Early diagnosis of frailty: Technological and non-intrusive devices for clinical detection

This work analyses different concepts for frailty diagnosis based on affordable standard technology such as smartphones or wearable devices. The goal is to provide ideas that go beyond classical diagnostic tools such as magnetic resonance imaging or tomography, thus changing the paradigm; enabling the detection of frailty without expensive facilities, in an ecological way for both patients and medical staff and even with continuous monitoring. Fried's five-point phenotype model of frailty along with a model based on trials and several classical physical tests were used for device classification. This work provides a starting point for future researchers who will have to try to bridge the gap separating elderly people from technology and medical tests in order to provide feasible, accurate and affordable tools for frailty monitoring for a wide range of users.This work was sponsored by the Spanish Ministry of Science, Innovation and Universities and the European Regional Development Fund (ERDF) across projects RTC-2017-6321-1 AEI/FEDER, UE, TEC2016-76021-C2-2-R AEI/FEDER, UE and PID2019-107270RB-C21/AEI/10.13039/501100011033, UE

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

State of the art of audio- and video based solutions for AAL

Working Group 3. Audio- and Video-based AAL ApplicationsIt is a matter of fact that Europe is facing more and more crucial challenges regarding health and social care due to the demographic change and the current economic context. The recent COVID-19 pandemic has stressed this situation even further, thus highlighting the need for taking action. Active and Assisted Living (AAL) technologies come as a viable approach to help facing these challenges, thanks to the high potential they have in enabling remote care and support. Broadly speaking, AAL can be referred to as the use of innovative and advanced Information and Communication Technologies to create supportive, inclusive and empowering applications and environments that enable older, impaired or frail people to live independently and stay active longer in society. AAL capitalizes on the growing pervasiveness and effectiveness of sensing and computing facilities to supply the persons in need with smart assistance, by responding to their necessities of autonomy, independence, comfort, security and safety. The application scenarios addressed by AAL are complex, due to the inherent heterogeneity of the end-user population, their living arrangements, and their physical conditions or impairment. Despite aiming at diverse goals, AAL systems should share some common characteristics. They are designed to provide support in daily life in an invisible, unobtrusive and user-friendly manner. Moreover, they are conceived to be intelligent, to be able to learn and adapt to the requirements and requests of the assisted people, and to synchronise with their specific needs. Nevertheless, to ensure the uptake of AAL in society, potential users must be willing to use AAL applications and to integrate them in their daily environments and lives. In this respect, video- and audio-based AAL applications have several advantages, in terms of unobtrusiveness and information richness. Indeed, cameras and microphones are far less obtrusive with respect to the hindrance other wearable sensors may cause to one’s activities. In addition, a single camera placed in a room can record most of the activities performed in the room, thus replacing many other non-visual sensors. Currently, video-based applications are effective in recognising and monitoring the activities, the movements, and the overall conditions of the assisted individuals as well as to assess their vital parameters (e.g., heart rate, respiratory rate). Similarly, audio sensors have the potential to become one of the most important modalities for interaction with AAL systems, as they can have a large range of sensing, do not require physical presence at a particular location and are physically intangible. Moreover, relevant information about individuals’ activities and health status can derive from processing audio signals (e.g., speech recordings). Nevertheless, as the other side of the coin, cameras and microphones are often perceived as the most intrusive technologies from the viewpoint of the privacy of the monitored individuals. This is due to the richness of the information these technologies convey and the intimate setting where they may be deployed. Solutions able to ensure privacy preservation by context and by design, as well as to ensure high legal and ethical standards are in high demand. After the review of the current state of play and the discussion in GoodBrother, we may claim that the first solutions in this direction are starting to appear in the literature. A multidisciplinary 4 debate among experts and stakeholders is paving the way towards AAL ensuring ergonomics, usability, acceptance and privacy preservation. The DIANA, PAAL, and VisuAAL projects are examples of this fresh approach. This report provides the reader with a review of the most recent advances in audio- and video-based monitoring technologies for AAL. It has been drafted as a collective effort of WG3 to supply an introduction to AAL, its evolution over time and its main functional and technological underpinnings. In this respect, the report contributes to the field with the outline of a new generation of ethical-aware AAL technologies and a proposal for a novel comprehensive taxonomy of AAL systems and applications. Moreover, the report allows non-technical readers to gather an overview of the main components of an AAL system and how these function and interact with the end-users. The report illustrates the state of the art of the most successful AAL applications and functions based on audio and video data, namely (i) lifelogging and self-monitoring, (ii) remote monitoring of vital signs, (iii) emotional state recognition, (iv) food intake monitoring, activity and behaviour recognition, (v) activity and personal assistance, (vi) gesture recognition, (vii) fall detection and prevention, (viii) mobility assessment and frailty recognition, and (ix) cognitive and motor rehabilitation. For these application scenarios, the report illustrates the state of play in terms of scientific advances, available products and research project. The open challenges are also highlighted. The report ends with an overview of the challenges, the hindrances and the opportunities posed by the uptake in real world settings of AAL technologies. In this respect, the report illustrates the current procedural and technological approaches to cope with acceptability, usability and trust in the AAL technology, by surveying strategies and approaches to co-design, to privacy preservation in video and audio data, to transparency and explainability in data processing, and to data transmission and communication. User acceptance and ethical considerations are also debated. Finally, the potentials coming from the silver economy are overviewed.publishedVersio

Gait phase classification for in-home gait assessment

With growing ageing population, acquiring joint measurements with sufficient accuracy for reliable gait assessment is essential. Additionally, the quality of gait analysis relies heavily on accurate feature selection and classification. Sensor-driven and one-camera optical motion capture systems are becoming increasingly popular in the scientific literature due to their portability and cost-efficacy. In this paper, we propose 12 gait parameters to characterise gait patterns and a novel gait-phase classifier, resulting in comparable classification performance with a state-of-the-art multi-sensor optical motion system. Furthermore, a novel multi-channel time series segmentation method is proposed that maximizes the temporal information of gait parameters improving the final classification success rate after gait event reconstruction. The validation, conducted over 126 experiments on 6 healthy volunteers and 9 stroke patients with handlabelled ground truth gait phases, demonstrates high gait classification accuracy

Smart Sensors for Healthcare and Medical Applications

This book focuses on new sensing technologies, measurement techniques, and their applications in medicine and healthcare. Specifically, the book briefly describes the potential of smart sensors in the aforementioned applications, collecting 24 articles selected and published in the Special Issue “Smart Sensors for Healthcare and Medical Applications”. We proposed this topic, being aware of the pivotal role that smart sensors can play in the improvement of healthcare services in both acute and chronic conditions as well as in prevention for a healthy life and active aging. The articles selected in this book cover a variety of topics related to the design, validation, and application of smart sensors to healthcare

Healthcare applications of single camera markerless motion capture: a scoping review

Funding This work was funded by a University of Aberdeen Elphinstone PhD scholarship. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Peer reviewedPublisher PD

A protected discharge facility for the elderly: design and validation of a working proof-of-concept

With the increasing share of elderly population worldwide, the need for assistive technologies to support clinicians in monitoring their health conditions is becoming more and more relevant. As a quantitative tool, geriatricians recently proposed the notion of frail elderly, which rapidly became a key element of clinical practices for the estimation of well-being in aging population. The evaluation of frailty is commonly based on self-reported outcomes and occasional physicians evaluations, and may therefore contain biased results. Another important aspect in the elderly population is hospitalization as a risk factor for patient\u2019s well being and public costs. Hospitalization is the main cause of functional decline, especially in older adults. The reduction of hospitalization time may allow an improvement of elderly health conditions and a reduction of hospital costs. Furthermore, a gradual transition from a hospital environment to a home-like one, can contribute to the weaning of the patient from a condition of hospitalization to a condition of discharge to his home. The advent of new technologies allows for the design and implementation of smart environments to monitor elderly health status and activities, fulfilling all the requirements of health and safety of the patients. From these starting points, in this thesis I present data-driven methodologies to automatically evaluate one of the main aspects contributing to the frailty estimation, i.e., the motility of the subject. First I will describe a model of protected discharge facility, realized in collaboration and within the E.O. Ospedali Galliera (Genoa, Italy), where patients can be monitored by a system of sensors while physicians and nurses have the opportunity to monitor them remotely. This sensorised facility is being developed to assist elderly users after they have been dismissed from the hospital and before they are ready to go back home, with the perspective of coaching them towards a healthy lifestyle. The facility is equipped with a variety of sensors (vision, depth, ambient and wearable sensors and medical devices), but in my thesis I primarily focus on RGB-D sensors and present visual computing tools to automatically estimate motility features. I provide an extensive system assessment I carried out onthree different experimental sessions with help of young as well as healthy aging volunteers. The results I present are in agreement with the assessment manually performed by physicians, showing the potential capability of my approach to complement current protocols of evaluation

Predictive Models For Falls-Risk Assessment in Older People, Using Markerless Motion Capture

Falling in old age contributes to considerable misery for many people. Currently, there is a lack of practical, low cost and objective methods for identifying those at risk of falls. This thesis aims to address this need. The majority of the literature related to falls risk and balance impairment uses force plates to quantify postural sway. The use of such devices in a clinical setting is rare, mainly due to cost. However, some force-plate-based commercial products have been created, e.g. the Balance Master. To align the research in this thesis to both the literature and existing methods of assessing postural sway, a method is proposed which can generate sway metrics from the output of a low-cost markerless motion capture device (Kinect V2). Good agreement was found between the proposed method and the output of the Balance Master. A key reason for the lack of research into falls-risk using markerless motion capture, is the lack of an appropriate dataset. To address this issue, a dataset of clinical movements, recorded using markerless motion capture, was created. Named KINECAL, It contains the recordings of 90 participants, labelled by age and falls-risk. The data provided includes depth images, 3D joint positions, sway metrics and socioeconomic and health meta data. Many studies have noted that postural sway increases with age and conflate age-related changes with falls risk. However, if one examines sub-populations of older people, such as master athletes, It is clear that this is not necessarily true. The structure of KINECAL allows for the examination of age-related factors and falls-risk factors simultaneously. In addition, it includes labels of falls history, clinical impairment and comprehensive metadata. KINECAL was used to identify sway metrics most closely associated with falls risk, as distinct from the ageing process. Using the identified metrics, a model was developed that can identify those who would be classified as impaired by a range of clinical tests. Finally, a model is proposed, which can predict fallers by placing individuals on a scale of physical impairment. An autoencoder was used to model, healthy adult sit-to-stand movements. Using an anomaly detection approach, an individuals level of impairment can be plotted relative to this healthy standard. Using this model, the existence of two older populations (one with a high falls risk and one with a low falls risk) is demonstrated

A Comparative Study of the Clinical use of Motion Analysis from Kinect Skeleton Data

The analysis of human motion as a clinical tool can bring many benefits such as the early detection of disease and the monitoring of recovery, so in turn helping people to lead independent lives. However, it is currently under used. Developments in depth cameras, such as Kinect, have opened up the use of motion analysis in settings such as GP surgeries, care homes and private homes. To provide an insight into the use of Kinect in the healthcare domain, we present a review of the current state of the art. We then propose a method that can represent human motions from time-series data of arbitrary length, as a single vector. Finally, we demonstrate the utility of this method by extracting a set of clinically significant features and using them to detect the age related changes in the motions of a set of 54 individuals, with a high degree of certainty (F1- score between 0.9 - 1.0). Indicating its potential application in the detection of a range of age-related motion impairments