Identification of stair climbing ability levels in community-dwelling older adults based on the geometric mean of stair ascent and descent speed: The GeMSS classifier.

The aim was to develop a quantitative approach to identify three stair-climbing ability levels of older adults: no, somewhat and considerable difficulty. Timed-up-and-go test, six-minute-walk test, and Berg balance scale were used for statistical comparison to a new stair climbing ability classifier based on the geometric mean of stair speeds (GeMSS) in ascent and descent on a flight of eight stairs with a 28° pitch in the housing unit where the participants, 28 (16 women) urban older adults (62-94 years), lived. Ordinal logistic regression revealed the thresholds between the three ability levels for each functional test were more stringent than thresholds found in the literature to classify walking ability levels. Though a small study, the intermediate classifier shows promise of early identification of difficulties with stairs, in order to make timely preventative interventions. Further studies are necessary to obtain scaling factors for stairs with other pitches.

Exploring the use of sensors to measure behavioral interactions: an experimental evaluation of using hand trajectories.

Humans appear to be sensitive to relative small changes in their surroundings. These changes are often initially perceived as irrelevant, but they can cause significant changes in behavior. However, how exactly people's behavior changes is often hard to quantify. A reliable and valid tool is needed in order to address such a question, ideally measuring an important point of interaction, such as the hand. Wearable-body-sensor systems can be used to obtain valuable, behavioral information. These systems are particularly useful for assessing functional interactions that occur between the endpoints of the upper limbs and our surroundings. A new method is explored that consists of computing hand position using a wearable sensor system and validating it against a gold standard reference measurement (optical tracking device). Initial outcomes related well to the gold standard measurements (r = 0.81) showing an acceptable average root mean square error of 0.09 meters. Subsequently, the use of this approach was further investigated by measuring differences in motor behavior, in response to a changing environment. Three subjects were asked to perform a water pouring task with three slightly different containers. Wavelet analysis was introduced to assess how motor consistency was affected by these small environmental changes. Results showed that the behavioral motor adjustments to a variable environment could be assessed by applying wavelet coherence techniques. Applying these procedures in everyday life, combined with correct research methodologies, can assist in quantifying how environmental changes can cause alterations in our motor behavior.

The effect of neutral-cushioned running shoes on the intra-articular force in the haemophilic ankle.

BACKGROUND: The ankle continues to be one of the most affected joints in the haemophilia patient, and as cartilage damage progresses, the joint can feel unstable, painful and stiff. Anecdotally, patients often report that sports trainers can improve their pain and daily function, however the actual mechanism for this remains unclear. METHODS: Nine patients with ankle haemarthropathy and three controls were examined using 'CODAmotion' analysis and a force plate. Kinematic and kinetic variables of the hip, knee and ankle were recorded. Data was imported from CODA to Excel, where a programme using 2D modelling of the ankle joint forces was employed. This calculated intra-articular force from heel strike to toe-off. FINDINGS: The haemophilia group at midstance showed an increase in intra-articular force in the ankle when wearing the trainer compared to the shoe (P=<0.05). Overall the haemophilia cohort had an increased joint force in both the trainers and shoes, compared to controls. INTERPRETATION: The type of footwear worn by individuals with ankle arthropathy has a significant effect on the amount of force acting at the joint surface. Sports shoes, in providing better comfort and foot support, may facilitate an increased muscular activity around the ankle and therefore improved dynamic joint stability, accounting for why some patients with ankle arthropathy report less pain. Further research is needed to establish levels of acceptable force and the combined effects of orthotics and footwear.

Using a body sensor network to measure the effect of fatigue on stair climbing performance.

In terms of self-rated health, the most important activities of daily living are those involving mobility. Of these activities stair climbing is regarded as the most strenuous. A loss of stair climbing ability with age is normally associated with a loss of muscle strength and power, while other factors that influence muscle function, such as fatigue, are often not taken into account. So far no research has been published on how long-lasting fatigue affects activities of daily living, despite the fact that it has been repeatedly proven, in laboratory settings, to influence muscle force production over long periods of time. Technological advances in body sensor networks (BSNs) now provide a method to measure performance during complex real-life situations. In this study the use of a BSN was explored to investigate the effects of long-lasting fatigue on stair climbing performance in 20 healthy adults. Stair climbing performance was measured before and after a fatiguing protocol using a BSN. Performance was defined by temporal and spatial parameters. Long-lasting fatigue was successfully induced in all participants using an exercise protocol. The BSN showed that post-exercise fatigue did not influence stair climbing times (p > 0.2) and no meaningful changes in joint angles were found. No effect on overall stair climbing performance was found, despite a clear presence of long-lasting fatigue. This study shows that physiological paradigms can be further explored using BSNs. Ecological validity of lab-based measurements can be increased by combining them with BSNs.

A portable system for collecting anatomical joint angles during stair ascent: a comparison with an optical tracking device.

BACKGROUND: Assessments of stair climbing in real-life situations using an optical tracking system are lacking, as it is difficult to adapt the system for use in and around full flights of stairs. Alternatively, a portable system that consists of inertial measurement units (IMUs) can be used to collect anatomical joint angles during stair ascent. The purpose of this study was to compare the anatomical joint angles obtained by IMUs to those calculated from position data of an optical tracking device. METHODS: Anatomical joint angles of the thigh, knee and ankle, obtained using IMUs and an optical tracking device, were compared for fourteen healthy subjects. Joint kinematics obtained with the two measurement devices were evaluated by calculating the root mean square error (RMSE) and by calculating a two-tailed Pearson product-moment correlation coefficient (r) between the two signals. RESULTS: Strong mean correlations (range 0.93 to 0.99) were found for the angles between the two measurement devices, as well as an average root mean square error (RMSE) of 4 degrees over all the joint angles, showing that the IMUs are a satisfactory system for measuring anatomical joint angles. CONCLUSION: These highly portable body-worn inertial sensors can be used by clinicians and researchers alike, to accurately collect data during stair climbing in complex real-life situations.

Standing balance evaluation using a triaxial accelerometer.

This paper presents a new inherently triaxial accelerometer-based system for determining the ability to maintain balance while standing. In this study, the accelerometer was placed at the back of the subject at the approximate height of the centre of mass. The data were processed to obtain five performance parameters. Paired t-tests indicated that the accelerometer measurements were able to distinguish between the different test conditions as well as or better than simultaneous AMTI force platform measurements (P < or = 0.05). The accelerometer system is fully portable, independent of inclination in space, low-cost and allows long term measurements of standing balance.

Accelerometer and rate gyroscope measurement of kinematics: an inexpensive alternative to optical motion analysis systems.

A general-purpose system to obtain the kinematics of gait in the sagittal plane based on body-mounted sensors was developed. It consisted of four uniaxial seismic accelerometers and one rate gyroscope per body segment. Tests were done with 10 young healthy volunteers, walking at five different speeds on a treadmill. In order to study the system's accuracy, measurements were made with an optic, passive-marker system and the body-mounted system, simultaneously. In all the comparison cases, the curves obtained from the two systems were very close, showing root mean square errors representing <7% full range in 75% of the cases (overall mean 6.64%, standard deviation 4.13%) and high coefficients of multiple correlation in 100% of cases (overall mean 0.9812, standard deviation 0.02). Calibration of the body-mounted system is done against gravity. The body-mounted sensors do not hinder natural movement. The calculation algorithms are computationally demanding and only are applicable off-line. The body-mounted sensors are accurate, inexpensive and portable and allow long-term recordings in clinical, sport and ergonomics settings.