Development of a Wireless Mobile Computing Platform for Fall Risk Prediction

Falls are a major health risk with which the elderly and disabled must contend. Scientific research on smartphone-based gait detection systems using the Internet of Things (IoT) has recently become an important component in monitoring injuries due to these falls. Analysis of human gait for detecting falls is the subject of many research projects. Progress in these systems, the capabilities of smartphones, and the IoT are enabling the advancement of sophisticated mobile computing applications that detect falls after they have occurred. This detection has been the focus of most fall-related research; however, ensuring preventive measures that predict a fall is the goal of this health monitoring system. By performing a thorough investigation of existing systems and using predictive analytics, we built a novel mobile application/system that uses smartphone and smart-shoe sensors to predict and alert the user of a fall before it happens. The major focus of this dissertation has been to develop and implement this unique system to help predict the risk of falls. We used built-in sensors --accelerometer and gyroscope-- in smartphones and a sensor embedded smart-shoe. The smart-shoe contains four pressure sensors with a Wi-Fi communication module to unobtrusively collect data. The interactions between these sensors and the user resulted in distinct challenges for this research while also creating new performance goals based on the unique characteristics of this system. In addition to providing an exciting new tool for fall prediction, this work makes several contributions to current and future generation mobile computing research

A review of the accuracy and utility of motion sensors to measure physical activity of frail older hospitalised patients.

The purpose of this review was to examine the utility and accuracy of commercially available motion sensors to measure step-count and time spent upright in frail older hospitalized patients. A database search (CINAHL and PubMed, 2004–2014) and a further hand search of papers’ references yielded 24 validation studies meeting the inclusion criteria. Fifteen motion sensors (eight pedometers, six accelerometers, and one sensor systems) have been tested in older adults. Only three have been tested in hospital patients, two of which detected postures and postural changes accurately, but none estimated step-count accurately. Only one motion sensor remained accurate at speeds typical of frail older hospitalized patients, but it has yet to be tested in this cohort. Time spent upright can be accurately measured in the hospital, but further validation studies are required to determine which, if any, motion sensor can accurately measure step-count

Développement et étude de la validité d'une semelle instrumentée pour le comptage de pas

Les semelles instrumentées sont des dispositifs pouvant être utilisées pour la quantification de pas et la reconnaissance des activités. Il existe plusieurs modèles de semelles instrumentées, avec des niveaux de validité variables. Ce mémoire comprend trois objectifs : 1) faire une revue systématique de la littérature sur la validité de critère des semelles instrumentées existantes pour identifier les postures, les types d’activités et compter les pas, 2) développer une semelle instrumentée et 3) étudier sa validité pour le comptage de pas. Pour l’objectif 1, cinq bases de données ont permis de sélectionner 33 articles sur la validité de critère de seize modèles de semelles instrumentées pour la détection de posture, de type d’activités et de pas. Selon les indicateurs utilisés, les validités de critère varient de 65,8% à 100% pour la reconnaissance des activités et des postures et de 96% à 100% pour la détection de pas. En somme, peu d’études ont utilisé les semelles instrumentées pour le comptage de pas bien qu’elles démontrent une très bonne validité. Pour les objectifs 2 et 3, nous avons équipé une semelle commercialisée de cinq capteurs de pression et testé trois méthodes de traitement des signaux de pression pour la quantification de pas. Ces trois méthodes sont basées sur le signal de chaque capteur de pression, la moyenne ou la somme cumulée des cinq signaux de pression. Les résultats ont montré que notre semelle instrumentée détectait le pas avec un taux de succès de 94,8 ± 9,4% à 99,5 ± 0,4% à des vitesses de marche confortable et de 97,0 ± 6,2% à 99,6 ± 0,4% à des vitesses de marche rapide à l’intérieur et à l’extérieur d’un bâtiment avec les trois méthodes. Toutefois, la méthode basée sur la somme cumulée avait les niveaux de précision plus élevés pour le comptage de pasInstrumented insoles are devices which can be used for quantifying steps and recognizing activities. Validity of many instrumented insoles varies from medium to high. This thesis has three objectives: 1) to systematically review the literature on the validity of existing instrumented insoles for posture, type of activities recognition, and step counting, 2) to develop an instrumented insole and 3) to study its criterion validity for step counting. For objective 1, five databases were used to select 33 articles on criterion validity of sixteen insole models for posture and type of activities recognition, and step detection. According to indicators used, validity values vary from 65.8% to 100% for activities and postures recognition and from 96% to 100% for detection of steps. In summary, few studies have used instrumented insoles for steps counting even though they demonstrated a very good validity. For objectives 2 and 3, we equipped a commercialized insole with five pressure sensors and tested three pressure signal processing methods for step quantification. These three methods are based on signal of each pressure sensor, average or cumulative sum of five pressure signals. Results showed that our instrumented insole detected steps with a success rate varying from 94.8 ± 9.4% to 99.5 ± 0.4% at self-selected walking speeds and from 97.0 ± 6.2% to 99.6 ± 0.4% at maximal walking speeds in indoor and outdoor settings with all three processing methods. However, cumulative sum method had the highest levels of accuracy for step counting

State-of-the-Art Review on Wearable Obstacle Detection Systems Developed for Assistive Technologies and Footwear

Walking independently is essential to maintaining our quality of life but safe locomotion depends on perceiving hazards in the everyday environment. To address this problem, there is an increasing focus on developing assistive technologies that can alert the user to the risk destabilizing foot contact with either the ground or obstacles, leading to a fall. Shoe-mounted sensor systems designed to monitor foot-obstacle interaction are being employed to identify tripping risk and provide corrective feedback. Advances in smart wearable technologies, integrating motion sensors with machine learning algorithms, has led to developments in shoe-mounted obstacle detection. The focus of this review is gait-assisting wearable sensors and hazard detection for pedestrians. This literature represents a research front that is critically important in paving the way towards practical, low-cost, wearable devices that can make walking safer and reduce the increasing financial and human costs of fall injuries

Recent Innovations in Footwear and the Role of Smart Footwear in Healthcare—A Survey

© 2024 The Author(s). Licensee MDPI, Basel, Switzerland. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/Smart shoes have ushered in a new era of personalised health monitoring and assistive technologies. Smart shoes leverage technologies such as Bluetooth for data collection and wireless transmission, and incorporate features such as GPS tracking, obstacle detection, and fitness tracking. As the 2010s unfolded, the smart shoe landscape diversified and advanced rapidly, driven by sensor technology enhancements and smartphones’ ubiquity. Shoes have begun incorporating accelerometers, gyroscopes, and pressure sensors, significantly improving the accuracy of data collection and enabling functionalities such as gait analysis. The healthcare sector has recognised the potential of smart shoes, leading to innovations such as shoes designed to monitor diabetic foot ulcers, track rehabilitation progress, and detect falls among older people, thus expanding their application beyond fitness into medical monitoring. This article provides an overview of the current state of smart shoe technology, highlighting the integration of advanced sensors for health monitoring, energy harvesting, assistive features for the visually impaired, and deep learning for data analysis. This study discusses the potential of smart footwear in medical applications, particularly for patients with diabetes, and the ongoing research in this field. Current footwear challenges are also discussed, including complex construction, poor fit, comfort, and high cost.Peer reviewe

Using plantar pressure for free-living posture recognition and sedentary behaviour monitoring

Health authorities in numerous countries and even the World Health Organization (WHO) are concerned with low levels of physical activity and increasing sedentary behaviour amongst the general population. In fact, emerging evidences identify sedentary behaviour as a ubiquitous characteristic of contemporary lifestyles. This has major implications for the general health of people worldwide particularly for the prevalence of non-communicable conditions (NCDs) such as cardiovascular disease, diabetes and cancer and their risk factors such as raised blood pressure, raised blood sugar and overweight. Moreover, sedentary time appears to be uniquely associated with health risks independent of physical activity intensity levels. However, habitual sedentary behaviour may prove complex to be accurately measured as it occurs across different domains, including work, transport, domestic duties and even lei¬sure. Since sedentary behaviour is mostly reflect as too much sitting, one of the main concerns is being able to distinguish among different activities, such as sitting and standing. Widely used devices such as accelerometer-based activity monitors have a limited ability to detect sedentary activities accurately. Thus, there is a need of a viable large-scale method to efficiently monitor sedentary behaviour. This thesis proposes and demonstrates how a plantar pressure based wearable device and machine learning classification techniques have significant capability to monitor daily life sedentary behaviour. Firstly, an in-depth review of research and market ready plantar pressure and force technologies is performed to assess their measurement capabilities and limitations to measure sedentary behaviour. Afterwards, a novel methodology for measuring daily life sedentary behaviour using plantar pressure data and a machine learning predictive model is developed. The proposed model and its algorithm are constructed using a dataset of 20 participants collected at both laboratory-based and free-living conditions. Sitting and standing variations are included in the analysis as well as the addition of a potential novel activities, such as leaning. Video footage is continuously collected using of a wearable camera as an equivalent of direct observation to allow the labelling of the training data for the machine learning model. The optimal parameters of the model such as feature set, epoch length, type of classifier is determined by experimenting with multiple iterations. Different number and location of plantar pressure sensors are explored to determine the optimal trade-off between low computational cost and accurate performance. The model s performance is calculated using both subject dependent and subject independent validation by performing 10-fold stratified cross-validation and leave-one-user-out validation respectively. Furthermore, the proposed model activity performance for daily life monitoring is validated against the current criterion (i.e. direct observation) and against the de facto standard, the activPAL. The results show that the proposed machine learning classification model exhibits excel-lent recall rates of 98.83% with subject dependent training and 95.93% with independent training. This work sets the groundwork for developing a future plantar pressure wearable device for daily life sedentary behaviour monitoring in free-living conditions that uses the proposed ma-chine leaning classification model. Moreover, this research also considers important design characteristics of wearable devices such as low computational cost and improved performance, addressing the current gap in the physical activity and sedentary behaviour wearable market

A randomised controlled trial to measure the effects of an augmented prescribed exercise programme (APEP) on length of stay, physical ability and quality of life in frail older medical patients in the acute setting

The aim of this thesis was to measure the effectiveness of additional exercises on length of stay, physical performance and quality of life for frail older medical inpatients. The thesis, in three phases (1) identified a suitable and accurate motion sensor to measure walking in hospital, (2) measured walking in hospital, and (3) measured the effectiveness of an augmented prescribed exercise programme (APEP) for frail older acute medical (RCT). Phase 1: A scholarly review identified two accelerometers and three pedometers showing potential, and a validation study (n=32), identified one of these as suitably accurate. Phase 2: The accelerometer was used to measure the association between walking (step-count) and (1) length of stay, (2) physical performance and (3) potential influencers of walking (n=154). More walking (50%) was associated with a 6% shorter hospital stay. Better physical performance on admission predicted 15% more walking, and assigned bed-rest and tethering treatments were associated with less walking (70% and 30% respectively). Phase 3: The effectiveness of the APEP was measured (n=190), using length of stay as the primary outcome measure. Twice-daily exercise sessions were delivered; strengthening/balance to the intervention group, stretching/relaxation to the control group. Many (35%) patients were transferred to sub-acute care. A 30% shorter length of stay (patients discharged directly home only), was detected, however, failed to reach significant significance (n=128), (HR 1.3 (CI 0.90-1.87) p=0.1). Improved physical performance at discharge (β 0.88 (CI 0.2-1.57) p=0.01), quality of life at follow-up (β 0.28 (CI 0.91-0.47) p=0.004) and less negative events (pooled falls, prolonged hospital stays, deaths and long-term care admissions) (OR 0.42 (0.2-0.92) p=0.03, post hoc analysis) were detected. The results indicate that older inpatients’ inactivity is associated with length of stay. Additional exercises improved physical performance and quality of life. Its effect on length of stay remains inconclusive

Biomechanics beyond the lab: Remote technology for osteoarthritis patient data—A scoping review

The objective of this project is to produce a review of available and validated technologies suitable for gathering biomechanical and functional research data in patients with osteoarthritis (OA), outside of a traditionally fixed laboratory setting. A scoping review was conducted using defined search terms across three databases (Scopus, Ovid MEDLINE, and PEDro), and additional sources of information from grey literature were added. One author carried out an initial title and abstract review, and two authors independently completed full-text screenings. Out of the total 5,164 articles screened, 75 were included based on inclusion criteria covering a range of technologies in articles published from 2015. These were subsequently categorised by technology type, parameters measured, level of remoteness, and a separate table of commercially available systems. The results concluded that from the growing number of available and emerging technologies, there is a well-established range in use and further in development. Of particular note are the wide-ranging available inertial measurement unit systems and the breadth of technology available to record basic gait spatiotemporal measures with highly beneficial and informative functional outputs. With the majority of technologies categorised as suitable for part-remote use, the number of technologies that are usable and fully remote is rare and they usually employ smartphone software to enable this. With many systems being developed for camera-based technology, such technology is likely to increase in usability and availability as computational models are being developed with increased sensitivities to recognise patterns of movement, enabling data collection in the wider environment and reducing costs and creating a better understanding of OA patient biomechanical and functional movement data

Biomechanics beyond the lab: remote technology for osteoarthritis patient data-a scoping review

The objective of this project is to produce a review of available and validated technologies suitable for gathering biomechanical and functional research data in patients with osteoarthritis (OA), outside of a traditionally fixed laboratory setting. A scoping review was conducted using defined search terms across three databases (Scopus, Ovid MEDLINE, and PEDro), and additional sources of information from grey literature were added. One author carried out an initial title and abstract review, and two authors independently completed full-text screenings. Out of the total 5,164 articles screened, 75 were included based on inclusion criteria covering a range of technologies in articles published from 2015. These were subsequently categorised by technology type, parameters measured, level of remoteness, and a separate table of commercially available systems. The results concluded that from the growing number of available and emerging technologies, there is a well-established range in use and further in development. Of particular note are the wide-ranging available inertial measurement unit systems and the breadth of technology available to record basic gait spatiotemporal measures with highly beneficial and informative functional outputs. With the majority of technologies categorised as suitable for part-remote use, the number of technologies that are usable and fully remote is rare and they usually employ smartphone software to enable this. With many systems being developed for camera-based technology, such technology is likely to increase in usability and availability as computational models are being developed with increased sensitivities to recognise patterns of movement, enabling data collection in the wider environment and reducing costs and creating a better understanding of OA patient biomechanical and functional movement data

Children’s Fitness and Quality of Movement

Introduction: Movement is essential to life and plays a key role in development throughout childhood. Movement can be assessed by its quantity and quality. Movement is important to measure as it can aid early intervention. Current research suggests that global levels of fitness are declining, with a lack of research surrounding children’s natural fitness levels as they get older. Quantity of movement is commonly studied, however quality is becoming increasingly popular. A clear understanding of the methods of technology used to measure quality of movement is important as understanding this area will aid in designing appropriate interventions.Methods: This thesis comprises of two experimental studies. Study one is a repeated measures design using previously collected Swanlinx data to investigate how components of children’s fitness change over a one-year period. Study two is a scoping review investigating the measurement of quality of movement with technology in the form of MEM’s devices, while aiming to gain clarity on the definition of quality.Results: Study one revealed that children’s fitness levels increase across a one-year period, in all components of fitness, except sit and reach. Boys performed significantly better in all fitness components, apart from sit and reach. Study two demonstrated the broad field that is included under the term of quality, showing clarity is needed in this area. A large number of devices, movements and populations are being observed, with multiple definitions of quality which is dependent on the metrics collected.Conclusion: Study one concludes that children’s fitness levels increase over one-year, with boys performing better than girls. This can be used to understand children’s natural fitness levels and aid future interventions in participation. Study two concludes that there are multiple ways to assess quality of movement however a clear definition of the quality should be stated, aiding comparison of quality