Novel Digital Gait Kinematic Solution to Improve Frailty

  • Geraldine Rodgers
  • Anne Mottley
  • Diana Hodgins
Keywords: Digital, Gait, Falls, Frailty, Intervention

Abstract

Introduction: Frailty effects a person’s health and correlates with mobility and falls.  Intervention studies that focus on exercise have demonstrated improved mobility and functional ability in some frailty groups.  This study tested a personalised intervention programme automatically generated from digital gait data on frail older people under the care of the North East London Foundation Trust, Community Hospital setting.

Methods: One hundred and twenty one people, average age 79, who suffered an injurious fall and were under the care of the Community Hospital, completed the personalised intervention programme.  Objective gait kinematic data, obtained using GaitSmartTM automatically generated a personalised exercise programme. Each participant received four tests, approximately 3 weeks apart and was provided with a copy of their report plus personalised exercises. Frailty was measured using the Edmonton Frailty Scale (EFS), fear of falling was measured using the Falls Efficacy Scale-International (FES-I) and speed was determined from the gait data (GS). 

Results: Five parameters were analysed for all 121 participants at the start and end of the intervention: EFS; FES-I; GS; speed; walking aid. There was a statistically significance between the start and end (p<0.001) for all the parameters.

Conclusion: The results demonstrate that addressing frailty using a digital gait solution that sets exercises based on the gait kinematic data, did reverse frailty.   This four session programme has shown to improve frailty levels and fear of falling.  It also reduced the reliance on walking aids and increased average walking speed from 0.46 to 0.62 m/s.

 

References

(1) Gale C R, Cooper C, Sayer A A. Prevalence of frailty and disability: findings from the English Longitudinal Study of Ageing. Age and Ageing 2015; 44: 162–165

(2) Health at a glance OECD 2017

(3) Clegg A, Young J, Iliffe S, Rikkert M O, Rockwood K. Frailty in older people Lancet. 2013 March 2; 381(9868): 752–762

(4) Buckinx F, Rolland Y, Reginster JY, Ricour C, Petermans J, Bruyère O. Burden of frailty in the elderly population: perspectives for a public health challenge. Archives of Public Health (2015) 73:19

(5) Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56:M146–56.

(6) Theou O, Stathokostas L, Roland KP, Jakobi JM, Patterson C, Vandervoort AA, et al. The effectiveness of exercise interventions for the management of frailty: a systematic review. J Aging Res. 2011;2011:569194.

(7) Clegg A P, Barber S E, Young J B, Forster A. Do home-based exercise interventions improve outcomes for frail older people? Findings from a systematic review Rev Clin Gerontol. 2012 February; 22(1): 68–78

(8) Perna S, Francis M, Bologna C, Moncaglieri F, Riva A, Morazzoni P, Allegrini P, Isu A, Vigo B, Guerriero F, Rondanelli M. Performance of Edmonton Frail Scale on frailty assessment: its association with multi-dimensional geriatric conditions assessed with specific screening tools. BMC Geriatrics (2017) 17:2

(9) Monda M, Goldberg A, Richards R, Smith A, Smitham P, Thornton M, McCarthy I. Use of Inertial Measurement Units to Assess Age-Related Changes in Gait Kinematics in an Active Population. Journal of Aging and Physical Activity, 23: 18-23. 2015

(10) Kempen G, Yardley L, Van Haastregt J, Zijlstra G, Beyer N, Hauer K, Todd C. The Short FES-I: a shortened version of the falls efficacy scale-international to assess fear of falling. Age and Ageing 2008; 37: 45–50.

(11) Campbell A J, Robertson C. Otago exercise programme to prevent falls in older adults. Otago Medical School, University of Otago, March 2003

(12) Tarazona-Santabalbina F J, Gómez-Cabrera M C, Pérez-Ros P, Martínez-Arnau F M, Cabo H, Tsaparas K, Salvador-Pascual A, Rodriguez-Mañas L, Viña J. A Multicomponent Exercise Intervention that Reverses Frailty and Improves Cognition, Emotion, and Social Networking in the Community-Dwelling Frail Elderly: A Randomized Clinical Trial. JAMDA 17 (2016) 426e433

(13) Chan D D, Tsou H, Yang R, Tsauo J, Chen C, Hsiung C A, Kuo K N. A pilot randomized controlled trial to improve geriatric frailty. BMC Geriatrics 2012, 12:58

(14) Fairhall N, Aggar C, Kurrle SE, Sherrington C, Lord S, Lockwood K, Monaghan N, Cameron ID: Frailty Intervention Trial (FIT). BMC Geriatr 2008, 8:27.

(15) Cameron I, Fairhall N, Gill L, Lockwood K, Langron C, Aggar C, Monaghan N, Kurrle S. Clinical Study Developing Interventions for Frailty. Advances in Geriatrics Volume 2015, Article ID 845356

(16) Fairhall N, Sherrington C, Kurrle S, Lord S, Lockwood K, Cameron I. Effect of a multifactorial interdisciplinary intervention on mobility related disability in frail older people: randomised controlled trial. BMC Medicine 2012, 10:120

(17) Abellan Van Kan G, Rolland Y, Andrieu S, Bauer J, Beauchet O, Bonnefoy M, Cesari M, Donini L M, Gillette-Guyonnet S, Inzitari M, Nourhashemi F, Onder G, Ritz P, Salva A, Visser M, Vellas B. Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people. An international academy on nutrition and aging (iana) Task force. The Journal of Nutrition, Health & Aging Volume 13, Number 10, 2009

(18) Perera S, Samir H. Mody S, Woodman R, Studenski S. Meaningful Change and Responsiveness in Common Physical Performance Measures in Older Adults. J Am Geriatr Soc 54:743–749, 2006

(19) Su B, Newson R, Soljak H, Soljak M. Associations between post-operative rehabilitation of hip fracture and outcomes: national database analysis. BMC Musculoskeletal Disorders (2018) 19:211

(20) Arken C L, Lach H W, Birge S J, Miller J P. The Prevalence and Correlates of Fear of Falling in Elderly Persons Living in the Community. American Journal of Public Health, April 1994, Vol 84, No. 4.
Published
2020-10-31
How to Cite
Rodgers, G., Mottley, A., & Hodgins, D. (2020). Novel Digital Gait Kinematic Solution to Improve Frailty . Journal of Biomedical Engineering and Medical Imaging, 7(5), 01-10. https://doi.org/10.14738/jbemi.75.8894