scholarly journals Using Embedded Sensors in Independent Living to Predict Gait Changes and Falls

2016 ◽  
Vol 39 (1) ◽  
pp. 78-94 ◽  
Author(s):  
Lorraine J. Phillips ◽  
Chelsea B. DeRoche ◽  
Marilyn Rantz ◽  
Gregory L. Alexander ◽  
Marjorie Skubic ◽  
...  
Keyword(s):  
Big Data ◽  
Gait Speed ◽  
Independent Living ◽  
Stride Length ◽  
Embedded Sensors ◽  
Sensor Systems ◽  
Preliminary Results ◽  
Gait Parameters ◽  
Cumulative Change ◽  
Over Time

This study explored using Big Data, totaling 66 terabytes over 10 years, captured from sensor systems installed in independent living apartments to predict falls from pre-fall changes in residents’ Kinect-recorded gait parameters. Over a period of 3 to 48 months, we analyzed gait parameters continuously collected for residents who actually fell ( n = 13) and those who did not fall ( n = 10). We analyzed associations between participants’ fall events ( n = 69) and pre-fall changes in in-home gait speed and stride length ( n = 2,070). Preliminary results indicate that a cumulative change in speed over time is associated with the probability of a fall ( p < .0001). The odds of a resident falling within 3 weeks after a cumulative change of 2.54 cm/s is 4.22 times the odds of a resident falling within 3 weeks after no change in in-home gait speed. Results demonstrate using sensors to measure in-home gait parameters associated with the occurrence of future falls.

Digital Biomarkers of Cognitive Frailty: The Value of Detailed Gait Assessment Beyond Gait Speed

Gerontology ◽  
2021 ◽  
pp. 1-10
Author(s):  
He Zhou ◽  
Catherine Park ◽  
Mohammad Shahbazi ◽  
Michele K. York ◽  
Mark E. Kunik ◽  
...  
Keyword(s):  
Older Adults ◽  
Steady State ◽  
Dual Task ◽  
Gait Speed ◽  
Stride Length ◽  
Cognitive Frailty ◽  
Single Task ◽  
Double Support ◽  
Gait Parameters ◽  
Digital Biomarkers

<b><i>Background:</i></b> Cognitive frailty (CF), defined as the simultaneous presence of cognitive impairment and physical frailty, is a clinical symptom in early-stage dementia with promise in assessing the risk of dementia. The purpose of this study was to use wearables to determine the most sensitive digital gait biomarkers to identify CF. <b><i>Methods:</i></b> Of 121 older adults (age = 78.9 ± 8.2 years, body mass index = 26.6 ± 5.5 kg/m<sup>2</sup>) who were evaluated with a comprehensive neurological exam and the Fried frailty criteria, 41 participants (34%) were identified with CF and 80 participants (66%) were identified without CF. Gait performance of participants was assessed under single task (walking without cognitive distraction) and dual task (walking while counting backward from a random number) using a validated wearable platform. Participants walked at habitual speed over a distance of 10 m. A validated algorithm was used to determine steady-state walking. Gait parameters of interest include steady-state gait speed, stride length, gait cycle time, double support, and gait unsteadiness. In addition, speed and stride length were normalized by height. <b><i>Results:</i></b> Our results suggest that compared to the group without CF, the CF group had deteriorated gait performances in both single-task and dual-task walking (Cohen’s effect size <i>d</i> = 0.42–0.97, <i>p</i> &#x3c; 0.050). The largest effect size was observed in normalized dual-task gait speed (<i>d</i> = 0.97, <i>p</i> &#x3c; 0.001). The use of dual-task gait speed improved the area under the curve (AUC) to distinguish CF cases to 0.76 from 0.73 observed for the single-task gait speed. Adding both single-task and dual-task gait speeds did not noticeably change AUC. However, when additional gait parameters such as gait unsteadiness, stride length, and double support were included in the model, AUC was improved to 0.87. <b><i>Conclusions:</i></b> This study suggests that gait performances measured by wearable sensors are potential digital biomarkers of CF among older adults. Dual-task gait and other detailed gait metrics provide value for identifying CF above gait speed alone. Future studies need to examine the potential benefits of gait performances for early diagnosis of CF and/or tracking its severity over time.

scholarly journals Assessing the concurrent validity of a gait analysis system integrated into a smart walker in older adults with gait impairments

2019 ◽  
Vol 33 (10) ◽  
pp. 1682-1687 ◽  
Author(s):  
Christian Werner ◽  
Georgia Chalvatzaki ◽  
Xanthi S Papageorgiou ◽  
Costas S Tzafestas ◽  
Jürgen M Bauer ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Gait Speed ◽  
Concurrent Validity ◽  
Stride Length ◽  
Gait Parameters ◽  
Stance Time ◽  
Absolute Agreement ◽  
Analysis System ◽  
Smart Walker ◽  
Gait Impairments

Objective: To assess the concurrent validity of a smart walker–integrated gait analysis system with the GAITRite® system for measuring spatiotemporal gait parameters in potential users of the smart walker. Design: Criterion standard validation study. Setting: Research laboratory in a geriatric hospital. Participants: Twenty-five older adults (⩾65 years) with gait impairments (habitual rollator use and/or gait speed <0.6 m/s) and no severe cognitive impairment (Mini-Mental State Examination ⩾17). Main measures: Stride, swing and stance time; stride length; and gait speed were simultaneously recorded using the smart walker–integrated gait analysis system and the GAITRite system while participants walked along a 7.8-m walkway with the smart walker. Concurrent criterion-related validity was assessed using the Bland–Altman method, percentage errors (acceptable if <30%), and intraclass correlation coefficients for consistency (ICC3,1) and absolute agreement (ICC2,1). Results: Bias for stride, swing and stance time ranged from −0.04 to 0.04 seconds, with acceptable percentage errors (8.7%–23.0%). Stride length and gait speed showed higher bias (meanbias (SD) = 0.20 (0.11) m; 0.19 (0.13) m/s) and not acceptable percentage errors (31.3%–42.3%). Limits of agreement were considerably narrower for temporal than for spatial-related gait parameters. All gait parameters showed good-to-excellent consistency (ICC3,1 = 0.72–0.97). Absolute agreement was good-to-excellent for temporal (ICC2,1 = 0.72–0.97) but only poor-to-fair for spatial-related gait parameters (ICC2,1 = 0.37–0.52). Conclusion: The smart walker–integrated gait analysis system has good concurrent validity with the GAITRite system for measuring temporal but not spatial-related gait parameters in potential end-users of the smart walker. Stride length and gait speed can be measured with good consistency, but with only limited absolute accuracy.

scholarly journals Smoothness of Gait in Healthy and Cognitively Impaired Individuals: A Study on Italian Elderly Using Wearable Inertial Sensor

Sensors ◽  
2020 ◽  
Vol 20 (12) ◽  
pp. 3577 ◽  
Author(s):  
Massimiliano Pau ◽  
Ilaria Mulas ◽  
Valeria Putzu ◽  
Gesuina Asoni ◽  
Daniela Viale ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Gait Speed ◽  
Stride Length ◽  
Inertial Sensor ◽  
Cognitive Impairments ◽  
Gait Parameters ◽  
Acceleration Data ◽  
Trunk Acceleration ◽  
Spatio Temporal

The main purpose of the present study was to compare the smoothness of gait in older adults with and without cognitive impairments, using the harmonic ratio (HR), a metric derived from trunk accelerations. Ninety older adults aged over 65 (age: 78.9 ± 4.8 years; 62% female) underwent instrumental gait analysis, performed using a wearable inertial sensor and cognitive assessment with the Mini Mental State Examination (MMSE) and Addenbrooke’s Cognitive Examination Revised (ACE-R). They were stratified into three groups based on their MMSE performance: healthy controls (HC), early and advanced cognitive decline (ECD, ACD). The spatio-temporal and smoothness of gait parameters, the latter expressed through HR in anteroposterior (AP), vertical (V) and mediolateral (ML) directions, were derived from trunk acceleration data. The existence of a relationship between gait parameters and degree of cognitive impairment was also explored. The results show that individuals with ECD and ACD exhibited significantly slower speed and shorter stride length, as well as reduced values of HR in the AP and V directions compared to HC, while no significant differences were found between ECD and ACD in any of the investigated parameters. Gait speed, stride length and HR in all directions were found to be moderately correlated with both MMSE and ACE-R scores. Such findings suggest that, in addition to the known changes in gait speed and stride length, important reductions in smoothness of gait are likely to occur in older adults, owing to early/prodromal stages of cognitive impairment. Given the peculiar nature of these metrics, which refers to overall body stability during gait, the calculation of HR may result in being useful in improving the characterization of gait patterns in older adults with cognitive impairments.

scholarly journals The effect of a knee brace on gait parameters of hypertonic hemiplegic patients

2008 ◽  
Vol 64 (2) ◽  
Author(s):  
M.R. Modisane ◽  
A. Stewart ◽  
M. Riley
Keyword(s):  
Gait Speed ◽  
Stride Length ◽  
Walking Speed ◽  
Knee Brace ◽  
Gait Parameters ◽  
The Mean ◽  
Ashworth Scale

The aim of this study was to investigate the effects of the useof a knee brace on 15 subjects with hypertonic hemiparesis. The middlecerebral artery was involved in all subjects. The Ashworth scale was usedto screen for the presence of spasticity in the quadriceps muscles.Measurements of gait speed, step and stride length were taken in the middle 10 metres of a 15 metre paper walkway. A comparison of these gait parameters without and with the use of a knee brace was made. A ques-tionnaire was also used to evaluate how subjects responded to the use of aknee brace.The results showed that the mean speed for all 15 subjects increased withthe use of a brace, (p = 0.05). Step and stride length without and with the use of a brace showed no statistical differences.It was therefore concluded that the FECK brace appears to have an effect on the walking speed of subjects withhypertonic  hemiparesis

scholarly journals Gait parameters of individuals with Parkinson disease decline during one-year period

2020 ◽  
Vol 25 ◽  
pp. 7-18
Author(s):  
Kadri Medijainen ◽  
Mati Pääsuke ◽  
Aet Lukmann ◽  
Pille Taba
Keyword(s):  
Parkinson Disease ◽  
Gait Speed ◽  
Stride Length ◽  
Rating Scale ◽  
Double Support ◽  
Healthy Elderly ◽  
Gait Characteristics ◽  
Gait Parameters ◽  
Gait Function ◽  
One Year

Parkinson’s disease (PD) is a neurodegenerative disease, influencing mainly elderly. The key motor factor affecting the level of participation in activities of daily living is the gait function, which is known to be progressively impaired in PD. However, gait characteristics also worsen due to normal aging. The main aim of this study was to investigate whether gait parameters decline in individuals with PD in an interval of one year compared to healthy elderly. Selected gait characteristics were recorded using 3-D optoelectronic movement analysis system ELITE in 13 patients with mild-to-moderate PD and 13 age- and gender-matched controls. Hoehn and Yahr Scale and Unified Parkinson Disease Rating Scale were used for clinical assessment. It was found that PD patients walk with significantly shorter steps and stride and reduced gait speed. In one year, the stride length initiated with right foot and stride walk ratio further decrease in PD patients. On re-evaluation the percentages of stance, swing and double support phase differed significantly between groups. In second measurement, control subjects walked with reduced step width. It was concluded that gait speed and stride length decline in patients with PD in a period of one year, whereas no indication of deterioration of gait function is evident in healthy controls.

scholarly journals Longitudinal Changes in Temporospatial Gait Characteristics during the First Year Post-Stroke

2021 ◽  
Vol 11 (12) ◽  
pp. 1648
Author(s):  
John W. Chow ◽  
Dobrivoje S. Stokic
Keyword(s):  
Lower Extremity ◽  
Gait Speed ◽  
Stride Length ◽  
Double Support ◽  
Post Stroke ◽  
Gait Characteristics ◽  
Gait Parameters ◽  
Support Time ◽  
Post Onset ◽  
Step Parameters

Given the paucity of longitudinal data in gait recovery after stroke, we compared temporospatial gait characteristics of stroke patients during subacute (<2 months post-onset, T0) and at approximately 6 and 12 months post-onset (T1 and T2, respectively) and explored the relationship between gait characteristics at T0 and the changes in gait speed from T0 to T1. Forty-six participants were assessed at T0 and a subsample of 24 participants at T2. Outcome measures included Fugl-Meyer lower-extremity motor score, 14 temporospatial gait parameters and symmetry indices of 5 step parameters. Except for step width, all temporospatial parameters improved from T0 to T1 (p ≤ 0.0001). Additionally, significant improvements in symmetry were found for the initial double-support time and single-support time (p ≤ 0.0001). Although group results at T2 were not different from those at T1, the individual analysis revealed that 42% (10/24) of the subsample showed a significant increase in gait speed. The increase in gait speed from T0 to T1 was negatively correlated with gait speed and stride length, and positively correlated with the symmetry indices of stance and single-support times at T0 (p ≤ 0.002). Temporospatial gait parameters and stance time symmetry improve over the first 6 months after stroke with an apparent plateau thereafter. Approximately 40% of the subsample continue to increase gait speed from 6 to 12 months post-stroke. A greater increase in gait speed during the first 6 months post-stroke is associated with initially slower walking, shorter stride length, and more pronounced asymmetry in stance and single-support times. The improvement in lower-extremity motor function and bilateral improvements in step parameters collectively suggest that gait changes over the first 12 months after stroke are likely due to neurological recovery, although some compensation by the non-paretic side cannot be excluded.

What Gait Features Influence the Amount and Intensity of Physical Activity in People with Multiple Sclerosis?

2020 ◽  
Author(s):  
Massimiliano Pau ◽  
Micaela Porta ◽  
Giuseppina Pilloni ◽  
Giancarlo Coghe ◽  
Eleonora Cocco
Keyword(s):  
Physical Activity ◽  
Multiple Sclerosis ◽  
Gait Speed ◽  
Stride Length ◽  
Inertial Sensor ◽  
Rank Correlation ◽  
Double Support ◽  
Temporal Parameters ◽  
Gait Parameters ◽  
Spatio Temporal

Abstract Background: Although the mutual relationship between ambulation and Physical Activity (PA) in people with Multiple Sclerosis (pwMS) has been described in several studies, there is still a lack of detailed information about the way in which specific aspects of the gait cycle are associated with amount and intensity of PA. This study aimed to verify the existence of possible relationships among PA parameters and the spatio-temporal parameters of gait when both are instrumentally assessed.Methods: Thirty-one pwMS (17F, 14M, mean age 52.5, mean Expanded Disability Status Scale score 3.1) were requested to wear a tri-axial accelerometer 24h/day for 7 consecutive days and underwent an instrumental gait analysis, performed using an inertial sensor located on the low back, immediately before the PA assessment period. Main spatio-temporal parameters of gait (i.e. gait speed, stride length, cadence and duration of stance, swing and double support phase) were extracted by processing trunk accelerations. PA was quantified using average number of daily steps and percentage of time spent at different PA intensity, the latter calculated using cut-point sets previously validated for MS. The existence of possible relationships between PA and gait parameters was assessed using Spearman’s rank correlation coefficient rho.Results: Gait speed and stride length were the parameters with the highest number of significant correlations with PA features. In particular, they were found moderately to largely correlated with number of daily steps (rho 0.62, p<0.001), percentage of sedentary activity (rho = -0.44, p<0.001) and percentage of moderate-to-vigorous activity (rho = 0.48, p<0.001). Small to moderate significant correlations were observed between PA intensity and duration of stance, swing and double support phases.Conclusions: The data obtained suggest that the most relevant determinants associated with higher and more intense levels of physical activity in free-living conditions are gait speed and stride length.The simultaneous quantitative assessment of gait parameters and PA levels might represent a useful support for physical therapists in tailoring optimized rehabilitative and training interventions.

scholarly journals Gait and Axial Spondyloarthritis: Comparative Gait Analysis Study Using Foot-Worn Inertial Sensors

10.2196/27087 ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. e27087
Author(s):  
Julie Soulard ◽  
Jacques Vaillant ◽  
Athan Baillet ◽  
Philippe Gaudin ◽  
Nicolas Vuillerme
Keyword(s):  
Pain Intensity ◽  
Gait Speed ◽  
Stride Length ◽  
Healthy Controls ◽  
Double Support ◽  
Swing Time ◽  
Gait Parameters ◽  
Stance Time ◽  
Double Support Time ◽  
Support Time

Background Axial spondyloarthritis (axSpA) can lead to spinal mobility restrictions associated with restricted lower limb ranges of motion, thoracic kyphosis, spinopelvic ankylosis, or decrease in muscle strength. It is well known that these factors can have consequences on spatiotemporal gait parameters during walking. However, no study has assessed spatiotemporal gait parameters in patients with axSpA. Divergent results have been obtained in the studies assessing spatiotemporal gait parameters in ankylosing spondylitis, a subgroup of axSpA, which could be partly explained by self-reported pain intensity scores at time of assessment. Inertial measurement units (IMUs) are increasingly popular and may facilitate gait assessment in clinical practice. Objective This study compared spatiotemporal gait parameters assessed with foot-worn IMUs in patients with axSpA and matched healthy individuals without and with pain intensity score as a covariate. Methods A total of 30 patients with axSpA and 30 age- and sex-matched healthy controls performed a 10-m walk test at comfortable speed. Various spatiotemporal gait parameters were computed from foot-worn inertial sensors including gait speed in ms–1 (mean walking velocity), cadence in steps/minute (number of steps in a minute), stride length in m (distance between 2 consecutive footprints of the same foot on the ground), swing time in percentage (portion of the cycle during which the foot is in the air), stance time in percentage (portion of the cycle during which part of the foot touches the ground), and double support time in percentage (portion of the cycle where both feet touch the ground). Results Age, height, and weight were not significantly different between groups. Self-reported pain intensity was significantly higher in patients with axSpA than healthy controls (P<.001). Independent sample t tests indicated that patients with axSpA presented lower gait speed (P<.001) and cadence (P=.004), shorter stride length (P<.001) and swing time (P<.001), and longer double support time (P<.001) and stance time (P<.001) than healthy controls. When using pain intensity as a covariate, spatiotemporal gait parameters were still significant with patients with axSpA exhibiting lower gait speed (P<.001), shorter stride length (P=.001) and swing time (P<.001), and longer double support time (P<.001) and stance time (P<.001) than matched healthy controls. Interestingly, there were no longer statistically significant between-group differences observed for the cadence (P=.17). Conclusions Gait was significantly altered in patients with axSpA with reduced speed, cadence, stride length, and swing time and increased double support and stance time. Taken together, these changes in spatiotemporal gait parameters could be interpreted as the adoption of a so-called cautious gait pattern in patients with axSpA. Among factors that may influence gait in patients with axSpA, patient self-reported pain intensity could play a role. Finally, IMUs allowed computation of spatiotemporal gait parameters and are usable to assess gait in patients with axSpA in clinical routine. Trial Registration ClinicalTrials.gov NCT03761212; https://clinicaltrials.gov/ct2/show/NCT03761212 International Registered Report Identifier (IRRID) RR2-10.1007/s00296-019-04396-4

scholarly journals Indoor Acoustic Requirements for Autism-Friendly Spaces

2021 ◽  
Vol 11 (9) ◽  
pp. 3942
Author(s):  
Federica Bettarello ◽  
Marco Caniato ◽  
Giuseppina Scavuzzo ◽  
Andrea Gasparella
Keyword(s):  
Independent Living ◽  
Security And Privacy ◽  
Inclusive Design ◽  
Acoustic Sensor ◽  
Smart Sensor ◽  
Sensor Systems ◽  
Passive Monitoring ◽  
Literature Overview ◽  
Impaired People ◽  
Final Optimization

The architecture of spaces for people on the autistic spectrum is evolving toward inclusive design, which should fit the requirements for independent, autonomous living, and proper support for relatives and caregivers. The use of smart sensor systems represents a valuable support to internal design in order to achieve independent living for impaired people. Accordingly, these devices can monitor or prevent hazardous situations, ensuring security and privacy. Acoustic sensor systems, for instance, could be used in order to realize a passive monitoring system. The correct functioning of such devices needs optimal indoor acoustic criteria. Nevertheless, these criteria should also comply with dedicated acoustic requests that autistic individuals with hearing impairment or hypersensitivity to sound could need. Thus, this research represents the first attempt to balance, integrate, and develop these issues, presenting (i) a wide literature overview related to both topics, (ii) a focused analysis on real facility, and (iii) a final optimization, which takes into account, merges, and elucidates all the presented unsolved issues.

Sign in / Sign up

Export Citation Format

Share Document