scholarly journals Instrumented Trail-Making Task: Application of Wearable Sensor to Determine Physical Frailty Phenotypes

Gerontology ◽  
2018 ◽  
Vol 65 (2) ◽  
pp. 186-197 ◽  
Author(s):  
He Zhou ◽  
Javad Razjouyan ◽  
Debopriyo Halder ◽  
Anand D. Naik ◽  
Mark E. Kunik ◽  
...  
Keyword(s):  
Inertial Sensor ◽  
Rotation Velocity ◽  
Test Methods ◽  
Assessment Tools ◽  
Mobility Limitations ◽  
Physical Frailty ◽  
Walking Test ◽  
Average Completion Time ◽  
Trail Making ◽  
Young Subjects

Background: The physical frailty assessment tools that are currently available are often time consuming to use with limited feasibility. Objective: To address these limitations, an instrumented trail-making task (iTMT) platform was developed using wearable technology to automate quantification of frailty phenotypes without the need of a frailty walking test. Methods: Sixty-one older adults (age = 72.8 ± 9.9 years, body mass index [BMI] = 27.4 ± 4.9 kg/m2) were recruited. According to the Fried Frailty Criteria, 39% of participants were determined as robust and 61% as non-robust (pre-frail or frail). In addition, 17 young subjects (age = 29.0 ± 7.2 years, BMI = 26.2 ± 4.6 kg/m2) were recruited to determine the healthy benchmark. The iTMT included reaching 5 indexed circles (including numbers 1-to-3 and letters A&amp;B placed in random orders), which virtually appeared on a computer-screen, by rotating one’s ankle-joint while standing. By using an ankle-worn inertial sensor, 3D ankle-rotation was estimated and mapped into navigation of a computer-cursor in real-time (100 Hz), allowing subjects to navigate the computer-cursor to perform the iTMT. The ankle-sensor was also used for quantifying ankle-rotation velocity (representing slowness), its decline during the test (representing exhaustion), and ankle-velocity variability (representing movement inefficiency), as well as the power (representing weakness) generated during the test. Comparative assessments included Fried frailty phenotypes and gait assessment. Results: All subjects were able to complete the iTMT, with an average completion time of 125 ± 85 s. The iTMT-derived parameters were able to identify the presence and absence of slowness, exhaustion, weakness, and inactivity phenotypes (Cohen’s d effect size = 0.90–1.40). The iTMT Velocity was significantly different between groups (d = 0.62–1.47). Significant correlation was observed between the iTMT Velocity and gait speed (r = 0.684 p < 0.001). The iTMT-derived parameters and age together enabled significant distinguishing of non-robust cases with area under curve of 0.834, sensitivity of 83%, and specificity of 67%. Conclusion: This study demonstrated a non-gait-based wearable platform to objectively quantify frailty phenotypes and determine physical frailty, using a quick and practical test. This platform may address the hurdles of conventional physical frailty phenotypes methods by replacing the conventional frailty walking test with an automated and objective process that reduces the time of assessment and is more practical for those with mobility limitations.

scholarly journals AN INNOVATIVE PLATFORM BASED ON WEARABLE SENSOR TO QUANTIFY FRAILTY PHENOTYPES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S683-S684
Author(s):  
He Zhou ◽  
Bijan Najafi
Keyword(s):  
Body Movement ◽  
Rotation Velocity ◽  
Wearable Sensor ◽  
Walking Test ◽  
Computer Screen ◽  
Trail Making ◽  
The Subject ◽  
Ankle Movement ◽  
Routine Assessment ◽  
Frailty Criteria

Abstract This study evaluated an innovative wearable sensor based platform (instrumented trail-making task, iTMT) to quickly quantify frailty phenotypes, without the need of walking test. 61 older adults (age=72.8 ± 9.9years, BMI=27.4±4.9kg/m2) were recruited and assessed by Fried Frailty Criteria to determine frailty phenotypes. All subjects participated the iTMT test by standing in front of a computer, wearing a wearable sensor on the front lower shin. The sensor tracked the subject’s ankle movement and projected it on a computer-screen as a moving cursor at real-time. The subject rotated the ankle joint to navigate the cursor to reach 5 indexed circles (including numbers 1-to-3 and letters A&B placed in random orders) in the alternative order of numbers and letters. The iTMT required coordination of brain and body movement, testing subject’s cognitive-motor function. The sensor quantified ankle-rotation biomechanics during the test. All subjects completed the iTMT with average time less than 3 minutes. The ankle-rotation velocity generated during the test distinguished between the presence and absence of Slowness phenotype (Cohen’s effect size d=1.40, p&lt;0.001). The decline of ankle-rotation velocity determined the presence of Exhaustion phenotype (d=0.98, p=0.003). The ankle-rotation power generated during the test determined the presence of Weakness phenotype (d=1.38, p&lt;0.001). The ankle-velocity variability determined the presence of Inactivity phenotype (d=0.90, p&lt;0.001). This study demonstrated the feasibility and validity of the iTMT to quantify frailty phenotypes. This new platform is time-efficient and doesn’t require walking test. It’s more practical for routine assessment in small and busy clinics among patients with mobility limitation.

Evaluation of Motor and Cognitive Performance in People with Parkinson’s Disease Using Instrumented Trail-Making Test

Gerontology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Ram kinker Mishra ◽  
Catherine Park ◽  
He Zhou ◽  
Bijan Najafi ◽  
T. Adam Thrasher
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Performance ◽  
Pairwise Comparison ◽  
Walking Test ◽  
Cognitively Normal ◽  
Early Results ◽  
Trail Making ◽  
Changes Over Time

<b><i>Introduction:</i></b> Parkinson’s disease (PD) progressively impairs motor and cognitive performance. The current tools to detect decline in motor and cognitive functioning are often impractical for busy clinics and home settings. To address the gap, we designed an instrumented trail-making task (iTMT) based on a wearable sensor (worn on the shin) with interactive game-based software installed on a tablet. The iTMT test includes reaching to 5 indexed circles, a combination of numbers (1–3) and letters (A&amp;B) randomly positioned inside target circles, in a sequential order, which virtually appears on a screen kept in front of the participants, by rotating one’s ankle joint while standing and holding a chair for safety. By measuring time to complete iTMT task (iTMT time), iTMT enables quantifying cognitive-motor performance. <b><i>Purpose:</i></b> This study’s objective is to examine the feasibility of iTMT to detect early cognitive-motor decline in PDs. <b><i>Method:</i></b> Three groups of volunteers, including 14 cognitively normal (CN) older adults, 14 PDs, and 11 mild cognitive impaireds (MCI), were recruited. Participants completed MoCA, 20 m walking test, and 3 trials of iTMT. <b><i>Results:</i></b> All participants enabled to complete iTMT with &#x3c;3 min, indicating high feasibility. The average iTMT time for CN-Older, PD, and MCI participants were 20.9 ± 0.9 s, 32.3 ± 2.4 s, and 40.9 ± 4.5 s, respectively. After adjusting for age and education level, pairwise comparison suggested large effect sizes for iTMT between CN-older versus PD (Cohen’s <i>d</i> = 1.7, <i>p</i> = 0.024) and CN-older versus MCI (<i>d</i> = 1.57, <i>p</i> &#x3c; 0.01). Significant correlations were observed when comparing iTMT time with the gait speed (<i>r</i> = −0.4, <i>p</i> = 0.011) and MoCA score (<i>r</i> = −0.56, <i>p</i> &#x3c; 0.01). <b><i>Conclusion:</i></b> This study demonstrated the feasibility and early results supporting the potential application of iTMT to determine cognitive-motor and distinguishing individuals with MCI and PD from CN-older adults. Future studies are warranted to test the ability of iTMT to track its subtle changes over time.

scholarly journals Recognition of Gait Activities Using Acceleration Data from A Smartphone and A Wearable Device

Proceedings ◽  
2019 ◽  
Vol 31 (1) ◽  
pp. 60 ◽  
Author(s):  
Irvin Hussein Lopez-Nava ◽  
Matias Garcia-Constantino ◽  
Jesus Favela
Keyword(s):  
Assisted Living ◽  
Inertial Sensor ◽  
Ambient Assisted Living ◽  
Human Gait ◽  
Support Vector ◽  
K Nearest Neighbors ◽  
Acceleration Data ◽  
Vector Machines ◽  
Young Subjects ◽  
Physical Spaces

Activity recognition is an important task in many fields, such as ambient intelligence, pervasive healthcare, and surveillance. In particular, the recognition of human gait can be useful to identify the characteristics of the places or physical spaces, such as whether the person is walking on level ground or walking down stairs in which people move. For example, ascending or descending stairs can be a risky activity for older adults because of a possible fall, which can have more severe consequences than if it occurred on a flat surface. While portable and wearable devices have been widely used to detect Activities of Daily Living (ADLs), few research works in the literature have focused on characterizing only actions of human gait. In the present study, a method for recognizing gait activities using acceleration data obtained from a smartphone and a wearable inertial sensor placed on the ankle of people is introduced. The acceleration signals were segmented based on the automatic detection of strides, also called gait cycles. Subsequently, a feature vector of the segmented signals was extracted, which was used to train four classifiers using the Naive Bayes, C4.5, Support Vector Machines, and K-Nearest Neighbors algorithms. Data was collected from seven young subjects who performed five gait activities: (i) going down an incline, (ii) going up an incline, (iii) walking on level ground, (iv) going down stairs, and (v) going up stairs. The results demonstrate the viability of using the proposed method and technologies in ambient assisted living contexts.

P775Effect of sacubitril-valsartan in reducing physical frailty in patients with advanced heart failure in waiting list for heart transplantation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
F Cacciatore ◽  
P Golino ◽  
C Amarelli ◽  
C Maiello ◽  
I Mattucci ◽  
...  
Keyword(s):  
Low Dose ◽  
Ace Inhibitor ◽  
Nyha Class ◽  
Waiting List ◽  
Left Ventricular Ejection ◽  
Physical Frailty ◽  
Vo2 Max ◽  
Walking Test ◽  
Frailty Score

Abstract Background Treatment with valsartan/sacubitril was found to be associated both with reduction in mortality risk for HF. Purpose To investigate the effect of sacubitril/valsartan on physical frailty (PF) in advanced HF patients in waiting list for heart transplantion (HT) in a two years follow-up study. Methods We enrolled 45 consecutive patients (status 2B UNOs). Patients tolerant to ACE-inhibitor and/or ARBs were treated with valsartan/sacubitril. Patients were required to have left ventricular ejection fraction (LVEF) of ≤35% and to be taking a stable dose of a β-blocker and an ACE inhibitor or an ARB for at least 4 weeks before enrollment. The dosage of sacubitril/valsartan was increased if tolerance was good. Frailty was assessed using an adapted version of Fried's Frailty Phenotype used in advanced HF patients in waiting list for transplantation. Patients were followed up until HT, device (TAH/LVAD) implant, or last follow-up visit. Results Mean NYHA class was 3.1±0.4, with 5.7% NYHA 2, 62.9% NYHA 3 and 31.4% NYHA 3B. LVEF was 25.1±6.4, VO2 max (ml/kg/min) was 10.3±2.3, cardiac index (L/min/m2) was 2.3±0.6, and NT-proBNP (pg/ml) was 4054.8±3977. At 3 months, 31.5% of patients received the target dose of 97/103 mg/BID, 31.6% the half dose (49/51mg BID) and 26.3% the low dose (24/26 mg BID) and 10.5% the half low dose (24/26 mg daily). The baseline mean value of physical frailty was 3.86±0.8, specifically 94.3% showed exhaustion, 91.4% physical inactivity, 88.6% weakness, 85.7% slowness and 28.6% loss of appetite. All patients had a frailty score ≥3. During follow-up there were no deaths. After treatment, NYHA class improved significantly (2.4±0.6 vs 3.1±0.4; p=0.002), with 5.7% NYHA 1, 48.6% NYHA 2, 42.9% NYHA 3 and 2.9% NYHA 3B (p<0.001). VO2 max consumption, Six Minute Walking Test increased while pulmonary systolic blood pressure, VE/VCO2 slope, and NT-proBNP, decreased. Both Diastolic and Systolic BP decrease, but only DBP was statistically significant. No differences were observed during follow-up for LVEF, E/E', TAPSE, IVC. A significant reduction in furosemide dosage was observed (103.57±71.3 mg to 81.4±54.6 mg; p=0.040) while no differences were observed in mineral corticoids antagonist and metolazone. These improvements occurred from the first month of treatment and were still significantly present at the end of follow up. PF decreased (3.86±0.8 vs 1.44±1.26; p<0.000) with a significant reduction in all domain of PF. 28.5% had a frailty score ≥3. Conclusions Our study shows an improvement in PH in patients with advanced HF in waiting list for HT after therapy with sacubitril/valsartan. These changes seem to appear very early after introduction of the treatment and to be maintained over time. The improvement in all physical domain was paralleled by VO2 max and 6-minute walking test increase. The pro-BNP-NT reduction was significant in the first month of treatment and remain quite stable in the follow-up.

scholarly journals Culture and Diagnosis of MCI in Hispanics: A Literature Review

2019 ◽  
Vol 34 (7) ◽  
pp. 1239-1239
Author(s):  
E Briceño ◽  
R Mehdipanah ◽  
X Gonzales ◽  
K Langa ◽  
D Levine ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Neuropsychological Tests ◽  
Mexican American ◽  
Normative Data ◽  
Neuropsychological Test ◽  
Test Methods ◽  
Assessment Tools ◽  
Culturally Appropriate ◽  
The Us

Abstract Objective Hispanics are a rapidly growing and aging segment of the US population. There is a critical need to accurately and efficiently detect those at risk for dementia, particularly those with Mild Cognitive Impairment (MCI). MCI diagnosis typically relies on neuropsychological tests, although cultural and linguistic factors impact neuropsychological test scores. The current study reviews neuropsychological studies on MCI in Hispanics to evaluate the factors in testing for MCI diagnosis. Participants and Method Studies were identified from a literature search utilizing Web of Science, PubMed, Google Scholar, and Scopus, using search terms “Hispanic OR Mexican American” and “Mild Cognitive Impairment,” and from the reference sections of studies identified through this search. Studies utilizing neuropsychological tests in the diagnosis of MCI for Hispanics living in the US were identified and reviewed. Approaches for sample characterization (e.g., country of origin and of education, literacy, language preference and proficiency), neuropsychological test methods (e.g., test selection and translation, normative data source), and method of MCI diagnosis were reviewed. Results Considerable variability was found across studies with regard to the incorporation – and the method of incorporation – of cultural factors and their consideration in the MCI diagnosis process for Hispanics. For example, several studies did not report their sample’s country of education, source of normative data used for determination of cognitive impairment, or method of test adaptation/translation. Conclusions Diagnosis of MCI in Hispanics has been complicated by a dearth of culturally appropriate neuropsychological assessment tools and normative data, which likely contributes to inconsistency across studies. Future studies are needed to further develop culturally appropriate neuropsychological methods to evaluate MCI in Hispanics in the US and to improve diagnostic accuracy in this population.

scholarly journals Mobility in Osteogenesis Imperfecta: A Multicenter North American Study

2018 ◽  
Author(s):  
Karen M. Kruger ◽  
Angela Caudill ◽  
Mercedes Rodriguez Celin ◽  
Sandesh CS Nagamani ◽  
Jay R Shapiro ◽  
...  
Keyword(s):  
Osteogenesis Imperfecta ◽  
Clinical Research ◽  
Patient Characteristics ◽  
Connective Tissue Disorder ◽  
Bone Fragility ◽  
Functional Mobility ◽  
Assessment Tools ◽  
Assistive Device ◽  
Type I ◽  
Mobility Limitations

BackgroundOsteogenesis imperfecta (OI) is a genetic connective tissue disorder characterized by increased bone fragility and recurrent fractures. The phenotypic severity of OI has a significant influence on the ability to walk but little is known about the ambulatory characteristics, strength, or functional abilities in individuals with OI, especially in the more severe forms. To advance clinical research in OI, the Linked Clinical Research Centers, network of clinical centers in North America with significant experience in treating patients with OI, was established in 2009. The purpose of this work was to characterize mobility in OI using standard clinical assessment tools. and determine if any patient characteristics could be used to predict mobility outcomes.MethodsData were collected at five clinical sites and included age, gender, ethnicity, height, weight, use of assistive device, and bisphosphonate use and mobility metrics (age at first walk, Gillette Functional Assessment Questionnaire, Functional Mobility Scale, and distance walked in the 6 minute walk test). Linear mixed models were developed to explore the relationships between subject demographics and mobility metrics.ResultsThe study identified 491 individuals age 3 and older. In general, the results showed minor limitations in the type I group while the more severe types showed more significant limitations in all mobility metrics analyzed. Height and weight were shown to be the most significant predictors of mobility metrics. Relationships with mobility and bisphosphonates varied with OI type and whether oral or IV was used.ConclusionThis paper is the most comprehensive report of mobility in individuals with OI to date. These results are vital to understanding the mobility limitations of specific types of OI and beneficial when developing rehabilitation protocols for this population. It is important for physicians, patients, and caregivers to gain insight into severity and classification of the disease and the influence of disease-related characteristics on the prognosis for mobility.

scholarly journals Methods and Rationale for Using GPS-Derived Objective Technologies to Examine Community Mobility in Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 565-565
Author(s):  
Kyle Moored ◽  
Andrea Rosso ◽  
Michelle Carlson ◽  
Breanna Crane
Keyword(s):  
Older Adults ◽  
Community Dwelling ◽  
Objective Measures ◽  
Walking Ability ◽  
Time Data ◽  
Walking Test ◽  
Community Mobility ◽  
Trail Making ◽  
Community Dwelling Older Adults ◽  
Therapy Intervention

Abstract Objective measures of community mobility are advantageous for capturing life-space activity. In contrast to subjective, self-reported approaches, GPS-derived objective measures leverage passive, real-time data collection techniques to mitigate recall bias and minimize participant burden. We present methods to quantify community mobility among a sample of 164 community-dwelling older adults (Mean age=77.3±6.5) from a physical therapy intervention aimed at improving walking ability. We characterized community mobility using activity space metrics (e.g., standard deviation ellipse (SDE) area), timing (e.g., time outside home), and shape (e.g., SDE compactness). We will discuss challenges and solutions to generating these metrics as well as their associations with physical and cognitive performance. Time outside of home and SDE area, but not SDE compactness, were correlated with better performance on the 6-Minute Walking Test and Trail-Making Test (Part B) (ρ=.20-.23, p’s&lt;.05). These findings will aid in understanding which community mobility measures are associated with functional capacity.

The Effect of Vertical and Multiplanar Accelerations on Differing Production Seat Belt Sensor Designs

2008 ◽  
Author(s):  
Steven E. Meyer ◽  
Arin A. Oliver ◽  
Davis A. Hock ◽  
Joshua D. Hayden ◽  
Stephen M. Forrest ◽  
...  
Keyword(s):  
Real World ◽  
Inertial Sensors ◽  
Inertial Sensor ◽  
Seat Belt ◽  
Design Feature ◽  
Test Methods ◽  
Center Of Gravity ◽  
Restraint System ◽  
Occupant Injury ◽  
Cup Design

In real world accidents, vehicles are often subjected to multiplanar crash environments such as those seen in multiple impacts or rollover collisions. These various impact environments can directly affect the accelerations experienced by the vehicle and its components. Particularly vulnerable is the vehicle sensitive (inertially activated) crash sensor that is commonly used in seat belt retractor design. Though these designs have been proven effective in the frontal crash environments, they have also been shown to be susceptible to unlocking and/or a delay in lockup by vertical and/or rotational accelerations [1–3]. Such delayed retractor response can result in belt webbing payout and significant occupant motion within the restraint system. This can increase the likelihood and severity of occupant injury within the vehicle and/or injury from partial or full ejection in rollovers. Occurrence of this phenomenon in the real world has been documented and previously published [4, 5]. Evidence of retractor sensor unlocking and resulting spoolout includes identifiable forensic markings on the restraint system components [6] as well as occupant excursion evidence including full ejection and excessive partial ejection of properly belted vehicle occupants. The subject paper will follow previously published test methodologies [1–3] and report on new testing conducted on four differing production seat belt retractor designs. The test methods include linear accelerator tests to document the effects of a vertical pulse on an inertially sensitive retractor and, secondly, rotational accelerator tests wherein the retractors were mounted on a rotating fixture and subjected to various roll rates. Two tested retractors are the ball and cup design with the retractor’s inertial sensor incorporated within the retractor mounted in the vehicle’s roof pillars. The other two tested retractor designs utilize remote mounted (near the vehicle’s center of gravity) inertial sensors. These retractors are biased to the locked position via a spring and are held unlocked only when a solenoid is energized by the vehicle’s remote inertial sensor. For the rotational acceleration tests, the retractors were mounted in similar positions to that seen in their respective production vehicles relative to the vehicle’s center of gravity. Two retractors were then tested concurrently on the same test apparatus such that they were subjected to equivalent multiplanar environments, and thus allowed for direct comparison of their retractor design sensitivities and lockup performance. Additionally, a vehicle pillar mounted retractor was tested with and without a webbing sensitive lockup feature to allow for analysis of this design feature in varying multiplanar environments. The retractors’ performance under both the linear/vertical and rollover test conditions were noticeably different and are analyzed in detail.

Using Smartphone Inertial Measurement Unit for Analysis of Human Gait

2019 ◽  
Vol 10 (3) ◽  
pp. 101-117 ◽  
Author(s):  
Sergey Reginya ◽  
Alexander Yu. Meigal ◽  
Liudmila I. Gerasimova-Meigal ◽  
Kirill Prokhorov ◽  
Alex Moschevikin
Keyword(s):  
Human Gait ◽  
Measurement Unit ◽  
Video Capture ◽  
Spectral Parameters ◽  
Walking Test ◽  
Spectrum Density ◽  
Young Subjects ◽  
Characteristic Features ◽  
Left Right Asymmetry ◽  
Motion Video

The study was aimed at searching the characteristic features of a human gait during a conventionally used neurologic walking test with the help of sensors (3D accelerometer and gyroscope) in a smartphone mounted on the person's head. This allowed reducing the amount of analyzed data and saving time for analysis in comparison with motion video capture methods. It has been found that merely one inertial unit is good enough to detect the gait left-right asymmetry in healthy subjects. Several parameters were derived, one of them (acceleration shock) proved to be the most informative one. The gyroscope signal allowed detecting the characteristics of the gait in Parkinson's disease patients seen as the excess of the power spectrum density in all three axes. Therefore, this study was aimed to extract amplitude and spectral parameters from acceleration and rotation rate signals of smartphone-based IMU attached to the head during the long version of the TUG test in a group of neurologically healthy young subjects.

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