44 research outputs found

    Patient Frailty: A Review

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    According to Geriator (2011), frailty is a common clinical syndrome in older adults that carries an increased risk for poor health outcomes such as falls, incident disability, hospitalization, and mortality. An operational definition of frailty is the existence of at least three out of five observable criteria indicating compromised energetics: low grip strength; low energy; slowed walking speed; low physical activity; and unintentional weight loss (Fried, et al. 2001). According to Dubois and Charpillet (2017), most transitions into frailty are due to unintentional weight loss which, in turn, impacts gait performance and subsequent general mobility. In this literature review, the focus is on those patients whose gait performance is compromised. As the common chain of events in this syndrome proceeds, poor gait performance results in low physical activity, decreasing muscular activity, and causing poor balance. Sarcopenia, exhaustion, poor gait performance and depression are primary risk factors for falls. This review also focuses on patients who are cared for at the home by the family physician, nurses, and family members. Research Question: How do existing methods identify patient frailty and what interventions can reduce adverse health outcomes and health care costs as well as maintain living at home for frail patients

    How wearable sensors have been utilised to evaluate frailty in older adults: a systematic review

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    Abstract Background Globally the population of older adults is increasing. It is estimated that by 2050 the number of adults over the age of 60 will represent over 21% of the world’s population. Frailty is a clinical condition associated with ageing resulting in an increase in adverse outcomes. It is considered the greatest challenge facing an ageing population affecting an estimated 16% of community-dwelling populations worldwide. Aim The aim of this systematic review is to explore how wearable sensors have been used to assess frailty in older adults. Method Electronic databases Medline, Science Direct, Scopus, and CINAHL were systematically searched March 2020 and November 2020. A search constraint of articles published in English, between January 2010 and November 2020 was applied. Papers included were primary observational studies involving; older adults aged > 60 years, used a wearable sensor to provide quantitative measurements of physical activity (PA) or mobility and a measure of frailty. Studies were excluded if they used non-wearable sensors for outcome measurement or outlined an algorithm or application development exclusively. The methodological quality of the selected studies was assessed using the Appraisal Tool for Cross-sectional Studies (AXIS). Results Twenty-nine studies examining the use of wearable sensors to assess and discriminate between stages of frailty in older adults were included. Thirteen different body-worn sensors were used in eight different body-locations. Participants were community-dwelling older adults. Studies were performed in home, laboratory or hospital settings. Postural transitions, number of steps, percentage of time in PA and intensity of PA together were the most frequently measured parameters followed closely by gait speed. All but one study demonstrated an association between PA and level of frailty. All reports of gait speed indicate correlation with frailty. Conclusions Wearable sensors have been successfully used to evaluate frailty in older adults. Further research is needed to identify a feasible, user-friendly device and body-location that can be used to identify signs of pre-frailty in community-dwelling older adults. This would facilitate early identification and targeted intervention to reduce the burden of frailty in an ageing population

    Chaussette instrumentée pour la mesure de la pression et du frottement

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    L’objectif est d’étudier la capacité des fibres optique polymérique (POF) à être insérées dans un tricot pour mesurer la pression mais également le frottement. Des POF commerciales et en cours de développement ont été comparées en termes de propriétés mécaniques nécessaires pour l’intégration de ces POF dans un tricot selon un procédé industriel. Ensuite la fibre choisie a été insérée dans différents liages de tricot afin de déterminer la configuration donnant la sensibilité au frottement et à la compression la plus élevée. A partir de la structure tricotée ainsi choisie, une chaussette a été réalisée. Finalement, une étude de faisabilité a montré que la chaussette instrumentée d’une POF permet de suivre les différentes phases de la marche

    E-Knitted Textile with Polymer Optical Fibers for Friction and Pressure Monitoring in Socks

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    The objective of this paper is to study the ability of polymer optical fiber (POF) to be inserted in a knitted fabric and to measure both pressure and friction when walking. Firstly, POF, marketed and in development, have been compared in terms of the required mechanical properties for the insertion of the fiber directly into a knitted fabric on an industrial scale, i.e. elongation, bending rigidity, and minimum bending radius before plastic deformation. Secondly, the chosen optical fiber was inserted inside several types of knitted fabric and was shown to be sensitive to friction and compression. The knitted structure with the highest sensitivity has been chosen for sock prototype manufacturing. Finally, a feasibility study with an instrumented sock showed that it is possible to detect the different phases of walking in terms of compression and friction

    Classification of Frailty among Community Dwelling Older Adults Using Parameters of Physical Activity Obtained Independently and Unsupervised

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    The global population is ageing at an unprecedented rate, with the percentage of those aged over 65 years expected to double and those aged over 80 years expected to treble by the year 2050. With ageing comes biological and physiological changes that affect functional capacity. Frailty is a potentially avoidable, reversible biopsychosocial condition associated with biological but not chronological age, affecting a quarter of all community-dwelling older adults. Frailty results in disability, increased dependency and institutionalisation. Screening for frailty could help reduce its prevalence and mitigate the adverse outcomes however, traditional screening tools are time-consuming to perform, require clinician input and by their subjective nature are flawed. The use of wearable sensors has been proposed as a means of screening for frailty and parameters of mobility and physical activity have been identified as being associated with frailty. The goal of this thesis was to examine if community-dwelling older adults could capture parameters of mobility and physical activity independently in their own home and if these parameters could discriminate between frail and non-frail status. This work provides evidence that a single parameter of mobility and physical activity obtained from a single body-worn sensor correlates with frailty. It also provides evidence that community-dwelling older adults can independently capture parameters of mobility and physical activity, unsupervised in their own home using a consumer-grade wearable device, and that these data can predict pre-frailty and frailty with acceptable accuracy. Thresholds for parameters of physical activity predictive of frailty have been identified. The results of this thesis will guide future work to focus community-dwelling older adults on the importance of frailty screening and guide the development of a user-friendly device or sensor system suitable for use by older adults for continuous data collection relevant to frailty

    Toward Smart Footwear to Track Frailty Phenotypes—Using Propulsion Performance to Determine Frailty

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    Frailty assessment is dependent on the availability of trained personnel and it is currently limited to clinic and supervised setting. The growing aging population has made it necessary to find phenotypes of frailty that can be measured in an unsupervised setting for translational application in continuous, remote, and in-place monitoring during daily living activity, such as walking. We analyzed gait performance of 161 older adults using a shin-worn inertial sensor to investigate the feasibility of developing a foot-worn sensor to assess frailty. Sensor-derived gait parameters were extracted and modeled to distinguish different frailty stages, including non-frail, pre-frail, and frail, as determined by Fried Criteria. An artificial neural network model was implemented to evaluate the accuracy of an algorithm using a proposed set of gait parameters in predicting frailty stages. Changes in discriminating power was compared between sensor data extracted from the left and right shin sensor. The aim was to investigate the feasibility of developing a foot-worn sensor to assess frailty. The results yielded a highly accurate model in predicting frailty stages, irrespective of sensor location. The independent predictors of frailty stages were propulsion duration and acceleration, heel-off and toe-off speed, mid stance and mid swing speed, and speed norm. The proposed model enables discriminating different frailty stages with area under curve ranging between 83.2–95.8%. Furthermore, results from the neural network suggest the potential of developing a single-shin worn sensor that would be ideal for unsupervised application and footwear integration for continuous monitoring during walking
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