 21:85. [PMID: 38807117 PMCID: PMC11131332 DOI: 10.1186/s12984-024-01375-0] [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: 12/18/2023] [Accepted: 05/10/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Sensor-based interventions (SI) have been suggested as an alternative rehabilitation treatment to improve older adults' functional performance. However, the effectiveness of different sensor technologies in improving gait and balance remains unclear and requires further investigation. METHODS Ten databases (Academic Search Premier; Cumulative Index to Nursing and Allied Health Literature, Complete; Cochrane Central Register of Controlled Trials; MEDLINE; PubMed; Web of Science; OpenDissertations; Open grey; ProQuest; and Grey literature report) were searched for relevant articles published up to December 20, 2022. Conventional functional assessments, including the Timed Up and Go (TUG) test, normal gait speed, Berg Balance Scale (BBS), 6-Minute Walk Test (6MWT), and Falling Efficacy Scale-International (FES-I), were used as the evaluation outcomes reflecting gait and balance performance. We first meta-analyzed the effectiveness of SI, which included optical sensors (OPTS), perception sensors (PCPS), and wearable sensors (WS), compared with control groups, which included non-treatment intervention (NTI) and traditional physical exercise intervention (TPEI). We further conducted sub-group analysis to compare the effectiveness of SI (OPTS, PCPS, and WS) with TPEI groups and compared each SI subtype with control (NTI and TPEI) and TPEI groups. RESULTS We scanned 6255 articles and performed meta-analyses of 58 selected trials (sample size = 2713). The results showed that SI groups were significantly more effective than control or TPEI groups (p < 0.000) in improving gait and balance performance. The subgroup meta-analyses between OPTS groups and TPEI groups revealed clear statistically significant differences in effectiveness for TUG test (mean difference (MD) = - 0.681 s; p < 0.000), normal gait speed (MD = 4.244 cm/s; p < 0.000), BBS (MD = 2.325; p = 0.001), 6MWT (MD = 25.166 m; p < 0.000), and FES-I scores (MD = - 2.036; p = 0.036). PCPS groups also presented statistically significant differences with TPEI groups in gait and balance assessments for normal gait speed (MD = 4.382 cm/s; p = 0.034), BBS (MD = 1.874; p < 0.000), 6MWT (MD = 21.904 m; p < 0.000), and FES-I scores (MD = - 1.161; p < 0.000), except for the TUG test (MD = - 0.226 s; p = 0.106). There were no statistically significant differences in TUG test (MD = - 1.255 s; p = 0.101) or normal gait speed (MD = 6.682 cm/s; p = 0.109) between WS groups and control groups. CONCLUSIONS SI with biofeedback has a positive effect on gait and balance improvement among a mixed population of older adults. Specifically, OPTS and PCPS groups were statistically better than TPEI groups at improving gait and balance performance, whereas only the group comparison in BBS and 6MWT can reach the minimal clinically important difference. Moreover, WS groups showed no statistically or clinically significant positive effect on gait and balance improvement compared with control groups. More studies are recommended to verify the effectiveness of specific SI. Research registration PROSPERO platform: CRD42022362817. Registered on 7/10/2022.
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Affiliation(s)
- Qian Mao
- School of Design, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jiaxin Zhang
- School of System Design and Intelligent Manufacturing, Southern University of Science and Technology, Shenzhen, China
| | - Lisha Yu
- School of Data Science, Lingnan University, Hong Kong, China
| | - Yang Zhao
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Yan Luximon
- School of Design, The Hong Kong Polytechnic University, Hong Kong, China
| | - Hailiang Wang
- School of Design, The Hong Kong Polytechnic University, Hong Kong, China.
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Kiah Hui Siew S, Yu J, Teo TL, Chua KC, Mahendran R, Rawtaer I. Technology and physical activity for preventing cognitive and physical decline in older adults: Protocol of a pilot RCT. PLoS One 2024; 19:e0293340. [PMID: 38394113 PMCID: PMC10889650 DOI: 10.1371/journal.pone.0293340] [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: 05/13/2022] [Accepted: 10/07/2023] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Cognitive frailty, defined as having both physical frailty and cognitive impairment that does not satisfy the criteria for Major Neurocognitive Disorder, represents an elevated risk for morbidity. Hence, it is crucial to mitigate such risks. Physical activity interventions have been found effective in protecting against physical frailty and cognitive deterioration. This pilot RCT examines if smartwatches and mobile phone applications can help to increase physical activity, thereby improving physical and cognitive outcomes. METHODS Older individuals (n = 60) aged 60 to 85 years old will have their physical activity tracked using a smartwatch. The subjects will be randomized into two arms: one group will receive daily notification prompts if they did not reach the recommended levels of PA; the control group will not receive prompts. Outcome variables of physical activity level, neurocognitive scores, and physical frailty scores will be measured at baseline, T1 (3 months), and T2 (6 months). Sleep quality, levels of motivation, anxiety, and depression will be controlled for in our analyses. We hypothesize that the intervention group will have higher levels of physical activity resulting in improved cognitive and physical outcomes at follow-up. This study was approved by the National University of Singapore's Institutional Review Board on 17 August 2020 (NUS-IRB Ref. No.: H-20-038). DISCUSSION Wearable sensors technology could prove useful by facilitating self-management in physical activity interventions. The findings of this study can justify the use of technology in physical activity as a preventive measure against cognitive frailty in older adults. This intervention also complements the rapidly rising use of technology, such as smartphones and wearable health devices, in our lives today. REGISTRATION DETAILS This study has been retrospectively registered on clinicaltrials.gov on 5th January 2021 (NCT Identifier: NCT04692974), after the first participant was recruited.
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Affiliation(s)
- Savannah Kiah Hui Siew
- Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Junhong Yu
- Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Tat Lee Teo
- School of Engineering, Ngee Ann Polytechnic, Singapore, Singapore
| | - Kuang Chua Chua
- School of Engineering, Ngee Ann Polytechnic, Singapore, Singapore
| | - Rathi Mahendran
- Yeo Boon Khim Mind Science Centre, National University of Singapore, Singapore, Singapore
| | - Iris Rawtaer
- Department of Psychiatry, Sengkang General Hospital, Singapore, Singapore
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Wang X, Cao J, Zhao Q, Chen M, Luo J, Wang H, Yu L, Tsui KL, Zhao Y. Identifying sensors-based parameters associated with fall risk in community-dwelling older adults: an investigation and interpretation of discriminatory parameters. BMC Geriatr 2024; 24:125. [PMID: 38302872 PMCID: PMC10836006 DOI: 10.1186/s12877-024-04723-w] [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: 04/23/2023] [Accepted: 01/18/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Falls pose a severe threat to the health of older adults worldwide. Determining gait and kinematic parameters that are related to an increased risk of falls is essential for developing effective intervention and fall prevention strategies. This study aimed to investigate the discriminatory parameter, which lay an important basis for developing effective clinical screening tools for identifying high-fall-risk older adults. METHODS Forty-one individuals aged 65 years and above living in the community participated in this study. The older adults were classified as high-fall-risk and low-fall-risk individuals based on their BBS scores. The participants wore an inertial measurement unit (IMU) while conducting the Timed Up and Go (TUG) test. Simultaneously, a depth camera acquired images of the participants' movements during the experiment. After segmenting the data according to subtasks, 142 parameters were extracted from the sensor-based data. A t-test or Mann-Whitney U test was performed on the parameters for distinguishing older adults at high risk of falling. The logistic regression was used to further quantify the role of different parameters in identifying high-fall-risk individuals. Furthermore, we conducted an ablation experiment to explore the complementary information offered by the two sensors. RESULTS Fifteen participants were defined as high-fall-risk individuals, while twenty-six were defined as low-fall-risk individuals. 17 parameters were tested for significance with p-values less than 0.05. Some of these parameters, such as the usage of walking assistance, maximum angular velocity around the yaw axis during turn-to-sit, and step length, exhibit the greatest discriminatory abilities in identifying high-fall-risk individuals. Additionally, combining features from both devices for fall risk assessment resulted in a higher AUC of 0.882 compared to using each device separately. CONCLUSIONS Utilizing different types of sensors can offer more comprehensive information. Interpreting parameters to physiology provides deeper insights into the identification of high-fall-risk individuals. High-fall-risk individuals typically exhibited a cautious gait, such as larger step width and shorter step length during walking. Besides, we identified some abnormal gait patterns of high-fall-risk individuals compared to low-fall-risk individuals, such as less knee flexion and a tendency to tilt the pelvis forward during turning.
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Affiliation(s)
- Xuan Wang
- Intelligent Sensing and Proactive Health Research Center, School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Junjie Cao
- Intelligent Sensing and Proactive Health Research Center, School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Qizheng Zhao
- Intelligent Sensing and Proactive Health Research Center, School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Manting Chen
- Intelligent Sensing and Proactive Health Research Center, School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Jiajia Luo
- Intelligent Sensing and Proactive Health Research Center, School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Hailiang Wang
- School of Design, the Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Lisha Yu
- School of Design, the Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Kwok-Leung Tsui
- Grado Department of Industrial and Systems Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Yang Zhao
- Intelligent Sensing and Proactive Health Research Center, School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.
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Eost-Telling C, Yang Y, Norman G, Hall A, Hanratty B, Knapp M, Robinson L, Todd C. Digital technologies to prevent falls in people living with dementia or mild cognitive impairment: a rapid systematic overview of systematic reviews. Age Ageing 2024; 53:afad238. [PMID: 38219225 PMCID: PMC10788098 DOI: 10.1093/ageing/afad238] [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: 06/14/2023] [Revised: 09/27/2023] [Indexed: 01/16/2024] Open
Abstract
OBJECTIVE Falls are a common cause of potentially preventable death, disability and loss of independence with an annual estimated cost of £4.4bn. People living with dementia (PlwD) or mild cognitive impairment (MCI) have an increased fall risk. This overview evaluates evidence for technologies aiming to reduce falls and fall risk for PlwD or MCI. METHODS In October 2022, we searched five databases for evidence syntheses. We used standard methods to rapidly screen, extract data, assess risk of bias and overlap, and synthesise the evidence for each technology type. RESULTS We included seven systematic reviews, incorporating 22 relevant primary studies with 1,412 unique participants. All reviews had critical flaws on AMSTAR-2: constituent primary studies were small, heterogeneous, mostly non-randomised and assessed as low or moderate quality. Technologies assessed were: wearable sensors, environmental sensor-based systems, exergaming, virtual reality systems. We found no evidence relating to apps. Review evidence for the direct impact on falls was available only from environmental sensors, and this was inconclusive. For wearables and virtual reality technologies there was evidence that technologies may differentiate PlwD who fell from those who did not; and for exergaming that balance may be improved. CONCLUSIONS The evidence for technology to reduce falls and falls risk for PlwD and MCI is methodologically weak, based on small numbers of participants and often indirect. There is a need for higher-quality RCTs to provide robust evidence for effectiveness of fall prevention technologies. Such technologies should be designed with input from users and consideration of the wider implementation context.
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Affiliation(s)
- Charlotte Eost-Telling
- National Institute for Health and Care Research (NIHR) Older People and Frailty Policy Research Unit, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, The University of Manchester, Manchester M13 9PT, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration Greater Manchester, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
| | - Yang Yang
- National Institute for Health and Care Research (NIHR) Older People and Frailty Policy Research Unit, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, The University of Manchester, Manchester M13 9PT, UK
| | - Gill Norman
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, The University of Manchester, Manchester M13 9PT, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration Greater Manchester, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
| | - Alex Hall
- National Institute for Health and Care Research (NIHR) Older People and Frailty Policy Research Unit, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, The University of Manchester, Manchester M13 9PT, UK
| | - Barbara Hanratty
- National Institute for Health and Care Research (NIHR) Older People and Frailty Policy Research Unit, Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne NE4 5PL, UK
| | - Martin Knapp
- National Institute for Health and Care Research (NIHR) Older People and Frailty Policy Research Unit, Care Policy and Evaluation Centre, London School of Economics and Political Science, London WC2A 2AE, UK
| | - Louise Robinson
- National Institute for Health and Care Research (NIHR) Older People and Frailty Policy Research Unit, Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne NE4 5PL, UK
| | - Chris Todd
- National Institute for Health and Care Research (NIHR) Older People and Frailty Policy Research Unit, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, The University of Manchester, Manchester M13 9PT, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration Greater Manchester, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
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Li KJ, Wong NLY, Law MC, Lam FMH, Wong HC, Chan TO, Wong KN, Zheng YP, Huang QY, Wong AYL, Kwok TCY, Ma CZH. Reliability, Validity, and Identification Ability of a Commercialized Waist-Attached Inertial Measurement Unit (IMU) Sensor-Based System in Fall Risk Assessment of Older People. BIOSENSORS 2023; 13:998. [PMID: 38131758 PMCID: PMC10742152 DOI: 10.3390/bios13120998] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/31/2023] [Accepted: 11/08/2023] [Indexed: 12/23/2023]
Abstract
Falls are a prevalent cause of injury among older people. While some wearable inertial measurement unit (IMU) sensor-based systems have been widely investigated for fall risk assessment, their reliability, validity, and identification ability in community-dwelling older people remain unclear. Therefore, this study evaluated the performance of a commercially available IMU sensor-based fall risk assessment system among 20 community-dwelling older recurrent fallers (with a history of ≥2 falls in the past 12 months) and 20 community-dwelling older non-fallers (no history of falls in the past 12 months), together with applying the clinical scale of the Mini-Balance Evaluation Systems Test (Mini-BESTest). The results show that the IMU sensor-based system exhibited a significant moderate to excellent test-retest reliability (ICC = 0.838, p < 0.001), an acceptable level of internal consistency reliability (Spearman's rho = 0.471, p = 0.002), an acceptable convergent validity (Cronbach's α = 0.712), and an area under the curve (AUC) value of 0.590 for the IMU sensor-based receiver-operating characteristic (ROC) curve. The findings suggest that while the evaluated IMU sensor-based system exhibited good reliability and acceptable validity, it might not be able to fully identify the recurrent fallers and non-fallers in a community-dwelling older population. Further system optimization is still needed.
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Affiliation(s)
- Ke-Jing Li
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China; (K.-J.L.); (N.L.-Y.W.); (M.-C.L.); (H.-C.W.); (T.-O.C.); (K.-N.W.); (Y.-P.Z.)
| | - Nicky Lok-Yi Wong
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China; (K.-J.L.); (N.L.-Y.W.); (M.-C.L.); (H.-C.W.); (T.-O.C.); (K.-N.W.); (Y.-P.Z.)
| | - Man-Ching Law
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China; (K.-J.L.); (N.L.-Y.W.); (M.-C.L.); (H.-C.W.); (T.-O.C.); (K.-N.W.); (Y.-P.Z.)
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China;
- Jockey Club Smart Ageing Hub, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Freddy Man-Hin Lam
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China;
| | - Hoi-Ching Wong
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China; (K.-J.L.); (N.L.-Y.W.); (M.-C.L.); (H.-C.W.); (T.-O.C.); (K.-N.W.); (Y.-P.Z.)
- Jockey Club Smart Ageing Hub, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Tsz-On Chan
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China; (K.-J.L.); (N.L.-Y.W.); (M.-C.L.); (H.-C.W.); (T.-O.C.); (K.-N.W.); (Y.-P.Z.)
- Jockey Club Smart Ageing Hub, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Kit-Naam Wong
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China; (K.-J.L.); (N.L.-Y.W.); (M.-C.L.); (H.-C.W.); (T.-O.C.); (K.-N.W.); (Y.-P.Z.)
- Jockey Club Smart Ageing Hub, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yong-Ping Zheng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China; (K.-J.L.); (N.L.-Y.W.); (M.-C.L.); (H.-C.W.); (T.-O.C.); (K.-N.W.); (Y.-P.Z.)
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China;
- Jockey Club Smart Ageing Hub, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Qi-Yao Huang
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hong Kong SAR, China;
| | - Arnold Yu-Lok Wong
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China;
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China;
| | - Timothy Chi-Yui Kwok
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China;
| | - Christina Zong-Hao Ma
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China; (K.-J.L.); (N.L.-Y.W.); (M.-C.L.); (H.-C.W.); (T.-O.C.); (K.-N.W.); (Y.-P.Z.)
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China;
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Waterval NFJ, Claassen CM, van der Helm FCT, van der Kruk E. Predictability of Fall Risk Assessments in Community-Dwelling Older Adults: A Scoping Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:7686. [PMID: 37765742 PMCID: PMC10536675 DOI: 10.3390/s23187686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023]
Abstract
Fall risk increases with age, and one-third of adults over 65 years old experience a fall annually. Due to the aging population, the number of falls and related medical costs will progressively increase. Correct prediction of who will fall in the future is necessary to timely intervene in order to prevent falls. Therefore, the aim of this scoping review is to determine the predictive value of fall risk assessments in community-dwelling older adults using prospective studies. A total of 37 studies were included that evaluated clinical assessments (questionnaires, physical assessments, or a combination), sensor-based clinical assessments, or sensor- based daily life assessments using prospective study designs. The posttest probability of falling or not falling was calculated. In general, fallers were better classified than non-fallers. Questionnaires had a lower predictive capability compared to the other assessment types. Contrary to conclusions drawn in reviews that include retrospective studies, the predictive value of physical tests evaluated in prospective studies varies largely, with only smaller-sampled studies showing good predictive capabilities. Sensor-based fall risk assessments are promising and improve with task complexity, although they have only been evaluated in relatively small samples. In conclusion, fall risk prediction using sensor data seems to outperform conventional tests, but the method's validity needs to be confirmed by large prospective studies.
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Affiliation(s)
- N. F. J. Waterval
- Department of Rehabilitation Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;
- Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands
| | - C. M. Claassen
- Biomechatronics & Human-Machine Control, Department of Biomechanical Engineering, Faculty of Mechanical Engineering (3me), Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
| | - F. C. T. van der Helm
- Biomechatronics & Human-Machine Control, Department of Biomechanical Engineering, Faculty of Mechanical Engineering (3me), Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
| | - E. van der Kruk
- Biomechatronics & Human-Machine Control, Department of Biomechanical Engineering, Faculty of Mechanical Engineering (3me), Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
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Wei S, Wu Z. The Application of Wearable Sensors and Machine Learning Algorithms in Rehabilitation Training: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:7667. [PMID: 37765724 PMCID: PMC10537628 DOI: 10.3390/s23187667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 08/24/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023]
Abstract
The integration of wearable sensor technology and machine learning algorithms has significantly transformed the field of intelligent medical rehabilitation. These innovative technologies enable the collection of valuable movement, muscle, or nerve data during the rehabilitation process, empowering medical professionals to evaluate patient recovery and predict disease development more efficiently. This systematic review aims to study the application of wearable sensor technology and machine learning algorithms in different disease rehabilitation training programs, obtain the best sensors and algorithms that meet different disease rehabilitation conditions, and provide ideas for future research and development. A total of 1490 studies were retrieved from two databases, the Web of Science and IEEE Xplore, and finally 32 articles were selected. In this review, the selected papers employ different wearable sensors and machine learning algorithms to address different disease rehabilitation problems. Our analysis focuses on the types of wearable sensors employed, the application of machine learning algorithms, and the approach to rehabilitation training for different medical conditions. It summarizes the usage of different sensors and compares different machine learning algorithms. It can be observed that the combination of these two technologies can optimize the disease rehabilitation process and provide more possibilities for future home rehabilitation scenarios. Finally, the present limitations and suggestions for future developments are presented in the study.
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Affiliation(s)
- Suyao Wei
- College of Furnishings and Industrial Design, Nanjing Forestry University, Nanjing 210037, China
| | - Zhihui Wu
- College of Furnishings and Industrial Design, Nanjing Forestry University, Nanjing 210037, China
- Co-Innovation Center of Efficient Processing and Utilization of Forest Resources, Nanjing Forestry University, Nanjing 210037, China
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