Abstract We used smartphone technology to differentiate the gait characteristics of older adults with osteoporosis with falls from those without falls. We assessed gait mannerism and obtained activities of daily living (ADLs) with wearable sensor systems (smartphones and inertial measurement units [IMUs]) to identify fall-risk characteristics. We recruited 49 persons with osteoporosis: 14 who had a fall within a year before recruitment and 35 without falls. IMU sensor signals were sampled at 50 Hz using a customized smartphone app (Lockhart Monitor) attached at the pelvic region. Longitudinal data was collected using MoveMonitor+ (DynaPort) IMU over three consecutive days. Given the close association between serum calcium, albumin, PTH, Vitamin D, and musculoskeletal health, we compared these markers in individuals with history of falls as compared to nonfallers. For the biochemical parameters fall group had significantly lower calcium ( P = 0.01*) and albumin ( P = 0.05*) and higher parathyroid hormone levels ( P = 0.002**) than nonfall group. In addition, persons with falls had higher sway area ( P = 0.031*), lower dynamic stability ( P < 0.001***), gait velocity ( P = 0.012*), and were less able to perform ADLs ( P = 0.002**). Thus, persons with osteoporosis with a history of falls can be differentiated by using dynamic real-time measurements that can be easily captured by a smartphone app, thus avoiding traditional postural sway and gait measures that require individuals to be tested in a laboratory setting.
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Prediction of fall risk among community-dwelling older adults using a wearable system
Abstract Falls are among the most common cause of decreased mobility and independence in older adults and rank as one of the most severe public health problems with frequent fatal consequences. In the present study, gait characteristics from 171 community-dwelling older adults were evaluated to determine their predictive ability for future falls using a wearable system. Participants wore a wearable sensor (inertial measurement unit, IMU) affixed to the sternum and performed a 10-m walking test. Measures of gait variability, complexity, and smoothness were extracted from each participant, and prospective fall incidence was evaluated over the following 6-months. Gait parameters were refined to better represent features for a random forest classifier for the fall-risk classification utilizing three experiments. The results show that the best-trained model for faller classification used both linear and nonlinear gait parameters and achieved an overall 81.6 ± 0.7% accuracy, 86.7 ± 0.5% sensitivity, 80.3 ± 0.2% specificity in the blind test. These findings augment the wearable sensor's potential as an ambulatory fall risk identification tool in community-dwelling settings. Furthermore, they highlight the importance of gait features that rely less on event detection methods, and more on time series analysis techniques. Fall prevention is a critical component in older individuals’ healthcare, and simple models based on gait-related tasks and a wearable IMU sensor can determine the risk of future falls.
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- Award ID(s):
- 1650566
- NSF-PAR ID:
- 10315442
- Date Published:
- Journal Name:
- Scientific Reports
- Volume:
- 11
- Issue:
- 1
- ISSN:
- 2045-2322
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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Real-time fall detection using a wearable sensor remains a challenging problem due to high gait variability. Furthermore, finding the type of sensor to use and the optimal location of the sensors are also essential factors for real-time fall-detection systems. This work presents real-time fall-detection methods using deep learning models. Early detection of falls, followed by pneumatic protection, is one of the most effective means of ensuring the safety of the elderly. First, we developed and compared different data-segmentation techniques for sliding windows. Next, we implemented various techniques to balance the datasets because collecting fall datasets in the real-time setting has an imbalanced nature. Moreover, we designed a deep learning model that combines a convolution-based feature extractor and deep neural network blocks, the LSTM block, and the transformer encoder block, followed by a position-wise feedforward layer. We found that combining the input sequence with the convolution-learned features of different kernels tends to increase the performance of the fall-detection model. Last, we analyzed that the sensor signals collected by both accelerometer and gyroscope sensors can be leveraged to develop an effective classifier that can accurately detect falls, especially differentiating falls from near-falls. Furthermore, we also used data from sixteen different body parts and compared them to determine the better sensor position for fall-detection methods. We found that the shank is the optimal position for placing our sensors, with an F1 score of 0.97, and this could help other researchers collect high-quality fall datasets.
- Free Publicly Accessible Full Text
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Accepted Manuscript1.0
- Journal Article:
- https://doi.org/10.1038/s41598-021-00458-5
