bluuebunny/crossref_metadata_2025_split huggingface dataset:
06 Development of Indexes Derived from Lower Trunk Angular Velocity During Modify Sit-to-Stand Test in the Community Elderly
Authors: Shota Koyama , Tsuyoshi Asai , Kensuke Oshima , Yoshihiro Fukumoto , Hiroki Kubo 
Published: December 2019

Abstract

Background
The sit-to-stand test (STS) is a representative motor test. In most of STS, the time taken to complete the test was used as its score, and its quality of motion has not been focused. In the present study, we measured the lower trunk angular velocity using gyro sensor during STS and computed the angular velocity-based indices (AV-index). We investigated its test-retest reliability and concurrent validity.

Method
Seventy-eight older people in community-dwelling were participated. Basic-health-related-information and the previous one-year fall-history were obtained by a questionnaire. As motor-function tests, One Leg Standing test (OLS), 3 minutes walking test (3MWT), Timed Up and Go test (TUG) were performed. Additionally, Modify Five-Times-STS was performed twice, the lower trunk angular velocity during the tests were measured using gyro sensor. From the obtained-signal waveforms in the sagittal plane (SP), root mean square (RMS) and coefficient of auto correlation (AC), the mean impact at sitting timing (STS impact) in Modify Five-Times-STS were computed. The intra-class correlation coefficient (ICC) was calculated for the test-retest reliability of the AV-indices. The coefficients of Pearson’s correlation were computed between AV-indices and the Five-Times-STS score, and scores of motor-function tests.

Result
The ICC of STS impact and RMS in SP were 0.85. The ICC of the other AV-index were lower than 0.5. The RMS in SP was significantly associated with OLS (r = 0.24), and 3MWT (r = 0.36), TUG (r = −0.32). Additionally, the STS impact was significantly associated with 3MWT (r = 0.54).

Conclusions
The test-retest reliability of two AV-index (STS impact and RMS in SP) is good. The concurrent validity of AV-index is partly confirmed.
101 Younger and Older Inpatient Fallers: What’s the Difference?
Authors: Pok Wen Kin Alan , Chong Gar Mit 
Published: December 2019

Abstract

Background
Falls are in important adverse event occurring in patients admitted to hospital, with potentially devastating consequences. An effective prevention and intervention programme may be devised by looking at the characteristics of falls in an institution.

Objective
To identify the differences between falls in older and younger patients in the medical wards of a tertiary hospital.

Methods
This is a retrospective cross-sectional study of data collected from the hospital Incidence Reporting system and Falls Intervention Team, looking at patients who had fallen in the Hospital Kuala Lumpur Medical Wards from January 2015 until December 2019. Parameters were codified as: patient age [young (≤50), pre-old (51-60), old (&gt;60)], sex, mental status pre-fall (alert, confused, drowsy), nursing shift where the fall occurred (morning, afternoon, night), time of week (weekday, weekend), location of fall (toilet, bedside, walkway, others), activity pre-fall (toileting, transferring, physiotherapy, sitting, walking, others) and injury sustained (major, minor, none). Data analysis was performed using the Chi-square test with SPSS v22.

Results
There were 457 inpatient fallers during the study period. Most of the fallers were old (57.3%), whilst 18.3% were pre-old and 24.6% were young. 62.8% fallers were male, and there were significantly more male fallers at all age groups (p 0.028). There was no significant difference between the age groups with regards to nursing shift (p 0.319), time of week (p 0.461), site (p 0.216), activity (p 0.457), mental status (p 0.479) nor injury (p 0.632).

Conclusion
Most fallers were old and male, but there was no significant difference between the circumstances and characteristics of falls between older and younger inpatients. This suggests that falls prevention and intervention measures may be applied generally to all age groups.

References
Cameron ID et al. Interventions for preventing falls in older people in nursing care facilities and hospitals. Cochrane Database 2010.
103 Physical Performance among Community-Dwelling Older People in Senawang
Authors: Ibrahim Amirah Fatin , Teoh Gaik Kin , Chong Mei Chan , Tan Maw Pin , Muda Siti Mariam , Khoo Phaik Lin 
Published: December 2019

Abstract

Introduction
Older adults may remove themselves voluntarily from social activities due to health concerns and physical limitations that leads to loneliness. Additionally, loneliness is associated with poorer health among older adults. Therefore, this study aims to improve health status among community-dwelling older adults in the sub-urban area through this social participation project by creating awareness on empowering the older adults in managing their health and social life.

Methods
This is a community-based participatory research (CBPR) applying both quantitative and qualitative approaches. Quantitative data was obtained with a standardized data collection document and obtained during a series of health screening programs. The data was analyzed using descriptive statistics.

Key results
87 older adults participated in two health screening events. The mean age was 66 ± 6.5 (SD) years, median BMI was 26.5 (IQR=6.4), mean systolic blood pressure was 141 ± 14.6 (SD) mmHg, median diastolic blood pressure was 78 (IQR=10) mmHg, median timed up and go was 10 (IQR=3) seconds, median trail-making test A was 45.8 (IQR=24.4) seconds, median trail-making test B was 115.8 (IQR=99.3) seconds. The mean hand grip strength for male was 30.76 ± 5.1 (SD) kg for right hand and 31.87 ± 24.5 (SD) kg for left hand. The mean hand grip strength for female was 18.40 ± 5.1 (SD) kg for right hand and 17.14 ± 5.0 (SD) kg for left hand.

Discussion
The results may represent a portion of community-dwelling older adults who are actively engage in community activities such as religious classes, weddings or events. Therefore, the results showed normal values for all physical and mental tests. However, 61% of the participants were overweight or obese and had higher mean systolic blood pressure suggesting the need for more education and awareness on health management.
109 Thai Traditional Game-Based Exercise for Gait and Balance of People with Parkinson's Disease
Authors: Khongprasert Surasa 
Published: December 2019

Abstract
Falls and recurrent falls are serious complications for people with PD. Poor standing balance, impaired ambulation, impaired lower-limb motor planning, postural instability and falling in previous year are associated with falling in PD. Exercise based computer game (Exergaming) have been used for motor rehabilitation to promote gait and balance and can encourage therapeutic activity. However, many commercially available games are not affordable for some people with Parkinson ’s disease. The aim of this study was to evaluate the effectiveness of Thai Traditional game (TTG) based exercise on gait and balance in people with Parkinson ’s disease. A total of 22 participants with PD (mild –moderate severity) were randomly assigned to either a TTG group or a control group. Participants in TTG completed 1 hour, 3 sessions a week for 10 weeks. The TTG comprises 10 games involved instruction in sit to standing, slow and fast walking speed, turning, weight shifting, reaching, obstacle stepping, cognition, clapping and singing. Gait and balance were assessed before and after the training sessions. Measures included the Berg Balance Scale (BBS), Balance platform, Timed Up and Go (TUG) and The GaitRite walkway. Participants in TTG groups showed significantly improved BBS, TUG, gait velocity and sagittal mean sway with eyes open (p &lt;0.05). Thai Traditional Game based exercise incorporated therapeutic movement could lead improvement in gait and balance and participants seem to enjoy playing as an activity while maintaining their functionality. Future studies should incorporate larger groups and focus on long-term compliance and follow-up.
110 Lower Hand Grip Strength Influences Falls Risk in Malaysians Aged 55 and above with Diabetes
Authors: Mat Sumaiyah Mat , Kamaruzzaman Shahrul Bahyah , Chin Ai-Vyrn , Tan Maw Pin 
Published: December 2019

Abstract

Background
Diabetes mellitus (DM) is a highly prevalent NCD affecting 20-30% of worldwide population with a rapidly rising prevalence in LMICs. It has been suggested that DM is one of the important risk factors for falls in older people attributed to complications. However, only a handful studies has evaluated the mechanisms of falls in diabetes.

Aim
To determine the potential mediating factors for falls individuals with diabetes mellitus

Methods
Cross-sectional analysis was conducted using the Malaysian Elders Longitudinal Study (MELoR) first wave data. The MELoR study recruited Klang Valley residents aged &gt;55 years. DM was defined as fasting hyperglycaemia (serum fasting glucose &gt; 6.66 mmol/l) or HbA1c &gt; 42 mmol/mol (6.1%) or self-reported diabetes by participants or consumption of hypoglycaemic medications. Falls were identified by enquiring about the presence of fall in the past 12 months. Physical measurements obtained were hand grip strength (HGS), timed-up-and-go (TUG) and functional reach.

Result
Of 1579 participants, mean (SD) age 68.85 (7.48) years and 901 (57.1%) female, DM was present in 796 (50.4%) participants while 363 (22.9%) had falls in the past 12months. DM was associated with 35% of increased odds of falls compared to those without DM (odds ratio (95% CI)= 1.35 (1.07-1.71)). The association was remained significant after adjustment of demographic differences, body mass index and TUG. The associations were, however, attenuated after the inclusion of HGS in the model.

Conclusion
Weaker HGS appeared to account for the increased risk of falls in individuals aged 55 ears and above with DM. Reduced HGS is a marker including in the frailty phenotype. It is unclear why HGS rather than TUG, which is a composite measure of gait speed, lower limb girdle and dynamic balance mediated the relationship. A prospective study is required to determine the temporal relation between HGS and falls in diabetes.
117 Study of Development and Validation of the Multi-Sensor based Kiosk Performing Short Physical Performance Battery Automatically
Authors: Jung Heewon , Lim Jae-Young , Park Jihong 
Published: December 2019

Abstract

Background
Short physical performance battery (SPPB) is a well-accepted clinical test to assess vulnerability in older adults. We aimed to develop and validate a multi-sensor based kiosk (e-SPPB kiosk) which can perform automated measurement for SPPB.

Methods
The e-SPPB kiosk was developed to measure 3 components of SPPB of standing balance, gait speed, and chair stand test with embedded sensors and algorithms. Feasibility and reliability of the e-SPPB kiosk was assessed with the manually measured SPPB (m-SPPB) by a physical therapist in participants aged 65 or older recruited from the outpatient rehabilitation clinic of the Seoul National University Bundang Hospital, Seongnam, Korea, from November 2018 to April 2019.

Results
In 34 participants with mean age of 73.6 (standard deviation [SD] 5.4), mean of e-SPPB total score was 10.1 (SD 2.2) and mean of m-SPPB total score was 10.2 (SD 2.3). Concordance between e-SPPB and m-SPPB total score was 0.94 (P&lt;0.001) and agreement by Kappa was 0.65 (P&lt;0.001). Agreements for components of e-SPPB and m-SPPB were 0.68 (P&lt;0.001), 0.73 (P&lt;0.001), 0.92 (P&lt;0.001) for standing balance, gait speed and chair stand test, respectively.

Conclusion
In older adults, physical performance measured by the e-SPPB kiosk correlated to m-SPPB measured by a single physical therapist. In multicenter studies for older people with physical performance as an outcome or selection criterion, e-SPPB kiosk can be used to reduce possible inter-rater variabilities of SPPB.
118 Use of Smart Wearable Devices for Gait Assessment Among Older Chinese
Authors: Zhong Runting , Rau Pei-Luen Patrick 
Published: December 2019

Abstract

Introduction
This study used smart bracelets and smartphones for gait assessment and analysis.

Method
Two hundred and twenty-eight older Chinese (mean age 69.3 ± 7.5 years) participated in this study. Participants wore either a smartphone or smart bracelet on their lower back while performing the gait test. They walked at a comfortable speed, at a comfortable speed and serially subtracting by three, and at a fast speed. This study measured gait parameters including speed, step frequency, acceleration root mean square (RMS), step regularity, symmetry and variability. Older adults were classified into pre-frail and non-frail groups based on the FRAIL SCALE (Kan et al., J Nutr Health Aging, 2008, 12, 29–37). We interviewed twenty-eight participants and three medical professionals and developed a smart app for gait assessment.

Results
It is fast and convenient to use smart wearable devices for gait assessment and analysis. The average speed (1.27m/s) of older Chinese seemed faster compared with older adults from literatures (Capistrant et al., Journal of the American Geriatrics Society, 2014, 62(2), 329-335). Acceleration RMS was correlated with speed (Pearson r = .65–.76, p &lt; .001) and could be a proxy of speed. Pre-frail older adults had significantly decreased speed, RMS, and step regularity compared with non-frail counterparts (ps &lt; .05); step frequency, RMS, regularity, symmetry and variability were significantly different between walking types (ps &lt; .001).
The smart app records gait data of 30 seconds and generate a real-time gait assessment report including step frequency, RMS, regularity, symmetry and variability after the gait test. Overall, the acceptability from older adults is positive with participants indicating the app was easy to use and useful.

Conclusion
The application is a useful tool for older Chinese to track their gait quality in home care.
119 Clinical Decision Support System (CDSS) on Medication-Related Fall Risk: Wishes and Needs of European Physicians
Authors: Ploegmakers Kim , Linn Annemiek , Medlock Stephanie , Van der Velde Nathalie , Van Weert Julia 
Published: December 2019

Abstract

Background
Medication is the second most important cause of falls in older adults, after mobility impairments. Doctors struggle to withdraw Fall Risk Increasing Drugs (FRIDs). They tend to overestimate the beneficial effect of medication and underestimate the risk of side effects. With an online survey we explored if 1) European doctors want digital support during medication review of older fallers by presentation of a personalized fall risk estimation of a patient and 2) what potential barriers and facilitators exist for the use of a Clinical Decision Support System (CDSS) that communicates fall risk.

Methods
We performed online surveys in 10 European countries among 359 European physicians who care for older fallers. 68% of the participants were geriatricians.

Results
88% of physicians would like to receive help with performing a medication review. Barriers for usage that were mentioned most frequently were: technical issues (74%), indicating a reason when overriding an alert (62%) and unclear advice (60%). Most important facilitators were if the system: is beneficial to patient care (75%), is user friendly (74%) and fits into the workflow (66%)

Conclusion
most physicians would like to receive help from a CDSS when performing a medication review. For a successful implementation the barriers and facilitators found must be taken into account during development of the system as well as differences between countries.
122 3OLLIN: APP to Assess the Risk of Falls in Older Adults
Authors: Parra-Rodríguez Lorena 
Published: December 2019

Abstract

Objective
To develop an app for Android smartphones (named 3Ollin) that assess the fall risk through the automated analysis of three physical performance (PP) tests and the history of falls of the participant.

Design
Cross-sectional design.

Setting
Community-dwelling older adults studied at the Functional Evaluation Laboratory at the National Institute of Geriatrics in Mexico.

Participants
Older adults (n=223) living in Mexico City were included. The participants were recruited from groups of pensioners from the National Autonomous University of Mexico, church groups, and other community programs.

Measurements
Data were collected about demographics, comorbidities, cognitive status, nutritional status, dependency and PP variables. The 3Ollin app evaluates the PP of the participants through the history of falls, the Timed Up and Go, the 30-second chair stand, and the 4-stage balance tests. The app incorporates them into the CDC’s Algorithm for Fall Risk Screening, Assessment, and Intervention.

Methods
All participants were evaluated by trained staff. The app has a registration system for users and patients, allows to perform the PP tests, acquires the data from the sensors signals, and sends and stores the information in the server of the National Institute of Geriatrics in Mexico.

Results
The mean age of the studied population was 73.5±7.0 years, 77.6% were women, and 37.2% did not complete the 4-stage balance test. The mean percentage error (MPE) between the gait speed measured through the GAITRite walkway (ms=103.5±26.1 cm/s) and the 3Ollin app (ms=100.0±30.3 cm/s) was 10.7%. The MPE between the number of chair lifts in 30 s according to the evaluator's observations (mCL=15±6 repetitions), and the 3Ollin app (mCL=19±6 repetitions) was 23.4%. Additionally, 87% were correctly classified according to the 3Ollin app.

Conclusions
This design first step of the 3Ollin app probed to offer a valid, efficient, costless performance evaluation, without the need of a laboratory environment.
126 Development of a Falls Prediction Tool for People with Diabetes Mellitus
Authors: Wettasinghe Asha , Dissanayake Dilshani , Allet Lara , Katulanda Prasad , Lord Stephen 
Published: December 2019

Abstract

Introduction
Diabetes mellitus (DM), aging and falls have been recognized as a growing and a challenging triad. Despite many tools to assess risk of falls, they may not be applicable for fall risk assessment in DM patients. The aim of the study was to develop a low- cost tool to predict the faller status of DM people.

Methods
People with DM (n=103) were recruited from diabetic clinics in Sri Lanka. Demographic, neuropathy status, contrast sensitivity (Melbourne Edge test) lower limb (LL) sensation, cognitive functions, fear of falling (Icon-FES), LL strength (maximal isometric quadriceps strength), hand reaction time, balance abilities (postural sway, maximal balance range, coordinated stability, unipedal stand time (UST) and tandem and near tandem standing ability), mobility (Timed up and go test-TUG) and gait parameters were assessed. Falls were prospectively recorded over six months. Data were analyzed using SPSS and STATA with negative binominal regression.

Results
Fall rates were significantly associated with DM symptoms (p=0.001) and examination scores (p=0.026), HbA1c (p=0.012), contrast sensitivity (p=0.033), TUG (p=0.006), quadriceps strength (p=0.015), sway path on floor eyes closed (p=0.002), sway on foam eyes opened (p=0.009), near tandem (p=0.006) and tandem (p=0.008) balance, UST (p=0.027), stride length (p=0.009), TUG times with cognitive task (p=0.007), dual task backward walking (p=0.005). A multivariate negative binomial regression model comprised two significant and independent variables influencing falls: quadriceps strength and tandem balance ability (likelihood ratio Chi square=12.43, p=0.002). For 1kg increase in quadriceps strength fall rates decreased by 0.94% and the presence of poor tandem balance increased fall rates by a factor of 2.48.

Discussion and Conclusion
We identified multiple factors that elucidate why people with DM fall. A simple, easy to use tool comprising two independent risk factors: tests of quadriceps strength and tandem balance ability are suggested as a simple screen for fall risk in this population. Such patients may then warrant further detailed assessment and a tailored intervention.
129 Effects of Physical Capacity, Executive Function, Mental Health and Polypharmacy on Gait and Falls Risks among Older Adults
Authors: Sarashina Eri , Mizukami Katsuyoshi , Begg Rezaul , Nagano Hanatsu 
Published: December 2019

Abstract
Falls prevention is an important healthcare topic in an ageing society due to serious and costly injuries. Gait biomechanics utilising 3D motion capture system can possibly identify fall-prone walking patterns. It is, therefore, important to reveal factors for negative gait changes and higher falls risks. A total of 54 community-dwelling senior citizens undertook a series of examinations: (i) fundamental gait assessment - step length, step width, double support time; (ii) the risk of tripping falls - minimum foot clearance (MFC); (iii) flat-foot contact - foot contact angle; (iv) fundamental physical tests - grip strength, functional reach, one-leg standing; (v) executive function - trail making test-A; (vi) Psychological health - General Health Questionnaire 12; (vii) falls history and (viii) polypharmacy. Pearson’s correlations were computed between gait data and the other potentially related factors. A reduced number of drugs (r = -.353, p &lt; .01) and prolonged one-leg standing i.e. improved balance (r =.333, p &lt; .05) demonstrated interlinks with greater step length, indicating the overall gait health. Step length was also strongly correlated with foot contact angle (r = .537, p &lt; .01), which was further associated with one leg standing (r = .339, &lt; .05). The risk of tripping (MFC) showed interrelations with one leg standing (r = .273, &lt; .05) and functional reach (r = .289, &lt; .05). Furthermore, step width was also correlated with one leg standing (r = -.289, &lt; .05) and functional reach (r = -.278, &lt; .05). Balance control capacity (one leg standing) and flexibility (functional reach) may be, therefore, closely related to gait control and tripping risks. While fundamental physical tests thus adequately reflected gait data, mental health and executive function were not correlated with gait data in the current study. Further investigation with a larger sample size will be required.
134 Reliability and Usability of Step Sensing System on Gait Speed and Stepping Accuracy Measurement: A Preliminary Evaluation
Authors: Jesadaporn Panas , Jayapravitra Yudh , Khumrin Piyapong 
Published: December 2019

Abstract

Background
Falls are the most common cause of injury among older people in Thailand. However, there are no established falls prevention programs in our community. Telehealth is one of the strategies to overcome this unmet need. We have developed the Step Sensing System (SSS) for measuring gait speed and stepping accuracy of multi target stepping task (MTST). This system comprises of the footstep sensing modules, controller box and analyzing computer. SSS records each footfall and compares with an assignment for each walking trail. The results will be sent to a cloud storage which are accessible by web-based and mobile applications. By using this technology, we are able to remotely access falls risk and monitor MTST performance in older people.

Methods
We placed footstep sensing modules under a 6-metre mat, then asked a 32-year-old healthy woman to walk across the mat for 4 trails: usual-pace, faster-pace, usual-pace with 1 assigned target and usual-pace with 2 assigned targets on an alternating sequence. We evaluated the system reliability by comparing gait speed and stepping accuracy on 3rd and 4th trails with video recorded by Intel RealsenseTM Depth Camera (model D415).

Results
SSS and video recording has excellent correlation for gait speed and stepping accuracy measurement (intraclass correlation coefficient [ICC] &gt; 0.99, p value &lt; 0.001). The user satisfaction measured by the System Usability Scale was 70/100.

Conclusions
SSS demonstrated promising results on gait speed and stepping accuracy measurement in controlled environment. For the next step, we plan to increase ability of gait measurement on various parameters and perform the validity assessment in community setting.