Abstract
Recent studies have reported a greater prevalence of spin turns, which are more unstable than step turns, in older adults compared to young adults in laboratory settings. Currently, turning strategies can only be identified through visual observation, either in-person or through video. This paper presents two unique methods and their combination to remotely monitor turning behavior using three uniaxial gyroscopes. Five young adults performed 90° turns at slow, normal, and fast walking speeds around a variety of obstacles while instrumented with three IMUs (attached on the trunk, left and right shank). Raw data from 360 trials were analyzed. Compared to visual classification, the two IMU methods’ sensitivity/specificity to detecting spin turns were 76.1%/76.7% and 76.1%/84.4%, respectively. When the two methods were combined, the IMU had an overall 86.8% sensitivity and 92.2% specificity, with 89.4%/100% sensitivity/specificity at slow speeds. This combined method can be implemented into wireless fall prevention systems and used to identify increased use of spin turns. This method allows for longitudinal monitoring of turning strategies and allows researchers to test for potential associations between the frequency of spin turns and clinically relevant outcomes (e.g., falls) in non-laboratory settings.
Highlights
Falls in elderly populations constitute a significant economic and healthcare burden, accounting for$7.8 billion USD in 2002 [1] and between $1,000 to $10,000 USD per fall [2]
Falls resulting from slips are more common during turning than straight walking [3] and falls while turning are 7.9 times more likely to result in hip fracture than falls during straight walking [4]
Spin turns are characterized by turning on the ipsilateral limb and step turns are characterized by turning on the contralateral limb
Summary
Falls in elderly populations constitute a significant economic and healthcare burden, accounting for$7.8 billion USD in 2002 [1] and between $1,000 to $10,000 USD per fall [2]. Spin turns are characterized by turning on the ipsilateral limb (e.g., left turn while the left limb is the stance limb) and step turns are characterized by turning on the contralateral limb (e.g., left turn while the right limb is the stance limb) Of these two strategies, spin turns are considered less stable than step turns because the whole-body center-of-mass (COM) remains outside the base-of-support (BOS) for the majority of the stance phase [9,10]. Spin turns are considered less stable than step turns because the whole-body center-of-mass (COM) remains outside the base-of-support (BOS) for the majority of the stance phase [9,10] Because of this COM displacement, one could expect step turns to be more prevalent
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