TY - JOUR
T1 - Detection of Real-World Trips in At-Fall Risk Community Dwelling Older Adults Using Wearable Sensors
AU - Handelzalts, Shirley
AU - Alexander, Neil B.
AU - Mastruserio, Nicholas
AU - Nyquist, Linda V.
AU - Strasburg, Debra M.
AU - Ojeda, Lauro V.
N1 - Funding Information:
Funding. Research reported herein was supported by a grant to the University of Michigan Injury Prevention Center by the Centers for Disease Control & Prevention Award Number R49-CE-002099 with secondary support from the National Institute of Aging (AG024824) and the National Center for Advancing Translational Sciences (UL1TR0 0 0224). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Centers for Disease Control & Prevention or the Department of Health and Human Services.
Publisher Copyright:
© Copyright © 2020 Handelzalts, Alexander, Mastruserio, Nyquist, Strasburg and Ojeda.
PY - 2020/9/2
Y1 - 2020/9/2
N2 - Background: Near-falls such as a trip, slip, stumble, or misstep involve a loss of balance (LOB) that does not result in a fall, occur more frequently than actual falls, and are associated with an increased fall risk. To date, studies have largely involved detection of simulated laboratory LOBs using wearable devices in young adults. Data on the detection of and kinematics of naturally occurring LOBs in people at high risk of falling are lacking. This may provide a new way to identify older adults at high risk for falls. We aimed to explore key body kinematics underlying real-world trips in at-fall risk community dwelling older adults wearing inertial measurement units (IMU). Methods: Five community-dwelling older adults with a history of falls who reported trips during the study period participated. They wore a voice recorder and 4 IMUs mounted on feet, lower back and wrist for two consecutive weeks to provide a record of the context and timing of LOB events. Sensor data prior to time-stamped voice recording of a trip were processed in order to visually identify unusual foot trajectories and lower back and arm orientations. Then, data of feet, lower back and wrist position and orientation were combined to create a three-dimensional animation representing the estimated body motion during the noted time segments in order to corroborate the occurrence of a trip. Events reported as a trip by the participant and identified as a trip by a researcher, blinded to voice recordings description, were included in the final analysis. Results: A total of 18 trips obtained from five participants were analyzed. Twelve trips occurred at home, three outside and for three the location was not reported. Trips were identified in the sensor data by observing (1) additional peaks to the typical foot velocity signal during swing phase; (2) increased velocity of the contralateral foot and (3) sharp changes in lower back pitch angles. Conclusions: Our approach demonstrates the feasibility of identifying and studying the mechanisms and context underlying trip-related LOBs in at-fall risk older adults during real world activities.
AB - Background: Near-falls such as a trip, slip, stumble, or misstep involve a loss of balance (LOB) that does not result in a fall, occur more frequently than actual falls, and are associated with an increased fall risk. To date, studies have largely involved detection of simulated laboratory LOBs using wearable devices in young adults. Data on the detection of and kinematics of naturally occurring LOBs in people at high risk of falling are lacking. This may provide a new way to identify older adults at high risk for falls. We aimed to explore key body kinematics underlying real-world trips in at-fall risk community dwelling older adults wearing inertial measurement units (IMU). Methods: Five community-dwelling older adults with a history of falls who reported trips during the study period participated. They wore a voice recorder and 4 IMUs mounted on feet, lower back and wrist for two consecutive weeks to provide a record of the context and timing of LOB events. Sensor data prior to time-stamped voice recording of a trip were processed in order to visually identify unusual foot trajectories and lower back and arm orientations. Then, data of feet, lower back and wrist position and orientation were combined to create a three-dimensional animation representing the estimated body motion during the noted time segments in order to corroborate the occurrence of a trip. Events reported as a trip by the participant and identified as a trip by a researcher, blinded to voice recordings description, were included in the final analysis. Results: A total of 18 trips obtained from five participants were analyzed. Twelve trips occurred at home, three outside and for three the location was not reported. Trips were identified in the sensor data by observing (1) additional peaks to the typical foot velocity signal during swing phase; (2) increased velocity of the contralateral foot and (3) sharp changes in lower back pitch angles. Conclusions: Our approach demonstrates the feasibility of identifying and studying the mechanisms and context underlying trip-related LOBs in at-fall risk older adults during real world activities.
KW - accelerometers
KW - balance
KW - inertial measurement units
KW - monitoring
KW - near-falls
KW - walking
UR - http://www.scopus.com/inward/record.url?scp=85090927234&partnerID=8YFLogxK
U2 - 10.3389/fmed.2020.00514
DO - 10.3389/fmed.2020.00514
M3 - Article
AN - SCOPUS:85090927234
SN - 2296-858X
VL - 7
JO - Frontiers in Medicine
JF - Frontiers in Medicine
M1 - 514
ER -