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13 pages, 1308 KiB

Open AccessArticle

“Can Do” vs. “Do Do” in Older Adults: A Cross-Sectional Analysis of Sensor-Derived Physical Activity Patterns

by Michael Adams, Lara Carrascosa, Carl-Philipp Jansen, Yvonne Ritter and Michael Schwenk

Sensors 2023, 23(4), 1879; https://doi.org/10.3390/s23041879 - 7 Feb 2023

Cited by 5 | Viewed by 1726

Abstract

(1) Background: Identifying groups with a misaligned physical capacity (PC) and physical activity (PA) is potentially relevant for health promotion. Although an important health determinant, deeper knowledge of underlying walking behavior patterns in older adults is currently missing. We aim to identify specific [...] Read more.

(1) Background: Identifying groups with a misaligned physical capacity (PC) and physical activity (PA) is potentially relevant for health promotion. Although an important health determinant, deeper knowledge of underlying walking behavior patterns in older adults is currently missing. We aim to identify specific PA signatures of misaligned groups and determine PA variables discriminating between groups. (2) Methods: In total, 294 community-dwelling older adults (≥70 years) were divided into four quadrants based on thresholds for PA (≥ or <5000 steps/day) and PC (≤ or >12 s, Timed Up and Go test). Kruskal–Wallis and effect sizes were calculated to compare quadrants’ PA variables and to determine the discriminative power of PA parameters on walking duration, frequency, and intensity. (3) Results: We identified quadrant-specific PA signatures. Compared with “can do–do do”, the “cannot do–do do” group performs shorter continuous and lower-intensity walks; the “can do–do not do” group takes fewer steps and walks with less intensity. The “cannot do–do not do” group presents lower values in all PA variables. “Walking duration greater or equal 3 METs” was the strongest discriminative PA variable. (4) Conclusion: We provide distinct PA signatures for four clinically different groups of older adults. Walking intensity is most useful to distinguish community-dwelling older adults, which is relevant for developing improved customized health promotion interventions. Full article

(This article belongs to the Special Issue Inertial Sensors for Clinically Relevant Mobility Outcome Measures)

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10 pages, 614 KiB

Open AccessArticle

Gait Characteristics Associated with Fear of Falling in Hospitalized People with Parkinson’s Disease

by Manuela Uhlig and Tino Prell

Sensors 2023, 23(3), 1111; https://doi.org/10.3390/s23031111 - 18 Jan 2023

Cited by 2 | Viewed by 2637

Abstract

Background: Fear of falling (FOF) is common in Parkinson’s disease (PD) and associated with distinct gait changes. Here, we aimed to answer, how quantitative gait assessment can improve our understanding of FOF-related gait in hospitalized geriatric patients with PD. Methods: In this cross-sectional [...] Read more.

Background: Fear of falling (FOF) is common in Parkinson’s disease (PD) and associated with distinct gait changes. Here, we aimed to answer, how quantitative gait assessment can improve our understanding of FOF-related gait in hospitalized geriatric patients with PD. Methods: In this cross-sectional study of 79 patients with advanced PD, FOF was assessed with the Falls Efficacy Scale International (FES-I), and spatiotemporal gait parameters were recorded with a mobile gait analysis system with inertial measurement units at each foot while normal walking. In addition, demographic parameters, disease-specific motor (MDS-revised version of the Unified Parkinson’s Disease Rating Scale, Hoehn & Yahr), and non-motor (Non-motor Symptoms Questionnaire, Montreal Cognitive Assessment) scores were assessed. Results: According to the FES-I, 22.5% reported low, 28.7% moderate, and 47.5% high concerns about falling. Most concerns were reported when walking on a slippery surface, on an uneven surface, or up or down a slope. In the final regression model, previous falls, more depressive symptoms, use of walking aids, presence of freezing of gait, and lower walking speed explained 42% of the FES-I variance. Conclusion: Our study suggests that FOF is closely related to gait changes in hospitalized PD patients. Therefore, FOF needs special attention in the rehabilitation of these patients, and targeting distinct gait parameters under varying walking conditions might be a promising part of a multimodal treatment program in PD patients with FOF. The effect of these targeted interventions should be investigated in future trials. Full article

(This article belongs to the Special Issue Inertial Sensors for Clinically Relevant Mobility Outcome Measures)

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18 pages, 9295 KiB

Open AccessArticle

Gait Detection from a Wrist-Worn Sensor Using Machine Learning Methods: A Daily Living Study in Older Adults and People with Parkinson’s Disease

by Yonatan E. Brand, Dafna Schwartz, Eran Gazit, Aron S. Buchman, Ran Gilad-Bachrach and Jeffrey M. Hausdorff

Sensors 2022, 22(18), 7094; https://doi.org/10.3390/s22187094 - 19 Sep 2022

Cited by 16 | Viewed by 5072

Abstract

Remote assessment of the gait of older adults (OAs) during daily living using wrist-worn sensors has the potential to augment clinical care and mobility research. However, hand movements can degrade gait detection from wrist-sensor recordings. To address this challenge, we developed an anomaly [...] Read more.

Remote assessment of the gait of older adults (OAs) during daily living using wrist-worn sensors has the potential to augment clinical care and mobility research. However, hand movements can degrade gait detection from wrist-sensor recordings. To address this challenge, we developed an anomaly detection algorithm and compared its performance to four previously published gait detection algorithms. Multiday accelerometer recordings from a wrist-worn and lower-back sensor (i.e., the “gold-standard” reference) were obtained in 30 OAs, 60% with Parkinson’s disease (PD). The area under the receiver operator curve (AUC) and the area under the precision–recall curve (AUPRC) were used to evaluate the performance of the algorithms. The anomaly detection algorithm obtained AUCs of 0.80 and 0.74 for OAs and PD, respectively, but AUPRCs of 0.23 and 0.31 for OAs and PD, respectively. The best performing detection algorithm, a deep convolutional neural network (DCNN), exhibited high AUCs (i.e., 0.94 for OAs and 0.89 for PD) but lower AUPRCs (i.e., 0.66 for OAs and 0.60 for PD), indicating trade-offs between precision and recall. When choosing a classification threshold of 0.9 (i.e., opting for high precision) for the DCNN algorithm, strong correlations (r > 0.8) were observed between daily living walking time estimates based on the lower-back (reference) sensor and the wrist sensor. Further, gait quality measures were significantly different in OAs and PD compared to healthy adults. These results demonstrate that daily living gait can be quantified using a wrist-worn sensor. Full article

(This article belongs to the Special Issue Inertial Sensors for Clinically Relevant Mobility Outcome Measures)

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19 pages, 390 KiB

Open AccessArticle

MaD GUI: An Open-Source Python Package for Annotation and Analysis of Time-Series Data

by Malte Ollenschläger, Arne Küderle, Wolfgang Mehringer, Ann-Kristin Seifer, Jürgen Winkler, Heiko Gaßner, Felix Kluge and Bjoern M. Eskofier

Sensors 2022, 22(15), 5849; https://doi.org/10.3390/s22155849 - 5 Aug 2022

Cited by 11 | Viewed by 5005

Abstract

Developing machine learning algorithms for time-series data often requires manual annotation of the data. To do so, graphical user interfaces (GUIs) are an important component. Existing Python packages for annotation and analysis of time-series data have been developed without addressing adaptability, usability, and [...] Read more.

Developing machine learning algorithms for time-series data often requires manual annotation of the data. To do so, graphical user interfaces (GUIs) are an important component. Existing Python packages for annotation and analysis of time-series data have been developed without addressing adaptability, usability, and user experience. Therefore, we developed a generic open-source Python package focusing on adaptability, usability, and user experience. The developed package, Machine Learning and Data Analytics (MaD) GUI, enables developers to rapidly create a GUI for their specific use case. Furthermore, MaD GUI enables domain experts without programming knowledge to annotate time-series data and apply algorithms to it. We conducted a small-scale study with participants from three international universities to test the adaptability of MaD GUI by developers and to test the user interface by clinicians as representatives of domain experts. MaD GUI saves up to 75% of time in contrast to using a state-of-the-art package. In line with this, subjective ratings regarding usability and user experience show that MaD GUI is preferred over a state-of-the-art package by developers and clinicians. MaD GUI reduces the effort of developers in creating GUIs for time-series analysis and offers similar usability and user experience for clinicians as a state-of-the-art package. Full article

(This article belongs to the Special Issue Inertial Sensors for Clinically Relevant Mobility Outcome Measures)

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14 pages, 299 KiB

Open AccessArticle

Factors Influencing Habitual Physical Activity in Parkinson’s Disease: Considering the Psychosocial State and Wellbeing of People with Parkinson’s and Their Carers

by Ríona Mc Ardle, Silvia Del Din, Rosie Morris, Lisa Alcock, Alison J. Yarnall, David J. Burn, Lynn Rochester, Rachael A. Lawson and on behalf of the ICICLE-PD Study Group

Sensors 2022, 22(3), 871; https://doi.org/10.3390/s22030871 - 24 Jan 2022

Cited by 5 | Viewed by 3516

Abstract

Participating in habitual physical activity (HPA) may slow onset of dependency and disability for people with Parkinson’s disease (PwP). While cognitive and physical determinants of HPA are well understood, psychosocial influences are not. This pilot study aimed to identify psychosocial factors associated with [...] Read more.

Participating in habitual physical activity (HPA) may slow onset of dependency and disability for people with Parkinson’s disease (PwP). While cognitive and physical determinants of HPA are well understood, psychosocial influences are not. This pilot study aimed to identify psychosocial factors associated with HPA to guide future intervention development. Sixty-four PwP participated in this study; forty had carer informants. PwP participants wore a tri-axial accelerometer on the lower back continuously for seven days at two timepoints (18 months apart), measuring volume, pattern and variability of HPA. Linear mixed effects analysis identified relationships between demographic, clinical and psychosocial data and HPA from baseline to 18 months. Key results in PwP with carers indicated that carer anxiety and depression were associated with increased HPA volume (p < 0.01), while poorer carer self-care was associated with reduced volume of HPA over 18 months (p < 0.01). Greater carer strain was associated with taking longer walking bouts after 18 months (p < 0.01). Greater carer depression was associated with lower variability of HPA cross-sectionally (p = 0.009). This pilot study provides preliminary novel evidence that psychosocial outcomes from PwP’s carers may impact HPA in Parkinson’s disease. Interventions to improve HPA could target both PwP and carers and consider approaches that also support psychosocial wellbeing. Full article

(This article belongs to the Special Issue Inertial Sensors for Clinically Relevant Mobility Outcome Measures)

11 pages, 903 KiB

Open AccessEditor’s ChoiceArticle

Validation of a Sensor-Based Gait Analysis System with a Gold-Standard Motion Capture System in Patients with Parkinson’s Disease

by Verena Jakob, Arne Küderle, Felix Kluge, Jochen Klucken, Bjoern M. Eskofier, Jürgen Winkler, Martin Winterholler and Heiko Gassner

Sensors 2021, 21(22), 7680; https://doi.org/10.3390/s21227680 - 18 Nov 2021

Cited by 38 | Viewed by 6029

Abstract

Digital technologies provide the opportunity to analyze gait patterns in patients with Parkinson’s Disease using wearable sensors in clinical settings and a home environment. Confirming the technical validity of inertial sensors with a 3D motion capture system is a necessary step for the [...] Read more.

Digital technologies provide the opportunity to analyze gait patterns in patients with Parkinson’s Disease using wearable sensors in clinical settings and a home environment. Confirming the technical validity of inertial sensors with a 3D motion capture system is a necessary step for the clinical application of sensor-based gait analysis. Therefore, the objective of this study was to compare gait parameters measured by a mobile sensor-based gait analysis system and a motion capture system as the gold standard. Gait parameters of 37 patients were compared between both systems after performing a standardized 5 × 10 m walking test by reliability analysis using intra-class correlation and Bland–Altman plots. Additionally, gait parameters of an age-matched healthy control group (n = 14) were compared to the Parkinson cohort. Gait parameters representing bradykinesia and short steps showed excellent reliability (ICC > 0.96). Shuffling gait parameters reached ICC > 0.82. In a stridewise synchronization, no differences were observed for gait speed, stride length, stride time, relative stance and swing time (p > 0.05). In contrast, heel strike, toe off and toe clearance significantly differed between both systems (p < 0.01). Both gait analysis systems distinguish Parkinson patients from controls. Our results indicate that wearable sensors generate valid gait parameters compared to the motion capture system and can consequently be used for clinically relevant gait recordings in flexible environments. Full article

(This article belongs to the Special Issue Inertial Sensors for Clinically Relevant Mobility Outcome Measures)

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11 pages, 7154 KiB

Open AccessCommunication

Measuring Gait Stability in People with Multiple Sclerosis Using Different Sensor Locations and Time Scales

by Roy Müller, Lucas Schreff, Lisa-Eyleen Koch, Patrick Oschmann and Daniel Hamacher

Sensors 2021, 21(12), 4001; https://doi.org/10.3390/s21124001 - 10 Jun 2021

Cited by 10 | Viewed by 3963

Abstract

The evaluation of local divergence exponent (LDE) has been proposed as a common gait stability measure in people with multiple sclerosis (PwMS). However, differences in methods of determining LDE may lead to different results. Therefore, the purpose of the current study was to [...] Read more.

The evaluation of local divergence exponent (LDE) has been proposed as a common gait stability measure in people with multiple sclerosis (PwMS). However, differences in methods of determining LDE may lead to different results. Therefore, the purpose of the current study was to determine the effect of different sensor locations and LDE measures on the sensitivity to discriminate PwMS. To accomplish this, 86 PwMS and 30 healthy participants were instructed to complete a six-minute walk wearing inertial sensors attached to the foot, trunk and lumbar spine. Due to possible fatigue effects, the LDE short (~50% of stride) and very short (~5% of stride) were calculated for the remaining first, middle and last 30 strides. The effect of group (PwMS vs. healthy participants) and time (begin, mid, end) and the effect of Expanded Disability Status Scale (EDSS) and time were assessed with linear random intercepts models. We found that perturbations seem to be better compensated in healthy participants on a longer time scale based on trunk movements and on a shorter time scale (almost instantaneously) according to the foot kinematics. Therefore, we suggest to consider both sensor location and time scale of LDE when calculating local gait stability in PwMS. Full article

(This article belongs to the Special Issue Inertial Sensors for Clinically Relevant Mobility Outcome Measures)

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Review

Jump to: Research

23 pages, 651 KiB

Open AccessReview

Gait Alteration in Individual with Limb Loss: The Role of Inertial Sensors

by Andrea Demeco, Antonio Frizziero, Christian Nuresi, Giovanni Buccino, Francesco Pisani, Chiara Martini, Ruben Foresti and Cosimo Costantino

Sensors 2023, 23(4), 1880; https://doi.org/10.3390/s23041880 - 7 Feb 2023

Cited by 6 | Viewed by 2550

Abstract

Amputation has a big impact on the functioning of patients, with negative effects on locomotion and dexterity. In this context, inertial measurement units represent a useful tool in clinical practice for motion analysis, and in the development of personalized aids to improve a [...] Read more.

Amputation has a big impact on the functioning of patients, with negative effects on locomotion and dexterity. In this context, inertial measurement units represent a useful tool in clinical practice for motion analysis, and in the development of personalized aids to improve a patient’s function. To date, there is still a gap of knowledge in the scientific literature on the application of inertial sensors in amputee patients. Thus, the aim of this narrative review was to collect the current knowledge on this topic and stimulate the publication of further research. Pubmed, Embase, Scopus, and Cochrane Library publications were screened until November 2022 to identify eligible studies. Out of 444 results, we selected 26 articles focused on movement analysis, risk of falls, energy expenditure, and the development of sensor-integrated prostheses. The results showed that the use of inertial sensors has the potential to improve the quality of life of patients with prostheses, increasing patient safety through the detection of gait alteration; enhancing the socio-occupational reintegration through the development of highly technologic and personalized prosthesis; and by monitoring the patients during daily life to plan a tailored rehabilitation program. Full article

(This article belongs to the Special Issue Inertial Sensors for Clinically Relevant Mobility Outcome Measures)

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