Is the timed-up and go test feasible in mobile devices? A systematic review

The number of older adults is increasing worldwide, and it is expected that by 2050 over 2 billion individuals will be more than 60 years old. Older adults are exposed to numerous pathological problems such as Parkinson’s disease, amyotrophic lateral sclerosis, post-stroke, and orthopedic disturbances. Several physiotherapy methods that involve measurement of movements, such as the Timed-Up and Go test, can be done to support efficient and effective evaluation of pathological symptoms and promotion of health and well-being. In this systematic review, the authors aim to determine how the inertial sensors embedded in mobile devices are employed for the measurement of the different parameters involved in the Timed-Up and Go test. The main contribution of this paper consists of the identification of the different studies that utilize the sensors available in mobile devices for the measurement of the results of the Timed-Up and Go test. The results show that mobile devices embedded motion sensors can be used for these types of studies and the most commonly used sensors are the magnetometer, accelerometer, and gyroscope available in off-the-shelf smartphones. The features analyzed in this paper are categorized as quantitative, quantitative + statistic, dynamic balance, gait properties, state transitions, and raw statistics. These features utilize the accelerometer and gyroscope sensors and facilitate recognition of daily activities, accidents such as falling, some diseases, as well as the measurement of the subject's performance during the test execution.info:eu-repo/semantics/publishedVersio

Real-time human ambulation, activity, and physiological monitoring:taxonomy of issues, techniques, applications, challenges and limitations

Automated methods of real-time, unobtrusive, human ambulation, activity, and wellness monitoring and data analysis using various algorithmic techniques have been subjects of intense research. The general aim is to devise effective means of addressing the demands of assisted living, rehabilitation, and clinical observation and assessment through sensor-based monitoring. The research studies have resulted in a large amount of literature. This paper presents a holistic articulation of the research studies and offers comprehensive insights along four main axes: distribution of existing studies; monitoring device framework and sensor types; data collection, processing and analysis; and applications, limitations and challenges. The aim is to present a systematic and most complete study of literature in the area in order to identify research gaps and prioritize future research directions

Fall Prediction and Prevention Systems: Recent Trends, Challenges, and Future Research Directions.

Fall prediction is a multifaceted problem that involves complex interactions between physiological, behavioral, and environmental factors. Existing fall detection and prediction systems mainly focus on physiological factors such as gait, vision, and cognition, and do not address the multifactorial nature of falls. In addition, these systems lack efficient user interfaces and feedback for preventing future falls. Recent advances in internet of things (IoT) and mobile technologies offer ample opportunities for integrating contextual information about patient behavior and environment along with physiological health data for predicting falls. This article reviews the state-of-the-art in fall detection and prediction systems. It also describes the challenges, limitations, and future directions in the design and implementation of effective fall prediction and prevention systems

Wearables for independent living in older adults: Gait and falls

Solutions are needed to satisfy care demands of older adults to live independently. Wearable technology (wearables) is one approach that offers a viable means for ubiquitous, sustainable and scalable monitoring of the health of older adults in habitual free-living environments. Gait has been presented as a relevant (bio)marker in ageing and pathological studies, with objective assessment achievable by inertial-based wearables. Commercial wearables have struggled to provide accurate analytics and have been limited by non-clinically oriented gait outcomes. Moreover, some research-grade wearables also fail to provide transparent functionality due to limitations in proprietary software. Innovation within this field is often sporadic, with large heterogeneity of wearable types and algorithms for gait outcomes leading to a lack of pragmatic use. This review provides a summary of the recent literature on gait assessment through the use of wearables, focusing on the need for an algorithm fusion approach to measurement, culminating in the ability to better detect and classify falls. A brief presentation of wearables in one pathological group is presented, identifying appropriate work for researchers in other cohorts to utilise. Suggestions for how this domain needs to progress are also summarised

Physical activity characterization:Does one site fit all?

Background: It is evident that a growing number of studies advocate a wrist-worn accelerometer for the assessment of patterns of physical activity a priori, yet the veracity of this site rather than any other body-mounted location for its accuracy in classifying activity is hitherto unexplored. Objective: The objective of this review was to identify the relative accuracy with which physical activities can be classified according to accelerometer site and analytical technique. Methods: A search of electronic databases was conducted using Web of Science, PubMed and Google Scholar. This review included studies written in the English language, published between database inception and December 2017, which characterized physical activities using a single accelerometer and reported the accuracy of the technique. Results: A total of 118 articles were initially retrieved. After duplicates were removed and the remaining articles screened, 32 full-text articles were reviewed, resulting in the inclusion of 19 articles that met the eligibility criteria. Conclusion: There is no 'one site fits all' approach to the selection of accelerometer site location or analytical technique. Research design and focus should always inform the most suitable location of attachment, and should be driven by the type of activity being characterized

Smartphone-based Human Fatigue Detection in an Industrial Environment Using Gait Analysis

Human fatigue due to repetitive and physically challenging jobs may result in poor performance and a Work-related Musculoskeletal Disorder (WMSD). Thus, the importance of being able to monitor fatigue to implement preventative interventions cannot be overstated. This study was designed to monitor fatigue through the development of a methodology that objectively classifies an individual’s level of fatigue in the workplace by utilizing the motion sensors embedded in smartphones. An experiment consisting of squatting tasks, primarily involving the lower extremity musculature, was conducted with 24 participants using a smartphone attached to their right shank. Using Borg’s Ratings of Perceived Exertion (RPE) to label gait data, we developed machine learning algorithms to classify each individual’s gait into two (no- vs. strong-fatigue), three (no-, medium-, and strong-fatigue) and four (no-, low-, medium-, and strong-fatigue) levels of fatigue, for which accuracy of 91%, 76%, and 61% were obtained, respectively. The outcomes of this study may facilitate the implementation of a proactive approach supporting the continuous monitoring of a worker’s fatigue level, which may subsequently enhance workers’ performance and reduce the risk of WMSDs

Gait Velocity Estimation using time interleaved between Consecutive Passive IR Sensor Activations

Gait velocity has been consistently shown to be an important indicator and predictor of health status, especially in older adults. It is often assessed clinically, but the assessments occur infrequently and do not allow optimal detection of key health changes when they occur. In this paper, we show that the time gap between activations of a pair of Passive Infrared (PIR) motion sensors installed in the consecutively visited room pair carry rich latent information about a person's gait velocity. We name this time gap transition time and show that despite a six second refractory period of the PIR sensors, transition time can be used to obtain an accurate representation of gait velocity. Using a Support Vector Regression (SVR) approach to model the relationship between transition time and gait velocity, we show that gait velocity can be estimated with an average error less than 2.5 cm/sec. This is demonstrated with data collected over a 5 year period from 74 older adults monitored in their own homes. This method is simple and cost effective and has advantages over competing approaches such as: obtaining 20 to 100x more gait velocity measurements per day and offering the fusion of location-specific information with time stamped gait estimates. These advantages allow stable estimates of gait parameters (maximum or average speed, variability) at shorter time scales than current approaches. This also provides a pervasive in-home method for context-aware gait velocity sensing that allows for monitoring of gait trajectories in space and time

Classifying Toe Walking Gait Patterns Among Children Diagnosed With Idiopathic Toe Walking Using Wearable Sensors and Machine Learning Algorithms

Idiopathic toe walking (ITW) is a gait abnormality in which children’s toes touch at initial contact and demonstrate limited or no heel contact throughout the gait cycle. Toe walking results in poor balance, increased risk of falling, and developmental delays among children. Identifying toe walking steps during walking can facilitate targeted intervention among children diagnosed with ITW. With recent advances in wearable sensing, communication technologies, and machine learning, new avenues of managing toe walking behavior among children are feasible. In this study, we investigate the capabilities of Machine Learning (ML) algorithms in identifying initial foot contact (heel strike versus toe strike) utilizing wearable body sensors. Thirty-six children (Age 9.4±2.8 years) diagnosed with ITW participated in this study. Six ML algorithms, consisting of Support Vector Machines (SVM), decision tree (DT), random forest (RF), K-nearest neighbors (KNN), Multi-layer Perceptron (MLP), and Gaussian process (GP), could successfully classify initial contact walking patterns among ITW. We found that a simple KNN algorithm resulted in the highest accuracy of 92.92% and an F1-score of 93.20% to differentiate toe walking gait versus best heel strike when using all four body sensors. We also found that toe walking resulted in higher variability in the sacral vertical accelerations among children diagnosed with ITW. Accurate quantification of toe walking steps in clinical applications is critical for assessing rehabilitation progress and designing new interventions for children diagnosed with ITW