scholarly journals Automatic Quantification of Tandem Walking Using a Wearable Device: New Insights Into Dynamic Balance and Mobility in Older Adults

2020 ◽  
Vol 76 (1) ◽  
pp. 101-107
Author(s):  
Natalie Ganz ◽  
Eran Gazit ◽  
Nir Giladi ◽  
Robert J Dawe ◽  
Anat Mirelman ◽  
...  
Keyword(s):  
Older Adults ◽  
Postural Control ◽  
Dynamic Balance ◽  
Principal Component ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Sensor Data ◽  
Quiet Standing ◽  
Mobility Disability ◽  
Community Dwelling Older Adults

Abstract Background Wearable sensors are increasingly employed to quantify diverse aspects of mobility. We developed novel tandem walking (TW) metrics, validated these measures using data from community-dwelling older adults, and evaluated their association with mobility disability and measures of gait and postural control. Methods Six hundred ninety-three community-dwelling older adults (age: 78.69 ± 7.12 years) wore a 3D accelerometer on their lower back while performing 3 tasks: TW, usual-walking, and quiet standing. Six new measures of TW were extracted from the sensor data along with the clinician’s conventional assessment of TW missteps (ie, trip other loss of balance in which recovery occurred to prevent a fall) and duration. Principal component analysis transformed the 6 new TW measures into 2 summary TW composite factors. Logistic regression models evaluated whether these TW factors were independently associated with mobility disability. Results Both TW factors were moderately related to the TW conventional measures (r < 0.454, p < .001) and were mildly correlated with usual-walking (r < 0.195, p < .001) and standing, postural control (r < 0.119, p < .001). The TW frequency composite factor (p = .008), but not TW complexity composite factor (p = .246), was independently associated with mobility disability in a model controlling for age, sex, body mass index, race, conventional measures of TW, and other measures of gait and postural control. Conclusions Sensor-derived TW metrics expand the characterization of gait and postural control and suggest that they reflect a relatively independent domain of mobility. Further work is needed to determine if these metrics improve risk stratification for other adverse outcomes (eg, falls and incident disability) in older adults.

scholarly journals How wearable sensors have been utilised to evaluate frailty in older adults: a systematic review

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Grainne Vavasour ◽  
Oonagh M. Giggins ◽  
Julie Doyle ◽  
Daniel Kelly
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Gait Speed ◽  
Outcome Measurement ◽  
Wearable Sensors ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Ageing Population ◽  
Application Development ◽  
Community Dwelling Older Adults

Abstract Background Globally the population of older adults is increasing. It is estimated that by 2050 the number of adults over the age of 60 will represent over 21% of the world’s population. Frailty is a clinical condition associated with ageing resulting in an increase in adverse outcomes. It is considered the greatest challenge facing an ageing population affecting an estimated 16% of community-dwelling populations worldwide. Aim The aim of this systematic review is to explore how wearable sensors have been used to assess frailty in older adults. Method Electronic databases Medline, Science Direct, Scopus, and CINAHL were systematically searched March 2020 and November 2020. A search constraint of articles published in English, between January 2010 and November 2020 was applied. Papers included were primary observational studies involving; older adults aged > 60 years, used a wearable sensor to provide quantitative measurements of physical activity (PA) or mobility and a measure of frailty. Studies were excluded if they used non-wearable sensors for outcome measurement or outlined an algorithm or application development exclusively. The methodological quality of the selected studies was assessed using the Appraisal Tool for Cross-sectional Studies (AXIS). Results Twenty-nine studies examining the use of wearable sensors to assess and discriminate between stages of frailty in older adults were included. Thirteen different body-worn sensors were used in eight different body-locations. Participants were community-dwelling older adults. Studies were performed in home, laboratory or hospital settings. Postural transitions, number of steps, percentage of time in PA and intensity of PA together were the most frequently measured parameters followed closely by gait speed. All but one study demonstrated an association between PA and level of frailty. All reports of gait speed indicate correlation with frailty. Conclusions Wearable sensors have been successfully used to evaluate frailty in older adults. Further research is needed to identify a feasible, user-friendly device and body-location that can be used to identify signs of pre-frailty in community-dwelling older adults. This would facilitate early identification and targeted intervention to reduce the burden of frailty in an ageing population.

scholarly journals Fitness, Balance Efficacy, and Postural Control in Community-Dwelling Older Adults

SAGE Open ◽  
2016 ◽  
Vol 6 (1) ◽  
pp. 215824401663179 ◽  
Author(s):  
Anna Lee ◽  
John R. Biggan ◽  
Christopher Ray
Keyword(s):  
Older Adults ◽  
Postural Control ◽  
Community Dwelling ◽  
Community Dwelling Older Adults

scholarly journals Relationship Between Dynamic Balance Measures and Functional Performance in Community-Dwelling Elderly People

2010 ◽  
Vol 90 (5) ◽  
pp. 748-760 ◽  
Author(s):  
Ankur Desai ◽  
Valerie Goodman ◽  
Naaz Kapadia ◽  
Barbara L. Shay ◽  
Tony Szturm
Keyword(s):  
Older Adults ◽  
Elderly People ◽  
Dynamic Balance ◽  
Community Dwelling ◽  
Standing Balance ◽  
Self Report ◽  
Clinical Test ◽  
Balance Assessment ◽  
Test Protocol ◽  
Community Dwelling Older Adults

BackgroundPoor balance control, mobility restrictions, and fall injuries are serious problems for many older adults.ObjectiveThe purpose of this study was to evaluate a new dynamic standing balance assessment test for identifying individuals at risk for falling in a group of community-dwelling older adults.DesignThis was a cross-sectional observational study of 72 community-dwelling older adults who were receiving rehabilitation in a geriatric day hospital.MethodA Dynamic Balance Assessment (DBA) test protocol was developed based on the concept of the Sensory Organization Test and the Clinical Test of Sensory Interaction and Balance. The DBA consists of 6 tasks performed on a normal floor surface and repeated on a sponge surface. A flexible pressure mat was used to record the foot's center of pressure (COP) on both surfaces, and loss of balance was recorded. Balance performance also was evaluated using the Berg Balance Scale, the Timed “Up & Go” Test, gait speed, and the Six-Minute Walk Test. Participants were classified as “fallers” or “nonfallers” based on a self-report.ResultsNo significant differences were noted between the faller group (n=47) and the nonfaller group (n=25) for demographic variables or medications. The DBA composite scores, which were derived from analysis of COP excursions of the 6 tasks performed on the sponge surface, were able to distinguish between fallers and nonfallers. Of the clinical tests, only the Timed “Up & Go” Test was able to differentiate between the faller and nonfaller groups.LimitationsA prospective study is needed to confirm the current findings and to expand testing to a larger and more diverse sample.ConclusionsThe findings indicate that analysis of the extent and amount of COP displacements during selected tasks and under different surface conditions is an appropriate method to assess dynamic standing balance controls and can discriminate between fallers and nonfallers among community-dwelling elderly people.

scholarly journals The Relationship Between Frailty and Depression, Quality of Life, Disability, and Hospitalization Among Community-Dwelling Older Adults

2020 ◽  
Author(s):  
Audai A. Hayajneh ◽  
Hanan Hammouri ◽  
Eman S. Al-Satari ◽  
Debra C. Wallace ◽  
Mohammad Rababa
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Health Outcomes ◽  
Secondary Analysis ◽  
Depression Scale ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
High Prevalence ◽  
Community Dwelling Older Adults

Abstract Background: Frailty syndrome is characterized by a decline in physiological and psychological reserve that leads to poor health outcomes. Objectives: The current study explored frailty and its impacts on health outcomes among older adults in close-knit Jordanian communities. Methods: A secondary analysis (N=109) of community-dwelling older adults aged 60 years or over was conducted. The Arabic version of the culturally adapted Tilburg Frailty Indicator, the Geriatric Depression Scale, the Montreal Cognitive Assessment, the SF-36 Quality of Life survey, and disability self-reports were used. Results: Despite Jordanian communities being very close-knit, the results indicated a high prevalence of frailty (78%) and depression (38%) and poor outcomes of cognitive dysfunction and low quality of life among the participating older adults. Further, the prevalence of frailty was found to be 4.2 times higher among females than males and 7.2 times higher among single older adults than married older adults. Conclusion: A high prevalence of frailty and its related adverse outcomes was found among older adults in Jordan.

scholarly journals Resistance training improves mobility disability in community-dwelling older adults: a meta-analysis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 904-904
Author(s):  
Christina Prevett ◽  
Kevin Moncion ◽  
Stuart Phillips ◽  
Julie Richardson ◽  
Ada Tang
Keyword(s):  
Older Adults ◽  
Resistance Training ◽  
Physical Function ◽  
Gait Speed ◽  
Positive Impact ◽  
Community Dwelling ◽  
Mobility Disability ◽  
Exercise Interventions ◽  
Walking Capacity ◽  
Community Dwelling Older Adults

Abstract Mobility disability is the impairment in function that affects the performance of daily tasks due to declines in physical function. Exercise interventions, particular resistance training, may have a positive impact on mobility disability, but the evidence for the effects of resistance training in older adults with mobility disability has not been previously systematically reviewed. This study was a systematic review of evidence related to resistance training on physical function for adults over 65 years of age with mobility disability. Four databases (PEDro, MedLine, Ovid, Web of Science) were searched from inception to February 2, 2021 for randomized controlled trials. Twenty-four articles from 22 studies (3,656 participants) were included in the review. Mean participant age ranged from 63-87 years and exercise interventions ranged from 10 weeks to 12 months in duration. Greater changes in 6-minute Walk Test (6MWT) distance (n=638, p<0.0001; mean difference (MD) 16.1 metres; 95%CI 12.3-19.9), lower extremity strength (n=785, p<0.0001; standard MD 2.01; 95%CI 1.27-2.75) and usual gait speed (n=2,106, p<0.001; MD 0.05 metres/second, 95%CI 0.03-0.07) were seen with resistance training as compared to control. These results were maintained if resistance training was a sole intervention or a component of a multi-component program. Sensitivity analysis based on risk of bias concerns did not change results. This review demonstrates that resistance training improves walking capacity, strength and walking speed in community-dwelling older adults and may facilitate aging in place. Since improvements in strength and gait speed contribute to independence, our results indicate highly beneficial outcomes for older persons.

scholarly journals Association ankle function and balance in community-dwelling older adults

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247885
Author(s):  
David Hernández-Guillén ◽  
Catalina Tolsada-Velasco ◽  
Sergio Roig-Casasús ◽  
Elena Costa-Moreno ◽  
Irene Borja-de-Fuentes ◽  
...  
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Dynamic Balance ◽  
Weight Bearing ◽  
Community Dwelling ◽  
Plantar Flexor ◽  
Flexor Muscle ◽  
Ankle Mobility ◽  
Ankle Function ◽  
Community Dwelling Older Adults

Background and purpose Ankle function declines with age. The objective of this study was to investigate the association between ankle function and balance in older adults, with a focus on range of motion (ROM) and strength. Methods This was a cross-sectional study that included 88 healthy community-dwelling older adults. Ankle mobility was measured while bearing weight (lunge test) and not bearing weight. The plantar-flexor muscle strength was assessed using a hand-held dynamometer. Balance was measured in terms of dynamic balance and mobility (timed up and go test), monopodal and bipodal static balance with open and closed eyes (single-leg stand test and platform measures), and margins of stability (functional reach test). Linear correlation and multiple regression analyses were conducted with a 95% CI. Results and discussion Most participants had limited ankle mobility (n = 75, 86%). Weight-bearing ankle dorsiflexion ROM was the strongest predictor of dynamic balance and included general mobility and stability (Radj2 = [0.34]; β = [-0.50]). In contrast, plantar-flexor muscle strength was a significant predictor of static standing balance with open eyes (Radj2 = [0.16–0.2]; β = [0.29–0.34]). Overall, weight-bearing ankle dorsiflexion ROM was a more representative measure of balance and functional performance; however, a non-weight-bearing mobility assessment provides complementary information. Therefore, both measures can be used in clinical practice. Conclusion This study supports the concept that ankle mobility contributes to the performance of dynamic tasks, while the plantar-flexor muscle strength helps to develop a standing static balance. Identification of alterations in ankle function is warranted and may assist in the design of tailored interventions. These interventions can be used in isolation or to augment conventional balance training in order to improve balance performance in community-dwelling older adults.

Can Insoles Be Used to Improve Static and Dynamic Balance of Community-Dwelling Older Adults? A Systematic Review on Recent Advances and Future Perspectives

2020 ◽  
Vol 28 (6) ◽  
pp. 971-986
Author(s):  
Christina Zong-Hao Ma ◽  
Wing-Kai Lam ◽  
Bao-Chi Chang ◽  
Winson Chiu-Chun Lee
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Postural Balance ◽  
Dynamic Balance ◽  
Community Dwelling ◽  
Good Knowledge ◽  
Medical Conditions ◽  
Future Perspectives ◽  
Dynamic Conditions ◽  
Community Dwelling Older Adults

This systematic review investigated the effects of orthopedic, vibrating, and textured insoles on the postural balance of community-dwelling older adults. Articles published in English from 1999 to 2019 investigating the effects of (a) orthopedic, (b) vibrating, and (c) textured insoles on static and dynamic balance in community-dwelling older adults were considered. Twenty-four trials with a total of 634 older adults were identified. The information gathered generally supported the balance-improving effects of orthopedic, vibrating, and textured insoles in both static and dynamic conditions among community-dwelling older adults. Further examination found that rigidity, texture patterns, vibration thresholds, and components like arch supports and heel cups are important factors in determining whether insoles can improve balance. This review highlights the potential of insoles for improving the static and dynamic balance of community-dwelling older adults. Good knowledge in insole designs and an understanding of medical conditions of older adults are required when attempts are made to improve postural balance using insoles.

Contribution of Head Position, Standing Surface, and Vision to Postural Control in Community-Dwelling Older Adults

2015 ◽  
Vol 70 (1) ◽  
pp. 7001270010p1 ◽  
Author(s):  
Fredrick D. Pociask ◽  
Rosanne DiZazzo-Miller ◽  
Allon Goldberg ◽  
Diane E. Adamo
Keyword(s):  
Older Adults ◽  
Postural Control ◽  
Head Position ◽  
Community Dwelling ◽  
Community Dwelling Older Adults

scholarly journals Predictors of real-life mobility in community-dwelling older adults: an exploration based on a comprehensive framework for analyzing mobility

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Eleftheria Giannouli ◽  
Michelle Pasquale Fillekes ◽  
Sabato Mellone ◽  
Robert Weibel ◽  
Otmar Bock ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Physical Functioning ◽  
Real Life ◽  
Cardiovascular Fitness ◽  
Community Dwelling ◽  
Sensor Data ◽  
Maximum Temperature ◽  
Life Space ◽  
Community Dwelling Older Adults

Abstract Background Reduced mobility is associated with a plethora of adverse outcomes. To support older adults in maintaining their independence, it first is important to have deeper knowledge of factors that impact on their mobility. Based on a framework that encompasses demographical, environmental, physical, cognitive, psychological and social domains, this study explores predictors of different aspects of real-life mobility in community-dwelling older adults. Methods Data were obtained in two study waves with a total sample of n = 154. Real-life mobility (physical activity-based mobility and life-space mobility) was assessed over one week using smartphones. Active and gait time and number of steps were calculated from inertial sensor data, and life-space area, total distance, and action range were calculated from GPS data. Demographic measures included age, gender and education. Physical functioning was assessed based on measures of cardiovascular fitness, leg and handgrip strength, balance and gait function; cognitive functioning was assessed based on measures of attention and executive function. Psychological and social assessments included measures of self-efficacy, depression, rigidity, arousal, and loneliness, sociableness, perceived help availability, perceived ageism and social networks. Maximum temperature was used to assess weather conditions on monitoring days. Results Multiple regression analyses indicated just physical and psychological measures accounted for significant but rather low proportions of variance (5–30%) in real-life mobility. Strength measures were retained in most of the regression models. Cognitive and social measures did not remain as significant predictors in any of the models. Conclusions In older adults without mobility limitations, real-life mobility was associated primarily with measures of physical functioning. Psychological functioning also seemed to play a role for real-life mobility, though the associations were more pronounced for physical activity-based mobility than life-space mobility. Further factors should be assessed in order to achieve more conclusive results about predictors of real-life mobility in community-dwelling older adults.

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