C linical assessment of gait and functional mobility in Italian healthy and cognitively impaired older persons using wea
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ORIGINAL ARTICLE
Clinical assessment of gait and functional mobility in Italian healthy and cognitively impaired older persons using wearable inertial sensors Ilaria Mulas1 · Valeria Putzu2 · Gesuina Asoni2 · Daniela Viale2 · Irene Mameli2 · Massimiliano Pau1 Received: 25 June 2020 / Accepted: 9 September 2020 © The Author(s) 2020
Abstract Aim The main purpose of the present study was to verify the feasibility of wearable inertial sensors (IMUs) in a clinical setting to screen gait and functional mobility in Italian older persons. In particular, we intended to verify the capability of IMUs to discriminate individuals with and without cognitive impairments and assess the existence of significant correlations between mobility parameters extracted by processing trunk accelerations and cognitive status. Methods This is a cross-sectional study performed on 213 adults aged over 65 years (mean age 77.0 ± 5.4; 62% female) who underwent cognitive assessment (through Addenbrooke’s Cognitive Examination Revised, ACE-R) instrumental gait analysis and the Timed Up and Go (TUG) test carried out using a wearable IMU located in the lower back. Results Individuals with cognitive impairments exhibit a peculiar gait pattern, characterized by significant reduction of speed (− 34% vs. healthy individuals), stride length (− 28%), cadence (− 9%), and increase in double support duration (+ 11%). Slight, but significant changes in stance and swing phase duration were also detected. Poorer performances in presence of cognitive impairment were observed in terms of functional mobility as overall and sub-phase TUG times resulted significantly higher with respect to healthy individuals (overall time, + 38%, sub-phases times ranging from + 22 to + 34%), although with some difference associated with age. The severity of mobility alterations was found moderately to strongly correlated with the ACE-R score (Spearman’s rho = 0.58 vs. gait speed, 0.54 vs. stride length, 0.66 vs. overall TUG time). Conclusion The findings obtained in the present study suggest that wearable IMUs appear to be an effective solution for the clinical assessment of mobility parameters of older persons screened for cognitive impairments within a clinical setting. They may represent a useful tool for the clinician in verifying the effectiveness of interventions to alleviate the impact of mobility limitations on daily life in cognitively impaired individuals. Keywords Gait · Timed-up-and-go (TUG) · Functional mobility · Older adults · Accelerometer · Inertial measurement unit (IMU)
Introduction The progressive loss of ambulation and functional mobility performance of humans is a physiologic consequence of aging mainly due to reductions in muscle strength and * Massimiliano Pau [email protected] 1
Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Piazza d’Armi, 09123 Cagliari, Italy
Center for Cognitive Disorders and Dementia, Geriatric Unit SS. Trinità Hospital, Via Romagna 16, 09127 Cagliari, Italy
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