Inter-limb Coordination Assessment and Fall Risk in ADL
Fall risk assessment research has largely been focused on individual biomechanical measures or assessment in clinical setting. The goal of the study was to evaluate the fall risk from the inertial sensor data from activities of daily living (ADL) based on
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Abstract
Fall risk assessment research has largely been focused on individual biomechanical measures or assessment in clinical setting. The goal of the study was to evaluate the fall risk from the inertial sensor data from activities of daily living (ADL) based on the inter-limb coordination assessment. Eight older adults with higher risk of falling and eight adults with no risk of falling were monitored for one week with hip and wrist sensor node. A one-way analysis of variance and 95% confidence interval were applied to investigate associations between extracted temporal inter-limb coordination measures for these two groups. Results have shown significantly higher asymmetry in lower limbs and between contralateral arm and leg for subjects with higher risk of falling, allowing us to reliably distinguish these two groups.
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Introduction
A leading cause of injuries in older adults is falling, causing a heavy burden on the health care system. Each year, one in every three adults aged over 65 falls [1]. Fall risk factors can be divided into five domains [2]: sociodemographic factors, medical and psychological factors, medication risk factors, mobility factors and sensory risk factors. Epidemiological studies have shown that transitions and walking are main mobility fall risk factors causing 41% and 36% of all falls respectively [3]. Previous studies have investigated mobility factors in terms of variability of biomechanical measures, such as
stride time, walking speed, stride length, stance and swing times and individual joint kinematics [4, 5]. The timing of gait events in the lower limbs is more asymmetric and less stable in older adults [6]. Additionally, gait stability and inter-limb coordination are very well correlated and as such good indicators for falls [7]. Inter-limb coordination primarily involves movements requiring sequential and simultaneous use of both sides of the body with a high degree of rhythmicity. More precisely, it involves the timing of motor cycles of the limbs in relation to one another [8]. Such actions are commonly divided into two categories [9]: bimanual coordination (involves skilled inter-limb coordination of the two arms or legs in a bimanual action) and coordination between hands and feet (involves the simultaneous coupling of the upper and lower limbs). Many previous studies focused only on lower extremities [10], assessed inter-limb coordination using camera based tools [11] or in clinical settings during short periods of time [12, 13]. While camera assessment tools are expensive and subject of privacy concerns, clinical assessments oversimplifies geriatric fall risk, which can be more accurately described with fuzzy boundaries as a multifactorial disorder. Our work focuses on assessment of coordination of upper and lower extremities in terms of fall risk in home environment during ADL using a system of two sensor nodes. A novel approach for inter-limb coordination assessment enables optimization of the number of sensors, thus enabling unobtrusive, user-friendly measurement during
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