Vision-Based Assessment of Gait Features Associated With Falls in People With Dementia

2019 ◽  
Vol 75 (6) ◽  
pp. 1148-1153 ◽  
Author(s):  
Sina Mehdizadeh ◽  
Elham Dolatabadi ◽  
Kimberley-Dale Ng ◽  
Avril Mansfield ◽  
Alastair Flint ◽  
...  
Keyword(s):  
Baseline Period ◽  
Demographic Variables ◽  
Lateral Margin ◽  
Time Variability ◽  
Period Range ◽  
Gait Stability ◽  
Margin Of Stability ◽  
People With Dementia ◽  
Gait Features ◽  
Important Marker

Abstract Background Gait impairments contribute to falls in people with dementia. In this study, we used a vision-based system to record episodes of walking over a 2-week period as participants moved naturally around their environment, and from these calculated spatiotemporal, stability, symmetry, and acceleration gait features. The aim of this study was to determine whether features of gait extracted from a vision-based system are associated with falls, and which of these features are most strongly associated with falling. Methods Fifty-two people with dementia admitted to a specialized dementia unit participated in this study. Thirty different features describing baseline gait were extracted from Kinect recordings of natural gait over a 2-week period. Baseline clinical and demographic measures were collected, and falls were tracked throughout the participants’ admission. Results A total of 1,744 gait episodes were recorded (mean 33.5 ± 23.0 per participant) over a 2-week baseline period. There were a total of 78 falls during the study period (range 0–10). In single variable analyses, the estimated lateral margin of stability, step width, and step time variability were significantly associated with the number of falls during admission. In a multivariate model controlling for clinical and demographic variables, the estimated lateral margin of stability (p = .01) was remained associated with number of falls. Conclusions Information about gait can be extracted from vision-based recordings of natural walking. In particular, the lateral margin of stability, a measure of lateral gait stability, is an important marker of short-term falls risk.

scholarly journals Gait changes over time in hospitalized older adults with advanced dementia: Predictors of mobility change

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259975
Author(s):  
Sina Mehdizadeh ◽  
Mohammadreza Faieghi ◽  
Andrea Sabo ◽  
Hoda Nabavi ◽  
Avril Mansfield ◽  
...  
Keyword(s):  
Older Adults ◽  
Range Of Motion ◽  
Neuropsychiatric Symptoms ◽  
Step Length ◽  
Time Variability ◽  
Mixed Effect ◽  
Gait Stability ◽  
Rehabilitation Outcomes ◽  
People With Dementia ◽  
Over Time

People with dementia are at risk of mobility decline. In this study, we measured changes in quantitative gait measures over a maximum 10-week period during the course of a psychogeriatric admission in older adults with dementia, with the aims to describe mobility changes over the duration of the admission, and to determine which factors were associated with this change. Fifty-four individuals admitted to a specialized dementia inpatient unit participated in this study. A vision-based markerless motion capture system was used to record participants’ natural gait. Mixed effect models were developed with gait measures as the dependent variables and clinical and demographic variables as predictors. We found that gait stability, step time, and step length decreased, and step time variability and step length variability increased over 10 weeks. Gait stability of men decreased more than that of women, associated with an increased sacrum mediolateral range of motion over time. In addition, the sacrum mediolateral range of motion decreased in those with mild neuropsychiatric symptoms over 10 weeks, but increased in those with more severe neuropsychiatric symptoms. Our study provides evidence of worsening of gait mechanics and control over the course of a hospitalization in older adults with dementia. Quantitative gait monitoring in hospital environments may provide opportunities to intervene to prevent adverse events, decelerate mobility decline, and monitor rehabilitation outcomes.

scholarly journals How does external lateral stabilization constrain normal gait, apart from improving medio-lateral gait stability?

2020 ◽  
Author(s):  
Mohammadreza Mahaki ◽  
Trienke IJmker ◽  
Han Houdijk ◽  
Sjoerd Matthijs Bruijn
Keyword(s):  
Step Length ◽  
Step Width ◽  
Arm Swing ◽  
Gait Stability ◽  
Normal Gait ◽  
Consumption Data ◽  
Gait Features ◽  
Pelvis Rotation ◽  
Set Up ◽  
Anterior Posterior

AbstractBackgroundThe effect of external lateral stabilization on medio-lateral gait stability has been investigated previously. However, existing lateral stabilization devices not only constrains lateral motions, but also transverse and frontal pelvis rotations. This study aimed to investigate the effect of external lateral stabilization with and without constrained transverse pelvis rotation on mechanical and metabolic gait features.MethodsWe undertook 2 experiments with eleven and ten young adult subjects, respectively. Experiment 2 supplemented experiment 1, as it considered several potential confounding factors in the design and set-up of experiment 1. Kinematic, kinetic, and breath-by-breath oxygen consumption data were recorded during 3 walking conditions (normal walking (Normal), lateral stabilization with (Free) and without transverse pelvis rotation (Restricted)) and at 3 speeds (0.83, 1.25, and 1.66 m/s) for each condition.ResultsExternal lateral stabilization significantly reduced the amplitudes of the transverse and frontal pelvis rotations, medio-lateral pelvis displacement, transverse thorax rotation, arm swing, and step width. The amplitudes of free vertical moment, anterior-posterior and vertical pelvis displacements, step length, and energy cost were not significantly influenced by external lateral stabilization. The removal of transverse pelvis rotation restriction by our experimental set-up resulted in significantly higher transverse pelvis rotation, although it remained significantly less than Normal condition. In concert, concomitant gait features such as transverse thorax rotation and arm swing were not significantly influenced by our new set-up.ConclusionExisting lateral stabilization set-ups not only constrain medio-lateral motions (i.e. medio-lateral pelvis displacement), but also constrains other movements such as transverse and frontal pelvis rotations, which leads to several other gait changes such as reduced transverse thorax rotation, and arm swing. Our new setup allowed for more transverse pelvis rotation, however, this did not result in more normal pelvis rotation, arm swing, etc. Hence, to provide medio-lateral support without constraining other gait variables, more elaborate set-ups are needed. Unless such a set-up is realized the observed side effects need to be taken into account when interpreting the effects of lateral stabilization as reported in previous studies.

scholarly journals Medial-lateral margin of stability for the comparison of two bone-anchored prostheses – a case study

2019 ◽  
Vol 22 (sup1) ◽  
pp. S212-S213
Author(s):  
V. Gibeaux ◽  
A. Naaim ◽  
T. Robert ◽  
L. Frossard ◽  
R. Dumas
Keyword(s):  
Lateral Margin ◽  
Margin Of Stability

Predictors of self- and caregiver-rated quality of life for people with dementia living in the community and in nursing homes in northern Taiwan

2014 ◽  
Vol 27 (5) ◽  
pp. 825-836 ◽  
Author(s):  
Hsiu-Li Huang ◽  
Li-Chueh Weng ◽  
Yu-Hsia Tsai ◽  
Yi-Chen (Yulanda) Chiu ◽  
Kang-Hua Chen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Depressive Symptoms ◽  
Demographic Variables ◽  
Community Dwelling ◽  
Key Factors ◽  
Dyadic Relationship ◽  
Dementia Severity ◽  
People With Dementia

ABSTRACTBackground:Factors affecting quality of life (QOL) ratings for people with dementia (PWD) have been well studied, but few studies have examined the effect of residence on PWD- and caregiver-rated QOL for PWDs. We designed this study to determine the factors related to PWD- and caregiver-rated QOL in dementia as well as factors related to the discrepancy in these ratings.Methods:For this cross-sectional study, we analyzed data from a convenience sample of 106 PWD-family caregiver dyads (58 community-dwelling dyads and 48 nursing-home dyads). PWDs’ data included socio-demographic variables, QOL (assessed by the Quality of Life-Alzheimer's Disease [QOL-AD] scale), cognition, dementia severity, depression, comorbidities, and quality of the dyadic relationship. Caregivers’ data included socio-demographic variables, depressive symptoms, and mutuality of the dyadic relationship.Results:QOL-AD scores were lower when rated by caregivers than by PWDs. The key factors positively related to both PWD- and caregiver-rated QOL for PWDs were fewer PWD depressive symptoms and higher quality of the PWD-caregiver relationship. The key factors related to the discrepancy in PWD- and caregiver-rated QOL in dementia were PWD residence in a nursing home and lower dementia severity, as well as higher caregiver depression, being an adult child caregiver, and lower caregiver-PWD mutuality.Conclusion:Caregiver-rated QOL for PWDs and the discrepancy in rated QOL were significantly associated with PWD residence. If caregiver-rated QOL is needed, the effect of residence of PWD should be taken into consideration. Caregivers’ depressive status and mutuality with PWD must be also carefully assessed.

scholarly journals An investigation of the spatio-temporal parameters of gait and margins of stability throughout adulthood

2020 ◽  
Vol 17 (166) ◽  
pp. 20200194
Author(s):  
Nolan Herssens ◽  
Tamaya van Criekinge ◽  
Wim Saeys ◽  
Steven Truijen ◽  
Luc Vereeck ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Lateral Margin ◽  
Leg Length ◽  
Temporal Characteristics ◽  
Margin Of Stability ◽  
Temporal Parameters ◽  
Age Related ◽  
Support Domain ◽  
Spatio Temporal ◽  
Base Of Support

Age-related changes in the way of walking may induce changes in dynamic stability. Therefore, the relationship between age, spatio-temporal characteristics and margins of stability was examined. One hundred and five healthy adults aged between 20 and 89 years old were analysed on spatio-temporal characteristics and margins of stability using three-dimensional motion analysis. Subjects walked barefoot over a 12-m-long walkway at their preferred walking speed. Covariance among gait characteristics was reduced using a factor analysis, identifying domains of gait. The influence of age, gender, body mass index (BMI) and leg length on domains of gait and margins of stability was investigated using linear mixed models. A stepwise linear regression identified domains of gait predicting the variance in margins of stability. Four domains of gait explaining 74.17% of the variance were identified. Age had a significant influence on the medio-lateral margin of stability and the ‘variability', ‘pace' and ‘base of support' domain. BMI significantly influenced the medio-lateral margin of stability; gender and leg length had no influence on either of the margins of stability. The ‘base of support’ domain predicted 26% of the variance in the medio-lateral margin of stability. When considering the margins of stability, especially when comparing multiple groups, age, BMI and spatio-temporal parameters should be taken into account.

scholarly journals Understanding the Association Between Antidepressants and the Risk of Being Diagnosed with Dementia in Older People: A Self-Controlled Case Series Study

2020 ◽  
Vol 78 (2) ◽  
pp. 735-744
Author(s):  
Zhongzhi Xu ◽  
Jiannan Yang ◽  
Kui Kai Lau ◽  
Paul S.F. Yip ◽  
Ian C.K. Wong ◽  
...  
Keyword(s):  
Older People ◽  
Psychiatric Symptoms ◽  
Antidepressant Treatment ◽  
Case Series ◽  
Baseline Period ◽  
Population Based ◽  
Adverse Outcomes ◽  
People With Dementia ◽  
Case Series Study ◽  
Series Study

Background: Given concerns about adverse outcomes for older people taking antidepressants in the literature, we investigated whether taking antidepressants elevates the risk of dementia. Objective: This study aims to investigate the putative association of antidepressants with the risk of dementia. Methods: We conducted a population-based self-controlled case series analysis of older people with dementia and taking antidepressants, using territory-wide medical records of 194,507 older patients collected by the Hospital Authority of Hong Kong, to investigate the association between antidepressant treatment and the risk of developing dementia in older people. Results: There was a significantly higher risk of being diagnosed with dementia during the pre-drug-exposed period (incidence rate ratio (IRR) 20.42 (95% CI: 18.66–22.34)) compared to the non-drug-exposed baseline period. The IRR remained high during the drug-exposed period (IRR 8.86 (7.80–10.06)) before returning to a baseline level after washout (IRR 1.12 (0.77–1.36)). Conclusion: The higher risk of dementia before antidepressant treatment may be related to emerging psychiatric symptoms co-occurring with dementia, which trigger medical consultations that result in a decision to begin antidepressants. Our findings do not support a causal relationship between antidepressant treatment and the risk of dementia.

scholarly journals Gait parameters and characteristics associated with increased risk of falls in people with dementia: a systematic review

2018 ◽  
Vol 31 (9) ◽  
pp. 1287-1303 ◽  
Author(s):  
Shirin Modarresi ◽  
Alison Divine ◽  
Jessica A. Grahn ◽  
Tom J. Overend ◽  
Susan W. Hunter
Keyword(s):  
Systematic Review ◽  
Rating Scale ◽  
Future Research ◽  
Time Variability ◽  
Double Support ◽  
People With Dementia ◽  
Gait Parameters ◽  
Increased Risk ◽  
Double Support Time ◽  
Support Time

ABSTRACTBackground:People with dementia fall twice as often and have more serious fall-related injuries than healthy older adults. While gait impairment as a generic term is understood as a fall risk factor in this population, a clear elaboration of the specific components of gait that are associated with falls risk is needed for knowledge translation to clinical practice and the development of fall prevention strategies for people with dementia.Objective:To review gait parameters and characteristics associated with falls in people with dementia.Methods:Electronic databases CINAHL, EMBASE, MedLine, PsycINFO, and PubMed were searched (from inception to April 2017) to identify prospective cohort studies evaluating the association between gait and falls in people with dementia.Results:Increased double support time variability, use of mobility aids, walking outdoors, higher scores on the Unified Parkinson’s Disease Rating Scale, and lower average walking bouts were associated with elevated risk of any fall. Increased double support time and step length variability were associated with recurrent falls. The reviewed articles do not support using the Performance Oriented Mobility Assessment and the Timed Up-and-Go tests to predict any fall in this population. There is limited research on the use of dual-task gait assessments for predicting falls in people with dementia.Conclusion:This systematic review shows the specific spatiotemporal gait parameters and features that are associated with falls in people with dementia. Future research is recommended to focus on developing specialized treatment methods for these specific gait impairments in this patient population.

Estimating Gait Stability: Asymmetrical Loading Effects Measured Using Margin of Stability and Local Dynamic Stability

2016 ◽  
Vol 48 (5) ◽  
pp. 455-467 ◽  
Author(s):  
Timothy A. Worden ◽  
Shawn M. Beaudette ◽  
Stephen H. M. Brown ◽  
Lori Ann Vallis
Keyword(s):  
Dynamic Stability ◽  
Local Dynamic ◽  
Gait Stability ◽  
Margin Of Stability ◽  
Local Dynamic Stability ◽  
Loading Effects

scholarly journals Kinect V2-Based Gait Analysis for Children with Cerebral Palsy: Validity and Reliability of Spatial Margin of Stability and Spatiotemporal Variables

Sensors ◽  
2021 ◽  
Vol 21 (6) ◽  
pp. 2104
Author(s):  
Yunru Ma ◽  
Kumar Mithraratne ◽  
Nichola Wilson ◽  
Yanxin Zhang ◽  
Xiangbin Wang
Keyword(s):  
Cerebral Palsy ◽  
Assessment Tool ◽  
Intraclass Correlation ◽  
Cost Effective ◽  
Stability Assessment ◽  
Validity And Reliability ◽  
Gait Stability ◽  
Kinect V2 ◽  
Margin Of Stability ◽  
Children With Cerebral Palsy

Children with cerebral palsy (CP) have high risks of falling. It is necessary to evaluate gait stability for children with CP. In comparison to traditional motion capture techniques, the Kinect has the potential to be utilised as a cost-effective gait stability assessment tool, ensuring frequent and uninterrupted gait monitoring. To evaluate the validity and reliability of this measurement, in this study, ten children with CP performed two testing sessions, of which gait data were recorded by a Kinect V2 sensor and a referential Motion Analysis system. The margin of stability (MOS) and gait spatiotemporal metrics were examined. For the spatiotemporal parameters, intraclass correlation coefficient (ICC2,k) values were from 0.83 to 0.99 between two devices and from 0.78 to 0.88 between two testing sessions. For the MOS outcomes, ICC2,k values ranged from 0.42 to 0.99 between two devices and 0.28 to 0.69 between two test sessions. The Kinect V2 was able to provide valid and reliable spatiotemporal gait parameters, and it could also offer accurate outcome measures for the minimum MOS. The reliability of the Kinect V2 when assessing time-specific MOS variables was limited. The Kinect V2 shows the potential to be used as a cost-effective tool for CP gait stability assessment.

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