Type and Location of Wearable Sensors for Monitoring Falls during Static and Dynamic Tasks in Healthy Elderly: A Review <s> Literature Research Strategy <s> OBJECTIVE: To measure sway velocity during static and dynamic posturography in "normal" older people and to determine which tests best distinguish young from older subjects. SUBJECTS: A sample of 30 young (18-39 years) and 82 community-dwelling older (> 75 years) subjects who reported normal balance underwent a battery of balance tests. MEASUREMENTS: Velocity and frequency of sway, Tinetti gait and balance score, self-reported fear of falling and number of falls. RESULTS: Mean sway velocity and the ratio of high to low frequency sway velocity were significantly increased in older subjects compared with younger subjects for static and dynamic tests with eyes open and with eyes closed. Measures of anterior-posterior sway velocity during angular tilt of the platform with eyes closed best distinguished young from older subjects (almost three-fourths of older subjects had values greater than 2 standard deviations from the young normal mean). Older subjects who reported falls in the past year did not have a significantly higher sway velocity on static or dynamic tests compared with those who did not report falls. However, subjects who reported a fear of falling had significantly higher sway velocity on dynamic tests with eyes closed compared to those who did not report a fear of falling. CONCLUSIONS: On average, velocity of sway is higher in older subjects compared with younger subjects, and the difference between young and old is greater with dynamic posturography than with static posturography. Language: en <s> BIB001 </s> Type and Location of Wearable Sensors for Monitoring Falls during Static and Dynamic Tasks in Healthy Elderly: A Review <s> Literature Research Strategy <s> BACKGROUND AND PURPOSE ::: This study examined the sensitivity and specificity of the Timed Up & Go Test (TUG) under single-task versus dual-task conditions for identifying elderly individuals who are prone to falling. ::: ::: ::: SUBJECTS ::: Fifteen older adults with no history of falls (mean age=78 years, SD=6, range=65-85) and 15 older adults with a history of 2 or more falls in the previous 6 months (mean age=86.2 years, SD=6, range=76-95) participated. ::: ::: ::: METHODS ::: Time taken to complete the TUG under 3 conditions (TUG, TUG with a subtraction task [TUGcognitive], and TUG while carrying a full cup of water [TUGmanual]) was measured. A multivariate analysis of variance and discriminant function and logistic regression analyses were performed. ::: ::: ::: RESULTS ::: The TUG was found to be a sensitive (sensitivity=87%) and specific (specificity=87%) measure for identifying elderly individuals who are prone to falls. For both groups of older adults, simultaneous performance of an additional task increased the time taken to complete the TUG, with the greatest effect in the older adults with a history of falls. The TUG scores with or without an additional task (cognitive or manual) were equivalent with respect to identifying fallers and nonfallers. ::: ::: ::: CONCLUSION AND DISCUSSION ::: The results suggest that the TUG is a sensitive and specific measure for identifying community-dwelling adults who are at risk for falls. The ability to predict falls is not enhanced by adding a secondary task when performing the TUG. <s> BIB002 </s> Type and Location of Wearable Sensors for Monitoring Falls during Static and Dynamic Tasks in Healthy Elderly: A Review <s> Literature Research Strategy <s> Rapid technological advances have prompted the development of a wide range of telemonitoring systems to enable the prevention, early diagnosis and management, of chronic conditions. Remote monitoring can reduce the amount of recurring admissions to hospital, facilitate more efficient clinical visits with objective results, and may reduce the length of a hospital stay for individuals who are living at home. Telemonitoring can also be applied on a long-term basis to elderly persons to detect gradual deterioration in their health status, which may imply a reduction in their ability to live independently. Mobility is a good indicator of health status and thus by monitoring mobility, clinicians may assess the health status of elderly persons. This article reviews the architecture of health smart home, wearable, and combination systems for the remote monitoring of the mobility of elderly persons as a mechanism of assessing the health status of elderly persons while in their own living environment. <s> BIB003 </s> Type and Location of Wearable Sensors for Monitoring Falls during Static and Dynamic Tasks in Healthy Elderly: A Review <s> Literature Research Strategy <s> BACKGROUND ::: A poor postural stability in older people is associated with an increased risk of falling. The posturographic tool has widely been used to assess balance control; however, its value in predicting falls remains unclear. ::: ::: ::: OBJECTIVE ::: The purpose of this prospective study was to determine the predictive value of posturography in the estimation of the risk of recurrent falls, including a comparison with standard clinical balance tests, in healthy non-institutionalized persons aged over 65. ::: ::: ::: METHODS ::: Two hundred and six healthy non-institutionalized volunteers aged over 65 were tested. Postural control was evaluated by posturographic tests, performed on static, dynamic and dynamized platforms (static test, slow dynamic test and Sensory Organization Test [SOT]) and clinical balance tests (Timed 'Up & Go' test, One-Leg Balance, Sit-to-Stand-test). Subsequent falls were monitored prospectively with self-questionnaire sent every 4 months for a period of 16 months after the balance testing. Subjects were classified prospectively in three groups of Non-Fallers (0 fall), Single-Fallers (1 fall) and Multi-Fallers (more than 2 falls). ::: ::: ::: RESULTS ::: Loss of balance during the last trial of the SOT sensory conflicting condition, when visual and somatosensory inputs were distorted, was the best factor to predict the risk of recurrent falls (OR = 3.6, 95% CI = 1.3-10.11). Multi-Fallers showed no postural adaptation during the repetitive trials of this sensory condition, contrary to Non-Fallers and Single-Fallers. The Multi-Fallers showed significantly more sway when visual inputs were occluded. The clinical balance tests, the static test and the slow dynamic test revealed no significant differences between the groups. ::: ::: ::: CONCLUSION ::: In a sample of non-institutionalized older persons aged over 65, posturographic evaluation by the SOT, especially with repetition of the same task in sensory conflicting condition, compared to the clinical tests and the static and dynamic posturographic test, appears to be a more sensitive tool to identify those at high-risk of recurrent falls. <s> BIB004 </s> Type and Location of Wearable Sensors for Monitoring Falls during Static and Dynamic Tasks in Healthy Elderly: A Review <s> Literature Research Strategy <s> OBJECTIVE ::: To describe the relationship between Sensory Organization Test (SOT) scores and reported falls in persons with vestibular and balance disorders. ::: ::: ::: DESIGN ::: Descriptive cross-sectional. ::: ::: ::: SETTING ::: Outpatient tertiary balance and falls clinic. ::: ::: ::: PARTICIPANTS ::: One hundred physical therapy (PT) charts of people referred to a balance and falls clinic were reviewed. Criteria for inclusion were that the patients had completed the SOT of computerized dynamic posturography (CDP), had a vestibular diagnosis, and had the numbers of falls recorded from patient report within the last 6 months at the initial examination. Rotational chair, caloric testing, oculomotor test, and Activities-Specific Balance Confidence (ABC) results were recorded, if available. ::: ::: ::: INTERVENTIONS ::: Not applicable. ::: ::: ::: MAIN OUTCOME MEASURES ::: The SOT composite and ABC scores as they related to reports of falls in the last 6 months. ::: ::: ::: RESULTS ::: The overall proportion of persons with vestibular disorders with positive 6-month history for 1 or more falls was 30% and for recurrent falls (>/=2) was 17%. Vestibular laboratory findings, age, sex, and vestibular diagnosis were not related to reported falls status. Patients who reported multiple falls prior to the PT examination had lower SOT composite scores than patients who reported 1 or no falls in the previous 6 months. The receiver operating characteristic curve identified a composite SOT score of less than 38 as demonstrating the highest likelihood ratio for differentiating between those people who reported no falls in the past 6 months and those who reported 2 or more falls. ::: ::: ::: CONCLUSIONS ::: Persons who are recurrent fallers perform worse on SOT than either nonfallers or 1-time fallers. CDP performance can help guide the clinician in the development of a safe exercise program. <s> BIB005 </s> Type and Location of Wearable Sensors for Monitoring Falls during Static and Dynamic Tasks in Healthy Elderly: A Review <s> Literature Research Strategy <s> AIM: To determine whether elderly subjects with distinct histories of falls presented differences concerning the influence of sensory interaction on balance. METHODS: Cross-sectional research. Ninety-six community-dwelling elderly subjects were divided into three groups, according to the history of falls within the past year (group 1, no falls; group 2, one fall; and group 3, recurrent falls). The Clinical Test of Sensory Interaction and Balance was used to evaluate the influence of sensory inputs on standing balance. The test required the subject to maintain stability during 30 s, under six conditions: (i) firm surface with eyes open; (ii) firm surface with eyes closed; (iii) firm surface with visual conflict; (iv) unstable surface with eyes open; (v) unstable surface with eyes closed; and (vi) unstable surface with visual conflict. The time expended on conditions and the number of abnormal cases were compared between groups. Each group was evaluated in relation to its performance in the progression of conditions. RESULTS: More abnormal cases occurred in group 3 compared to group 1 for conditions (iv) and (v); and compared to group 2 for condition (iv). Group 3 remained less time than group 1 under conditions (iv), (v) and (vi). Groups 1, 2 and 3 presented relevant decrements in trial duration from conditions (iv) to (v). For group 3, a significant decay was also noted from condition (i) to (ii). CONCLUSION: Sensorial interaction in the elderly varies according to their history of falls. Thus, it is possible to correctly guide the rehabilitation process and to prevent sensorial decays according to an individual's history of falls. Language: en <s> BIB006 </s> Type and Location of Wearable Sensors for Monitoring Falls during Static and Dynamic Tasks in Healthy Elderly: A Review <s> Literature Research Strategy <s> Active control of trunk motion is believed to enable humans to maintain stability during walking, suggesting that stability of the trunk is prioritized over other segments by the nervous system. We investigated if superior segments are more stable than inferior segments during walking and if age-related differences are more prominent in any particular body segments. Eighteen healthy older adults and 17 healthy young adults walked on a treadmill for two trials of 5 min each at their preferred speed. 3D kinematics of the trunk, pelvis, and left thigh, shank, and foot were recorded. Local divergence exponents and maximum Floquet multipliers (FM) were calculated to quantify each segment's responses to small inherent perturbations during walking. Both older and younger adults walked with similar preferred walking speeds (p = 0.86). Local divergence exponents were larger in inferior segments (p < 0.001), and larger in older adults (p < 0.001). FM was larger in the superior segments (p < 0.001), and larger in older adults (p < 0.001). The age-associated difference in local divergence exponents was larger for trunk motion (interaction p = 0.02). Thus, superior segments exhibited less local instability but greater orbital instability. Trunk motion was more sensitive to age-associated differences in dynamic stability during gait. Trunk motion should be considered in studying age-related deterioration of gait. <s> BIB007 </s> Type and Location of Wearable Sensors for Monitoring Falls during Static and Dynamic Tasks in Healthy Elderly: A Review <s> Literature Research Strategy <s> Falls not only present a considerable health threat, but the resulting treatment and loss of working days also place a heavy economic burden on society. Gait instability is a major fall risk factor, particularly in geriatric patients, and walking is one of the most frequent dynamic activities of daily living. To allow preventive strategies to become effective, it is therefore imperative to identify individuals with an unstable gait. Assessment of dynamic stability and gait variability via biomechanical measures of foot kinematics provides a viable option for quantitative evaluation of gait stability, but the ability of these methods to predict falls has generally not been assessed. Although various methods for assessing gait stability exist, their sensitivity and applicability in a clinical setting, as well as their cost-effectiveness, need verification. The objective of this systematic review was therefore to evaluate the sensitivity of biomechanical measures that quantify gait stability among elderly individuals and to evaluate the cost of measurement instrumentation required for application in a clinical setting. To assess gait stability, a comparative effect size (Cohen's d) analysis of variability and dynamic stability of foot trajectories during level walking was performed on 29 of an initial yield of 9889 articles from four electronic databases. The results of this survey demonstrate that linear variability of temporal measures of swing and stance was most capable of distinguishing between fallers and non-fallers, whereas step width and stride velocity prove more capable of discriminating between old versus young (OY) adults. In addition, while orbital stability measures (Floquet multipliers) applied to gait have been shown to distinguish between both elderly fallers and non-fallers as well as between young and old adults, local stability measures (λs) have been able to distinguish between young and old adults. Both linear and nonlinear measures of foot time series during gait seem to hold predictive ability in distinguishing healthy from fall-prone elderly adults. In conclusion, biomechanical measurements offer promise for identifying individuals at risk of falling and can be obtained with relatively low-cost tools. Incorporation of the most promising measures in combined retrospective and prospective studies for understanding fall risk and designing preventive strategies is warranted. <s> BIB008 </s> Type and Location of Wearable Sensors for Monitoring Falls during Static and Dynamic Tasks in Healthy Elderly: A Review <s> Literature Research Strategy <s> Characteristics of physical movements are indicative of infants' neuro-motor development and brain dysfunction. For instance, infant seizure, a clinical signal of brain dysfunction, could be identified and predicted by monitoring its physical movements. With the advance of wearable sensor technology, including the miniaturization of sensors, and the increasing broad application of micro- and nanotechnology, and smart fabrics in wearable sensor systems, it is now possible to collect, store, and process multimodal signal data of infant movements in a more efficient, more comfortable, and non-intrusive way. This review aims to depict the state-of-the-art of wearable sensor systems for infant movement monitoring. We also discuss its clinical significance and the aspect of system design. <s> BIB009
The aim of the manuscript is to provide an overview of the type and location of wearable sensors for the monitoring and assessment of falls during static and dynamic tasks (i.e., walking and standing) in healthy elderly people BIB003   . For this purpose, a bibliographical research on the most important scientific publication databases was performed. In particular, an approach similar to the one proposed in BIB009 in case of the newborns has been followed. We focused on IEEE Xplore, SpringerLink, Science Direct and PubMed databases. Articles related to both dynamic and static stability analysis have been taken into account, since, as previously reported, there is a close relationship between falls and static (i.e.,  BIB001 BIB004 BIB005 BIB006 ) or dynamic (i.e., BIB008  BIB002  BIB007 ) tasks. In order to perform this research, the set of keywords previously introduced has been applied. Figure 1 illustrates the flow chart of the selection process. The key point is represented by the AND block, which merges the other peripheral branches, in which each word is related to its synonyms by means of an OR condition. By doing so, the research is carried out via the intersection of at least one word per each peripheral block, otherwise the result of the query is null.