A Guide to Seasonal Migration: Increasing Snowbirds\u27 Longevity

With the demographic shift of the aging population within the United States, and the push for preventative healthcare measures, occupational therapy (OT) practitioners need to adjust the way they are delivering their services to best meet this growing population\u27s needs. Falls prevention is a method for occupational therapists to get involved in preventative care. The need for preventing falls is further supported by the concept of aging-in-place. Aging-in-place is popular amongst the older population, as older adults often wish to remain in their homes and natural contexts for as long as possible. Homes can come in many different forms; and for this scholarly project, the contexts of the recreational vehicle (RV) home and the recreational vehicle (RV) park are addressed to enable snowbirds to continue to engage in seasonal migration. The purpose of this scholarly project is to provide the snowbird population with the opportunity to continue participating in seasonal migration for as long as they desire. To achieve this objective, a series of checklists were created that will assist snowbirds, RV park owners, and occupational therapists in identifying potential safety hazards in their immediate environment; however, the checklists are not intended to be all inclusive. The overall product is intended to increase the snowbirds\u27 safety, independence, and longevity in their occupation of seasonal migration. The Model of Human Occupation (MOHO) and the Ecological Model of Human Performance (EHP) were used as a guide throughout the creation of this product. Concepts of MOHO, such as volition, habituation, and performance capacity, were guiding factors in the product\u27s development. The snowbirds\u27 volition to participate in seasonal migration was analyzed, as well as their daily habits and routines within their environment. The safety of the snowbirds\u27 environment was addressed to match a variety of performance capacities. The EHP model was also used to analyze the snowbirds\u27 context and provide a safe environment for the snowbirds to perform their daily tasks. The intervention strategies such as: establish/restore, alter, adapt/modify, prevent, and create assisted in developing the series of checklists that are intended to increase the snowbirds\u27 performance range in their natural contexts

Empowering patients in self-management of parkinson's disease through cooperative ICT systems

The objective of this chapter is to demonstrate the technical feasibility and medical effectiveness of personalised services and care programmes for Parkinson's disease, based on the combination of mHealth applications, cooperative ICTs, cloud technologies and wearable integrated devices, which empower patients to manage their health and disease in cooperation with their formal and informal caregivers, and with professional medical staff across different care settings, such as hospital and home. The presented service revolves around the use of two wearable inertial sensors, i.e. SensFoot and SensHand, for measuring foot and hand performance in the MDS-UPDRS III motor exercises. The devices were tested in medical settings with eight patients, eight hyposmic subjects and eight healthy controls, and the results demonstrated that this approach allows quantitative metrics for objective evaluation to be measured, in order to identify pre-motor/pre-clinical diagnosis and to provide a complete service of tele-health with remote control provided by cloud technologies. © 2016, IGI Global. All rights reserved

Computer vision based techniques for fall detection with application towards assisted living

In this thesis, new computer vision based techniques are proposed to detect falls of an elderly person living alone. This is an important problem in assisted living. Different types of information extracted from video recordings are exploited for fall detection using both analytical and machine learning techniques. Initially, a particle filter is used to extract a 2D cue, head velocity, to determine a likely fall event. The human body region is then extracted with a modern background subtraction algorithm. Ellipse fitting is used to represent this shape and its orientation angle is employed for fall detection. An analytical method is used by setting proper thresholds against which the head velocity and orientation angle are compared for fall discrimination. Movement amplitude is then integrated into the fall detector to reduce false alarms. Since 2D features can generate false alarms and are not invariant to different directions, more robust 3D features are next extracted from a 3D person representation formed from video measurements from multiple calibrated cameras. Instead of using thresholds, different data fitting methods are applied to construct models corresponding to fall activities. These are then used to distinguish falls and non-falls. In the final works, two practical fall detection schemes which use only one un-calibrated camera are tested in a real home environment. These approaches are based on 2D features which describe human body posture. These extracted features are then applied to construct either a supervised method for posture classification or an unsupervised method for abnormal posture detection. Certain rules which are set according to the characteristics of fall activities are lastly used to build robust fall detection methods. Extensive evaluation studies are included to confirm the efficiency of the schemes

Smart aging : utilisation of machine learning and the Internet of Things for independent living

Smart aging utilises innovative approaches and technology to improve older adults’ quality of life, increasing their prospects of living independently. One of the major concerns the older adults to live independently is “serious fall”, as almost a third of people aged over 65 having a fall each year. Dementia, affecting nearly 9% of the same age group, poses another significant issue that needs to be identified as early as possible. Existing fall detection systems from the wearable sensors generate many false alarms; hence, a more accurate and secure system is necessary. Furthermore, there is a considerable gap to identify the onset of cognitive impairment using remote monitoring for self-assisted seniors living in their residences. Applying biometric security improves older adults’ confidence in using IoT and makes it easier for them to benefit from smart aging. Several publicly available datasets are pre-processed to extract distinctive features to address fall detection shortcomings, identify the onset of dementia system, and enable biometric security to wearable sensors. These key features are used with novel machine learning algorithms to train models for the fall detection system, identifying the onset of dementia system, and biometric authentication system. Applying a quantitative approach, these models are tested and analysed from the test dataset. The fall detection approach proposed in this work, in multimodal mode, can achieve an accuracy of 99% to detect a fall. Additionally, using 13 selected features, a system for detecting early signs of dementia is developed. This system has achieved an accuracy rate of 93% to identify a cognitive decline in the older adult, using only some selected aspects of their daily activities. Furthermore, the ML-based biometric authentication system uses physiological signals, such as ECG and Photoplethysmogram, in a fusion mode to identify and authenticate a person, resulting in enhancement of their privacy and security in a smart aging environment. The benefits offered by the fall detection system, early detection and identifying the signs of dementia, and the biometric authentication system, can improve the quality of life for the seniors who prefer to live independently or by themselves

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

Inertial sensor based full body 3D kinematics in the differential diagnosis between Parkinson’s Disease and mimics

The differential diagnosis of Parkinson’s Disease (PD) remains challenging with frequent mis and underdiagnosis. DAT-Scan has been a useful technique for assessing the lost integrity of the nigrostriatal pathway in PD and differentiating true parkinsonism from mimics. However, DAT-Scan remains unavailable in most non-specialized clinical centres, making imperative the search for other easy and low-cost solutions. This dissertation aimed to investigate the role of inertial sensors in distinguishing between the denervated and the non-denervated individuals. In this dissertation, we've used Inertial Sensor Based 3D Full Body Kinematics (FBK) and tested if this technique was able to distinguish between patients with changes in the DAT-Scan from those without. This was divided into two parts, being that firstly, a group of individuals was referred by the attending physician for DAT-Scan (123I-FP-CIT SPECT) to be able to compare FBK in those with and without evidence of dopaminergic depletion. Second, it was tested whether FBK could be used as a metric for the severity of dopaminergic depletion. Twenty-one patients participated in this study, being recruited from the Nuclear Medicine Unit in the Champalimaud Clinical Centre (CCC), Lisbon. Within these 21 patients, 10 of them had denervation (mean age, 68.4 ± 7.8 years) and the remaining 11 (mean age, 66.6 ± 7.4 years) did not present denervation. The analysis between the worst uptake ratio features and dimensional features, as well as the asymmetry indexes in the striatum revealed significant differences between denervated and non-denervated individuals. On the contrary, the kinematics did not do it. Overall, based on the collected kinematics data, it was identified that there was not any significant correlation between the kinematics and the DAT-Scan. What means that these kinematics variables were not able to explain the DAT-Scan. On the other hand, it was also checked that the kinematics data were strongly correlated to the motor symptoms (MDS-UPDRS III). This way, it was concluded that the classical biomechanics did not distinguish denervated from non-denervated individuals. Therefore, the kinematics could not give the same answer as the DAT-Scan. In spite of these results it would be relevant to keep researching other methods in order to find out the distinction between the denervation and no denervation in a low-cost way

Unsupervised monitoring of an elderly person\u27s activities of daily living using Kinect sensors and a power meter

The need for greater independence amongst the growing population of elderly people has made the concept of “ageing in place” an important area of research. Remote home monitoring strategies help the elderly deal with challenges involved in ageing in place and performing the activities of daily living (ADLs) independently. These monitoring approaches typically involve the use of several sensors, attached to the environment or person, in order to acquire data about the ADLs of the occupant being monitored. Some key drawbacks associated with many of the ADL monitoring approaches proposed for the elderly living alone need to be addressed. These include the need to label a training dataset of activities, use wearable devices or equip the house with many sensors. These approaches are also unable to concurrently monitor physical ADLs to detect emergency situations, such as falls, and instrumental ADLs to detect deviations from the daily routine. These are all indicative of deteriorating health in the elderly. To address these drawbacks, this research aimed to investigate the feasibility of unsupervised monitoring of both physical and instrumental ADLs of elderly people living alone via inexpensive minimally intrusive sensors. A hybrid framework was presented which combined two approaches for monitoring an elderly occupant’s physical and instrumental ADLs. Both approaches were trained based on unlabelled sensor data from the occupant’s normal behaviours. The data related to physical ADLs were captured from Kinect sensors and those related to instrumental ADLs were obtained using a combination of Kinect sensors and a power meter. Kinect sensors were employed in functional areas of the monitored environment to capture the occupant’s locations and 3D structures of their physical activities. The power meter measured the power consumption of home electrical appliances (HEAs) from the electricity panel. A novel unsupervised fuzzy approach was presented to monitor physical ADLs based on depth maps obtained from Kinect sensors. Epochs of activities associated with each monitored location were automatically identified, and the occupant’s behaviour patterns during each epoch were represented through the combinations of fuzzy attributes. A novel membership function generation technique was presented to elicit membership functions for attributes by analysing the data distribution of attributes while excluding noise and outliers in the data. The occupant’s behaviour patterns during each epoch of activity were then classified into frequent and infrequent categories using a data mining technique. Fuzzy rules were learned to model frequent behaviour patterns. An alarm was raised when the occupant’s behaviour in new data was recognised as frequent with a longer than usual duration or infrequent with a duration exceeding a data-driven value. Another novel unsupervised fuzzy approach to monitor instrumental ADLs took unlabelled training data from Kinect sensors and a power meter to model the key features of instrumental ADLs. Instrumental ADLs in the training dataset were identified based on associating the occupant’s locations with specific power signatures on the power line. A set of fuzzy rules was then developed to model the frequency and regularity of the instrumental activities tailored to the occupant. This set was subsequently used to monitor new data and to generate reports on deviations from normal behaviour patterns. As a proof of concept, the proposed monitoring approaches were evaluated using a dataset collected from a real-life setting. An evaluation of the results verified the high accuracy of the proposed technique to identify the epochs of activities over alternative techniques. The approach adopted for monitoring physical ADLs was found to improve elderly monitoring. It generated fuzzy rules that could represent the person’s physical ADLs and exclude noise and outliers in the data more efficiently than alternative approaches. The performance of different membership function generation techniques was compared. The fuzzy rule set obtained from the output of the proposed technique could accurately classify more scenarios of normal and abnormal behaviours. The approach for monitoring instrumental ADLs was also found to reliably distinguish power signatures generated automatically by self-regulated devices from those generated as a result of an elderly person’s instrumental ADLs. The evaluations also showed the effectiveness of the approach in correctly identifying elderly people’s interactions with specific HEAs and tracking simulated upward and downward deviations from normal behaviours. The fuzzy inference system in this approach was found to be robust in regards to errors when identifying instrumental ADLs as it could effectively classify normal and abnormal behaviour patterns despite errors in the list of the used HEAs

Instrumentation of a cane to detect and prevent falls

Dissertação de mestrado integrado em Engenharia Biomédica (área de especialização em Eletrónica Médica)The number of falls is growing as the main cause of injuries and deaths in the geriatric community. As a result, the cost of treating the injuries associated with falls is also increasing. Thus, the development of fall-related strategies with the capability of real-time monitoring without user restriction is imperative. Due to their advantages, daily life accessories can be a solution to embed fall-related systems, and canes are no exception. Moreover, gait assessment might be capable of enhancing the capability of cane usage for older cane users. Therefore, reducing, even more, the possibility of possible falls amongst them. Summing up, it is crucial the development of strategies that recognize states of fall, the step before a fall (pre-fall step) and the different cane events continuously throughout a stride. This thesis aims to develop strategies capable of identifying these situations based on a cane system that collects both inertial and force information, the Assistive Smart Cane (ASCane). The strategy regarding the detection of falls consisted of testing the data acquired with the ASCane with three different fixed multi-threshold fall detection algorithms, one dynamic multi-threshold and machine learning methods from the literature. They were tested and modified to account the use of a cane. The best performance resulted in a sensitivity and specificity of 96.90% and 98.98%, respectively. For the detection of the different cane events in controlled and real-life situations, a state-of-the-art finite-state-machine gait event detector was modified to account the use of a cane and benchmarked against a ground truth system. Moreover, a machine learning study was completed involving eight feature selection methods and nine different machine learning classifiers. Results have shown that the accuracy of the classifiers was quite acceptable and presented the best results with 98.32% of overall accuracy for controlled situations and 94.82% in daily-life situations. Regarding pre-fall step detection, the same machine learning approach was accomplished. The models were very accurate (Accuracy = 98.15%) and with the implementation of an online post-processing filter, all the false positive detections were eliminated, and a fall was able to be detected 1.019s before the end of the corresponding pre-fall step and 2.009s before impact.O número de quedas tornou-se uma das principais causas de lesões e mortes na comunidade geriátrica. Como resultado, o custo do tratamento das lesões também aumenta. Portanto, é necessário o desenvolvimento de estratégias relacionadas com quedas e que exibam capacidade de monitorização em tempo real sem colocar restrições ao usuário. Devido às suas vantagens, os acessórios do dia-a-dia podem ser uma solução para incorporar sistemas relacionados com quedas, sendo que as bengalas não são exceção. Além disso, a avaliação da marcha pode ser capaz de aprimorar a capacidade de uso de uma bengala para usuários mais idosos. Desta forma, é crucial o desenvolvimento de estratégias que reconheçam estados de queda, do passo anterior a uma queda e dos diferentes eventos da marcha de uma bengala. Esta dissertação tem como objetivo desenvolver estratégias capazes de identificar as situações anteriormente descritas com base num sistema incorporado numa bengala que coleta informações inerciais e de força, a Assistive Smart Cane (ASCane). A estratégia referente à deteção de quedas consistiu em testar os dados adquiridos através da ASCane com três algoritmos de deteção de quedas (baseados em thresholds fixos), com um algoritmo de thresholds dinâmicos e diferentes classificadores de machine learning encontrados na literatura. Estes métodos foram testados e modificados para dar conta do uso de informação adquirida através de uma bengala. O melhor desempenho alcançado em termos de sensibilidade e especificidade foi de 96,90% e 98,98%, respetivamente. Relativamente à deteção dos diferentes eventos da ASCane em situações controladas e da vida real, um detetor de eventos da marcha foi e comparado com um sistema de ground truth. Além disso, foi também realizado um estudo de machine learning envolvendo oito métodos de seleção de features e nove classificadores diferentes de machine learning. Os resultados mostraram que a precisão dos classificadores foi bastante aceitável e apresentou, como melhores resultados, 98,32% de precisão para situações controladas e 94.82% para situações do dia-a-dia. No que concerne à deteção de passos pré-queda, a mesma abordagem de machine learning foi realizada. Os modelos foram precisos (precisão = 98,15%) e com a implementação de um filtro de pós-processamento, todas as deteções de falsos positivos foram eliminadas e uma queda foi passível de ser detetada 1,019s antes do final do respetivo passo de pré-queda e 2.009s antes do impacto