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Background: Fall prevention exercise programmes are known to be effective, but access to these programmes is not always possible. The use of eHealth solutions might be a way forward to increase access and reach a wider population. In this feasibility study the aim was to explore the choice of programme, adherence, and self-reported experiences comparing two exercise programmes - a digital programme and a paper booklet.Methods: A participant preference trial of two self-managed fall prevention exercise interventions. Community-dwelling adults aged 70 years and older exercised independently for four months after one introduction meeting. Baseline information was collected at study start, including a short introduction of the exercise programme, a short physical assessment, and completion of questionnaires. During the four months intervention period, participants self-reported their performed exercises in an exercise diary. At a final meeting, questionnaires about their experiences, and post-assessments, were completed. For adherence analyses data from diaries were used and four subgroups for different levels of participation were compared. Exercise maintenance was followed up with a survey 12 months after study start.Results: Sixty-seven participants, with mean age 77 ± 4 years were included, 72% were women. Forty-three percent chose the digital programme. Attrition rate was 17% in the digital programme group and 37% in the paper booklet group (p = .078). In both groups 50-59% reported exercise at least 75% of the intervention period. The only significant difference for adherence was in the subgroup that completed ≥75% of exercise duration, the digital programme users exercised more minutes per week (p = .001). Participants in both groups were content with their programme but digital programme users reported a significantly higher (p = .026) degree of being content, and feeling supported by the programme (p = .044). At 12 months follow-up 67% of participants using the digital programme continued to exercise regularly compared with 35% for the paper booklet (p = .036).Conclusions: Exercise interventions based on either a digital programme or a paper booklet can be used as a self-managed, independent fall prevention programme. There is a similar adherence in both programmes during a 4-month intervention, but the digital programme seems to facilitate long-term maintenance in regular exercise.Trial Registration: ClinTrial: NCT02916849. [ABSTRACT FROM AUTHOR]

Background: The importance of involving members of the public in the development, implementation and dissemination of research is increasingly recognised. There have been calls to share examples of how this can be done, and this paper responds by reporting how professional and lay researchers collaborated on a research study about falls prevention among older patients in English acute hospitals. It focuses on how they worked together in ways that valued all contributions, as envisaged in the UK standards for public involvement for better health and social care research. Methods: The paper is itself an example of working together, having been written by a team of lay and professional researchers. It draws on empirical evidence from evaluations they carried out about the extent to which the study took patient and public perspectives into account, as well as reflective statements they produced as co-authors, which, in turn, contributed to the end-of-project evaluation. Results: Lay contributors' deep involvement in the research had a positive effect on the project and the individuals involved, but there were also difficulties. Positive impacts included lay contributors focusing the project on areas that matter most to patients and their families, improving the quality and relevance of outcomes by contributing to data analysis, and feeling they were 'honouring' their personal experience of the subject of study. Negative impacts included the potential for lay people to feel overwhelmed by the challenges involved in achieving the societal or organisational changes necessary to address research issues, which can cause them to question their rationale for public involvement. Conclusions: The paper concludes with practical recommendations for working together effectively in research. These cover the need to discuss the potential emotional impacts of such work with lay candidates during recruitment and induction and to support lay people with these impacts throughout projects; finding ways to address power imbalances and practical challenges; and tips on facilitating processes within lay groups, especially relational processes like the development of mutual trust. Plain English summary: Involving members of the public in all stages of research as equal partners is a powerful way to make research more relevant. This paper shares an example of such involvement, from a study about falls prevention in English hospitals. Developed by a team of lay people and professional researchers, the paper looks at how we worked together, drawing on evaluations we carried out about how the study took patient and public perspectives into account, and on personal reflections we wrote. Public involvement had a positive effect on the project and the individuals involved, but there were also difficulties. Positive impacts included lay people ensuring the study focused on what mattered most to patients and their families and feeling they had done right by their personal experience of the study's subject. Negative impacts included the potential for people to feel overwhelmed by the changes in organisations or in wider society needed to address the issues being explored by a research study, which could cause them to question why they became involved in the first place. The paper ends with practical recommendations about working together, covering things such as helping lay people with the emotional impact of involvement from the beginning to the end of projects; finding ways to ensure everybody is treated in the same way and solving practical problems; and tips on leading and supporting groups of this kind, especially with personal issues like trusting each other. [ABSTRACT FROM AUTHOR]

Background: Falling is highly prevalent among older adults and has serious impact. Age-induced mobility impairments, such as gait modifications, are strongly associated with increased fall risk. Among fall prevention interventions, those including exercises are most effective. However, there is an urgent need to further improve these kinds of interventions. Strengthening the plantar intrinsic foot muscles might benefit mobility in older adults, which may contribute to the reduction of fall risk. The aim of this paper is to provide a protocol to investigate the effect of a plantar intrinsic foot muscle strengthening training versus no training on gait and intrinsic foot muscle function in older adults who are involved in a functional exercise program. Methods: For this assessor-blinded RCT, older adults (> 65 years) are recruited who are involved in a group-based functional exercise program. Eligibility criteria include: being able to ambulate 10 m barefoot without using a walking aid and reporting to have either fear of falling or experienced a fall in the previous 12 months or have difficulties with mobility, gait, or balance in daily life. Participants are randomly assigned to an intervention and a control group. The intervention group follows a 12-week plantar intrinsic foot muscle strengthening training. The training consists of isolated and functional foot exercises to be performed 5 times a week, each session lasting approximately 20 min. The training is supervised once a week and the intensity gradually increases based on the participant's progression. Both groups keep a diary to report physical activities, fall incidents and movement related discomfort. The control condition is limited to keeping this diary. Data are collected at baseline and post-intervention. The trial outcomes are the between group differences in the mean change from baseline in maximum gait speed (primary outcome measure), capacity and strength of the plantar intrinsic foot muscles, foot and ankle biomechanics during gait, and various other fall risk-related variables. ANCOVA's are used to analyze the trial outcomes. Discussion: The results of this RCT will offer recommendations, related to plantar intrinsic foot muscle strengthening, to existing fall preventive exercise programs. Trial registration: The trial is registered in the United States National Library of Medicine through ClinicalTrials.gov (NCT05531136, 07/26/2022). [ABSTRACT FROM AUTHOR]

With the continuous promotion of smart substations, staff fall detection has become a key issue in automatic detection of substations. The injuries and safety hazards caused by falls among substation personnel are numerous. If a timely response can be made in the event of a fall, the injuries caused by falls can be reduced. In order to address the issues of low accuracy and poor real-time performance in detecting human falls in complex substation scenarios, this paper proposes an improved algorithm based on YOLOX. A customized feature extraction module is introduced to the YOLOX feature fusion network to extract diverse multiscale features. A recursive gated convolutional module is added to the head to enhance the expressive power of the features. Meanwhile, the SIoU(Soft Intersection over Union) loss function is utilized to provide more accurate position information for bounding boxes, thereby improving the model accuracy. Experimental results show that the improved algorithm achieves an mAP value of 78.45%, which is a 1.31% improvement over the original YOLOX. Compared to other similar algorithms, the proposed algorithm achieves high accuracy prediction of human falls with fewer parameters, demonstrating its effectiveness. [ABSTRACT FROM AUTHOR]

Background: Falls are common among older people in long-term care facilities (LTCFs). Falls cause considerable morbidity, mortality and reduced quality of life. Of numerous interventional studies of fall prevention interventions in LTCFs, some reduced falls. However, there are challenges to implementing these interventions in real-world (non-trial) clinical practice, and the implementation techniques may be crucial to successful translation. This systematic review thus aimed to synthesise the evidence on implementation strategies, implementation outcomes and clinical outcomes included in fall prevention intervention studies. Methods: A systematic search of six electronic databases (PubMed, CINAHL, EMBASE, PsycINFO, SCOPUS, Web of Science) and eight grey literature databases was conducted, involving papers published during 2001–2021, in English or Arabic, targeting original empirical studies of fall prevention interventions (experimental and quasi-experimental). Two seminal implementation frameworks guided the categorisation of implementation strategies and outcomes: the Expert Recommendations for Implementing Change (ERIC) Taxonomy and the Implementation Outcomes Framework. Four ERIC sub-categories and three additional implementation strategies were created to clarify overlapping definitions and reflect the implementation approach. Two independent researchers completed title/abstract and full-text screening, quality appraisal assessment, data abstraction and coding of the implementation strategies and outcomes. A narrative synthesis was performed to analyse results. Results: Four thousand three hundred ninety-seven potential papers were identified; 31 papers were included, describing 27 different fall prevention studies. These studies used 39 implementation strategies (3–17 per study). Educational and training strategies were used in almost all (n = 26), followed by evaluative strategies (n = 20) and developing stakeholders' interrelationships (n = 20). Within educational and training strategies, education outreach/meetings (n = 17), distributing educational materials (n = 17) and developing educational materials (n = 13) were the most common, with 36 strategies coded to the ERIC taxonomy. Three strategies were added to allow coding of once-off training, dynamic education and ongoing medical consultation. Among the 15 studies reporting implementation outcomes, fidelity was the most common (n = 8). Conclusion: This is the first study to comprehensively identify the implementation strategies used in falls prevention interventions in LTCFs. Education is the most common implementation strategy used in this setting. This review highlighted that there was poor reporting of the implementation strategies, limited assessment of implementation outcomes, and there was no discernible pattern of implementation strategies used in effective interventions, which should be improved and clearly defined. Trial registration: This systematic review was registered on the PROSPERO database; registration number: CRD42021239604. [ABSTRACT FROM AUTHOR]

In this paper, we construct a model for intelligent detection of lower limb posture fall prevention sensors, conduct an in-depth study of bright clothing for the elderly with smart detection of fall prevention, and design an article of colorful clothing for the elderly based on intelligent detection of lower limb posture fall prevention sensors. In this paper, the overall system scheme is determined according to the application, including the characteristic position of the device to be worn, the establishment of the reference coordinate system, and the setting of the overall system architecture. The data acquisition, transmission, and saving functions are realized, and the two-step extended Kalman filter, complementary filter, and DMP-Kalman filter are used to solve the posture angle of the measured object. The feasibility of the prototype was verified by testing the daily behavioral activity data and fall behavior data of the elderly, and the collected data were processed and analyzed by three data fusion algorithms, which proved the effectiveness of the algorithms, among which the DMP-Kalman filter algorithm has better performance. From the test results, the design of this paper can detect the posture angle of the human body more accurately, which provides a practical reference for fall detection equipment. Using clothing as a carrier, the fall detection and warning module is integrated with clothing to study an article of intelligent clothing for fall detection and warning for the elderly. A core issue in the integration process is the influence of the clothing on the detection module when the human body is moving. The effect of the material and loft of the clothing on the model is studied through experiments. The results of the two indexes, i.e., sensitivity and specificity, of the integrated model and the model not integrated with the clothing are around 98%. The experimental results of the material and loft of the clothing within a specific range have little influence on the model. The final intelligent garment design scheme was determined on this basis. [ABSTRACT FROM AUTHOR]

To evaluate the quality of reporting in published randomized controlled trials (RTCs) in the field of fall injuries. The 188 RTCs published between 2001 and 2011, indexed in EMBASE and Medline databases were extracted through searching by appropriate keywords and EMTree classification terms. The evaluation trustworthiness was assured through parallel evaluations of two experts in epidemiology and biostatistics. About 40%-75% of papers had problems in reporting random allocation method, allocation concealment, random allocation implementation, blinding and similarity among groups, intention to treat and balancing benefits and harms. Moreover, at least 10% of papers inappropriately/not reported the design, protocol violations, sample size justification, subgroup/adjusted analyses, presenting flow diagram, drop outs, recruitment time, baseline data, suitable effect size on outcome, ancillary analyses, limitations and generalizability. Considering the shortcomings found and due to the importance of the RCTs for fall injury prevention programmes, their reporting quality should be improved. [ABSTRACT FROM AUTHOR]

In recent years, there has been a growing recognition of the importance of balance and coordination in maintaining overall health, particularly among the elderly population. As societies around the world experience demographic shifts with an increasing number of elderly individuals, age-related declines in balance and coordination can lead to an elevated risk of falls and fall-related injuries, making it a significant public health concern. The need for effective balance rehabilitation and fall prevention strategies has become paramount. This paper presents a motion platform designed for balance rehabilitation exercises using exergames. The system consists of a 3 degrees of freedom (3DOF) platform actuated by four servomotors controlled by Omron-DeltaTau real-time motion controller. As a novelty with respect to other State of Art (SoA) actuated platforms, in the present work the movements of the user's body, which determine the platform motion, are tracked by exploiting a markerless motion capture system with an RGB camera and pose-estimation algorithm MediaPipe. The human displacement is used to generate the input for the roll rotation of the platform according to a one d.o.f. transfer function, whose parameters can be set to get different levels of difficulties in the exercise. The device offers therefore the flexibility to set different parameters to modify the level of the users' training. The proposed device has the potential for a larger variety of rehabilitation activities and exergames. This paper describes the elements adopted for the implementation of this human-in-the-loop system, presents some preliminary tests to explore the influence of transfer function parameters on human and platform movements, and concludes with future development possibilities. [ABSTRACT FROM AUTHOR]

Monitoring workers' safety compliance is critical to construction accident prevention. However, most of the previous research focuses on checking the entry of workers wearing safety belts and the monitoring of the fastening action of safety rope screw buckles has not yet been considered. In this paper, a reconstruction method for the safety rope fastening behaviour of workers is proposed based on inertial measurement units (IMU) and a time series approach to monitor safety belt use. The proposed method was applied and evaluated through on-site construction experiments. The experimental results show that the acceleration, angular velocity, and magnetic induction intensity data obtained by the inertial measurement unit exhibit clear behavioural characteristics during safety rope fastening. The trajectory of the safety rope can be reconstructed and monitored through inertial measurement units and a time series approach. The results of this study will contribute to the reconstruction and monitoring of safety rope attachment trajectories for scaffolding workers working at heights in order to prevent falls at construction sites. [ABSTRACT FROM AUTHOR]

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However, when our school reopened in June 2020, the students involved in this project immediately began educating the younger students at the school, because, as they all said "prevention starts before the fire starts." and "This CAN happen here!" Before we left, the students were very interested to learn if there were native grasses and wildflowers that could replace cheatgrass; we had a representative from our local agriculture extension office scheduled to visit the class at the end of March. During the school Tu B'Shvat celebration ("The Birthday of the Trees"), students had dictated about their favorite trees where they lived (Figure 5). [Extracted from the article]

This paper highlights an effective model for evaluating geriatric workforce enhancement professional development programs, using multiple methodologies (i.e., quantitative and qualitative). An adaptation of Kirkpatrick's (1994; 2010) model of evaluation was implemented to assess the evidence-based fall prevention program delivered at a Program for All Inclusive Care for the Elderly site. The purpose of this paper is to describe the program's design, data collection activities and instruments, and findings, and also suggest strategies for successfully replicating the approach. [ABSTRACT FROM AUTHOR]

Maintaining a stable upright posture is essential for performing activities of daily living, and impaired standing balance may impact an individual's quality of life. Therefore, accurate and sensitive methods for assessing static balance are crucial for identifying balance impairments, understanding the underlying mechanisms of the balance deficiencies, and developing targeted interventions to improve standing balance and prevent falls. This review paper first explores the methods to quantify standing balance. Then, it reviews traditional posturography and recent advancements in using wearable inertial measurement units (IMUs) to assess static balance in two populations: older adults and those with incomplete spinal cord injury (iSCI). The inclusion of these two groups is supported by their large representation among individuals with balance impairments. Also, each group exhibits distinct aspects in balance assessment due to diverse underlying causes associated with aging and neurological impairment. Given the high vulnerability of both demographics to balance impairments and falls, the significance of targeted interventions to improve standing balance and mitigate fall risk becomes apparent. Overall, this review highlights the importance of static balance assessment and the potential of emerging methods and technologies to improve our understanding of postural control in different populations. [ABSTRACT FROM AUTHOR]

Background: The number of Europeans aged over 65 will double between 2010 and 2060, reaching 30% of the European population. Nutrition is emerging as a key element of healthy life since both obesity and malnutrition are established risk factors for morbidity and disability. The aim of this umbrella review (UR) is to summarize the findings of all current systematic reviews (SRs) and meta-analyzes (MAs) on the effectiveness of nutritional intervention designed to promote healthy aging in older individuals. Methods: Eligible articles published in English or Italian between January 2000 and May 2016 were identified in six databases. Only studies that analyzed nutritional interventions in the population of 65years and over, or papers specifically targeting older adults were deemed eligible. Results: Twenty-eight papers, out of which twenty-five SRs and three MAs, met the inclusion criteria and were included in this umbrella SR. Supplementation with vitamin D and other kind of products was highly effective in preventing falls and fractures. Furthermore, several interventions, ranging from the prescription of supplements to environmental and organizational programs, resulted in an improvement in energy and protein intake, as well as positive weight outcomes. Positive findings were also found for the elderly at risk of malnutrition and for older patients with dementia. Conclusions: The findings of this UR indicate that the use of a wide range of supplements and environmental and organizational intervention improve a number of anthropometric, nutritional and functional indices in the elderly. [ABSTRACT FROM AUTHOR]

Slip is one of the leading causes of fall-related injuries among occupational and elderly population. Existing research supports proactive slip and fall prevention approaches, while active strategies remain underdeveloped. Development of active slip-induced fall prevention systems requires fast, effective slip detection. This paper aims to develop a novel, real-time slip detection and estimation algorithm during human walking. The slip estimation is built on a slip dynamic model for biped walkers with the integration of the human locomotion constraints. The slip detection uses a set of wearable inertial sensors attached on the lower limbs. A slip indicator is introduced to detect the slip shortly after the heel-strike event. We present an extended Kalman filter-based slip estimation to characterize the slipping distance. One attractive property of the algorithm is its fast, accurate slip onset detection and slipping distance estimation with low-cost, nonintrusive sensing features. Experiments are conducted to validate and demonstrate the performance of the proposed slip detection and estimation scheme. Note to Practitioners—Slip-induced falls often lead to injuries among elderly and professional workers. Active slip and fall prevention could potentially mitigate the negative societal and economic impacts due to slip-induced injuries. However, no assistive device is yet commercially available or reported for slip and fall prevention. This paper presents a first step toward this goal by development and evaluation of a fast slip detection scheme. The wearable slip detection system is small size and lightweight, consisting of five small inertial measurements units placed on the leg. The system can detect the initiation of foot slip several times faster compared to the human sensorimotor mechanisms. The simplicity of the system design, easy implementation, and the fast detection results demonstrate superior reliability and robustness compared to the other slip detection approaches. The proposed slip detection algorithm can find potential applications, such as humanoid robots and control, and healthcare, or home automation. [ABSTRACT FROM AUTHOR]

The risk of falls among the elderly population is one that may lead to dire consequences. It can significantly affect the quality of life of the victims and even lead to their premature death. Many technological tools have been proposed in the literature to detect falls, but little effort has been done regarding their prevention. In this paper, our research team proposes an inexpensive open vibration platform equipped with pressure sensors. The platform is built from easily available electronic components to be used as a tool by physiotherapists in order to help them in their evaluation of the postural control of individuals at risk of postural imbalance. The platform has been built to be easily reproducible by the scientific community. Moreover, the computer code necessary to make it work is fully open source and can be used in any non-commercial applications. A first version of the platform was tested with 7 healthy human participants. A simple reinforcement learning agent was deployed and tested to automatically calibrate the vibration motors for optimal stimulation. The agent exploited computer vision to capture the data from a force platform commercially available and use it as ground truth. Finally, a second version of the platform was built and is presented in the paper. That version is currently being validated clinically with both healthy and impaired human participants. The preliminary data are presented in this paper. [ABSTRACT FROM AUTHOR]

Due to the ever growing population of elderly people, there is a dramatic increase in fall accidents. Currently, multiple ideas exist to prevent the elderly from falling, by means of technology or individualised fall prevention training programs. Most of them are costly, difficult to implement or less used by the elderly, and they do not deliver the required results. Furthermore, the increasingly older population will also impact the workload of the medical and nursing personnel. Therefore, we propose a novel fall detection and warning system for nursing homes, relying on Bluetooth Low Energy wireless communication. This paper describes the hardware design of a fall-acceleration sensing wearable for the elderly. Moreover, the paper also focuses on a novel algorithm for real-time filtering of the measurement data as well as on a strategy to confirm the detected fall events, based on changes in the person's orientation. In addition, we compare the performance of the algorithm to a machine learning procedure using a convolutional neural network. Finally, the proposed filtering technique is validated via measurements and simulation. The results show that the proposed algorithm as well as the convolutional neural network both results in an excellent accuracy when validating on a common database. [ABSTRACT FROM AUTHOR]

Falls are one the leading causes of accidental death for all people, but the elderly are at particularly high risk. Falls are severe issue in the care of those elderly people who live alone and have limited access to health aides and skilled nursing care. Conventional vision-based systems for fall detection are prone to failure in conditions with low illumination. Therefore, an automated system that detects falls in low-light conditions has become an urgent need for protecting vulnerable people. This paper proposes a novel vision-based fall detection system that uses object tracking and image enhancement techniques. The proposed approach is divided into two parts. First, the captured frames are optimized using a dual illumination estimation algorithm. Next, a deep-learning-based tracking framework that includes detection by YOLOv7 and tracking by the Deep SORT algorithm is proposed to perform fall detection. On the Le2i fall and UR fall detection (URFD) datasets, we evaluate the proposed method and demonstrate the effectiveness of fall detection in dark night environments with obstacles. [ABSTRACT FROM AUTHOR]

This paper describes why older adults begin, continue, and discontinue group- and home-based falls prevention exercise and benefits and barriers to participation. Telephone surveys were used to collect data for 394 respondents. Most respondents reported not participating in group- (66%) or home-based (78%) falls prevention exercise recently. Reasons for starting group-based falls prevention exercise include health benefits (23–39%), health professional recommendation (13–19%), and social interaction (4–16%). They discontinued because the program finished (44%) or due to poor health (20%). Commonly reported benefits were social interaction (41–67%) and health (15–31%). Disliking groups was the main barrier (2–14%). Home-based falls prevention exercise was started for rehabilitation (46–63%) or upon health professional recommendation (22–48%) and stopped due to recovery (30%). Improvement in health (18–46%) was the main benefit. These findings could assist health professionals in prescribing group-based falls prevention exercise by considering characteristics of older adults who perceive social interaction to be beneficial. [ABSTRACT FROM AUTHOR]

Background: Falls prevention interventions are effective for community dwelling older adults however, the same cannot be said for older adults living in long-term care (LTC). The Staying UpRight (SUp) randomized controlled trial was designed to test the effectiveness of a progressive strength and balance group exercise program delivered to LTC residents. This paper explores the factors impacting LTC providers' decisions to continue the program on completion of the funded trial period. Methods: A qualitative study using an Interpretive Description approach. Semi-structured interviews and focus groups were conducted with 15 LTC staff involved in the randomized controlled trial. Data were analysed using conventional content analysis. Results: Practice change occurred following participation in the trial with some facilities starting exercise groups, some increasing the number of exercise groups offered and physical therapists selecting elements of the program to adopt into their practice. Decisions about continuing with SUp as designed were constrained by organizational decisions regarding funding and resources. Three factors were identified which informed decision-making: business models and philosophies, requirements for evidence, and valuing physical therapy. Conclusions: Managers and facilitators adapted SUp by selecting and delivering components of the program in response to the changes they had observed in participating residents. However, our findings highlight that while SUp was valued, the tight financial environment created by the current funding model in New Zealand did not support funding physical therapist delivered falls prevention exercise programs in LTC. This study may provide policy makers with important information on changes needed to support falls prevention service delivery in LTC. Trial registration: This study is a sub-study of a randomized controlled trial which was registered to the Australian New Zealand Clinical Trials Registry ACTRN12618001827224 on 09/11/2018. Universal trial number U1111-1217-7148. [ABSTRACT FROM AUTHOR]

This paper developed a simple and quantitative evaluation system for a single-leg standing test. The proposed method represents the stand-up motion as a state transition model by quantitative measurement using a camera with a depth sensor (Azure Kinect) and a force plate. It objectively evaluates the movement of each state. In the experiment using the prototype, the evaluation results by the system and the skilled athletic trainer were the same for all subjects, and the shape of the radar chart was different among the subjects whose evaluation scores were the same. The results show that the proposed system can be quantitative evaluation even at worksites without skilled evaluators. [ABSTRACT FROM AUTHOR]

Objective: To investigate cost-effectiveness and costs of fall prevention exercise programmes for older adults.Design: Systematic review.Data Sources: Medline, Embase, Web of Science, Scopus, National Institute for Health Research Economic Evaluation Database, Health Technology Assessment database, Tufts Cost-Effectiveness Analysis Registry, Research Papers in Economics and EconLit (inception to May 2022).Eligibility Criteria For Study Selection: Economic evaluations (trial-based or model-based) and costing studies investigating fall prevention exercise programmes versus no intervention or usual care for older adults living in the community or care facilities, and reporting incremental cost-effectiveness ratio (ICER) for fall-related outcomes or quality-adjusted life years (QALY, expressed as cost/QALY) and/or intervention costs.Results: 31 studies were included. For community-dwelling older adults (21 economic evaluations, 6 costing studies), results ranged from more effective and less costly (dominant) interventions up to an ICER of US$279 802/QALY gained and US$11 986/fall prevented (US$ in 2020). Assuming an arbitrary willingness-to-pay threshold (US$100 000/QALY), most results (17/24) were considered cost-effective (moderate certainty). The greatest value for money (lower ICER/QALY gained and fall prevented) appeared to accrue for older adults and those with high fall risk, but unsupervised exercise appeared to offer poor value for money (higher ICER/QALY). For care facilities (two economic evaluations, two costing studies), ICERs ranged from dominant (low certainty) to US$35/fall prevented (moderate certainty). Overall, intervention costs varied and were poorly reported.Conclusions: Most economic evaluations investigated fall prevention exercise programmes for older adults living in the community. There is moderate certainty evidence that fall prevention exercise programmes are likely to be cost-effective. The evidence for older adults living in care facilities is more limited but promising.Prospero Registration Number: PROSPERO 2020 CRD42020178023. [ABSTRACT FROM AUTHOR]

Background: Exercise is effective in order to prevent falls in community-dwelling older people. Self-management programs have the potential to increase access and reduce costs related to exercise-based fall prevention. However, information regarding older people's views of participating in such programs is needed to support implementation. The aim of this study was to explore older people's experiences of a self-management fall prevention exercise routine guided either by a digital program (web-based or mobile) or a paper booklet.Methods: This qualitative study was part of a feasibility study exploring two completely self-managed exercise interventions in which the participants tailored their own program, guided either by a digital program or a paper booklet. Individual face-to-face semi-structured interviews were conducted with a purposeful sample of 28 participants (18 women), mean age 76 yrs. Qualitative content analysis was used to analyse the data.Results: Self-managing and self-tailoring these exercise programs was experienced as 'Managing pieces of a personal puzzle'. To independently being able to create a program and manage exercise was described in the categories 'Finding my own level' and 'Programming it into my life'. The participants experienced the flexibility and independence provided by completely self-managed exercise as positive and constructive although it required discipline. Furthermore, different needs and preferences when managing their exercise were described, as well as varying sources of motivation for doing the exercise, as highlighted in the category 'Defining my source of motivation'. The category 'Evolving my acquired knowledge' captures the participants' views of building their competence and strategies for maintenance of the exercise. It describes a combined process of learning the program and developing reflection, which was more clearly articulated by participants using the digital program.Conclusions: This study provides new knowledge regarding experiences, preferences and motivations of older people to engage in home-based self-managed fall prevention exercise. They expressed both a capability and willingness to independently manage their exercise. A digital program seems to have strengthened the feeling of support while creating their own exercise program and tailoring it to their preferences and circumstances, which might therefore create better opportunities for adoption and adherence in the long term. [ABSTRACT FROM AUTHOR]

During the operations, firefighters can be injured or killed because of the smoke and heat emission from the fire area, broken structure elements such as floors, walls, or boiling liquid ejection and gas explosion. Therefore, this paper aims to develop an efficient and portable system to monitor falls and high CO level through integrating a three degrees of freedom accelerometer and an MQ7 sensor to recorded acceleration and measured CO concentration with the embedded fall and high CO level detection algorithms. The embedded fall detection algorithm can detect fall events with high accuracy without mistakenly identifying normal activities such as walking, standing, jogging, and jumping as fall events. The posture recognition and cascade posture recognition after three seconds are proposed in this paper to gain the accuracy of our proposed fall detection system. If a firefighter falls and is unable to stand up, the alert message will be sent to their commander at the outside through the GSM/GPRS module. The embedded high CO detection algorithm used to alert the dangerous CO level to recommend using self-contained breathing apparatuses (SCBA) and saving fresh air with acceptable CO level. We carefully investigated the proposed thresholds and window size before embedding them into the microcontroller. The sensitivity and accuracy achieved were around 96.5% and 93% respectively in our recorded data. Furthermore, the proposed fall detection algorithm also achieved higher geometric mean in comparison with Support Vector Machine classifier (SVM) and a nearest neighbor rule (NN) in the public datasets with the achieved around 99.44%, 98.41% and 95.76% respectively. [ABSTRACT FROM AUTHOR]

Purpose: Since construction workers often need to carry various types of loads in their daily routine, they are at risk of sustaining musculoskeletal injuries. Additionally, carrying a load during walking may disturb their walking balance and lead to fall injuries among construction workers. Different load carrying techniques may also cause different extents of physical exertion. Therefore, the purpose of this paper is to examine the effects of different load-carrying techniques on gait parameters, dynamic balance, and physiological parameters in asymptomatic individuals on both stable and unstable surfaces. Design/methodology/approach: Fifteen asymptomatic male participants (mean age: 31.5 ± 2.6 years) walked along an 8-m walkway on flat and foam surfaces with and without a load thrice using three different techniques (e.g. load carriage on the head, on the dominant shoulder, and in both hands). Temporal gait parameters (e.g. gait speed, cadence, and double support time), gait symmetry (e.g. step time, stance time, and swing time symmetry), and dynamic balance parameters [e.g. anteroposterior and mediolateral center of pressure (CoP) displacement, and CoP velocity] were evaluated. Additionally, the heart rate (HR) and electrodermal activity (EDA) was assessed to estimate physiological parameters. Findings: The gait speed was significantly higher when the load was carried in both hands compared to other techniques (Hand load, 1.02 ms vs Head load, 0.82 ms vs Shoulder load, 0.78 ms). Stride frequency was significantly decreased during load carrying on the head than the load in both hands (46.5 vs 51.7 strides/m). Step, stance, and swing time symmetry were significantly poorer during load carrying on the shoulder than the load in both hands (Step time symmetry ration, 1.10 vs 1.04; Stance time symmetry ratio, 1.11 vs 1.05; Swing time symmetry ratio, 1.11 vs 1.04). The anteroposterior (Shoulder load, 17.47 mm vs Head load, 21.10 mm vs Hand load, −5.10 mm) and mediolateral CoP displacements (Shoulder load, −0.57 mm vs Head load, −1.53 mm vs Hand load, −3.37 ms) significantly increased during load carrying on the shoulder or head compared to a load in both hands. The HR (Head load, 85.2 beats/m vs Shoulder load, 77.5 beats/m vs No load, 69.5 beats/m) and EDA (Hand load, 14.0 µS vs Head load, 14.3 µS vs Shoulder load, 14.1 µS vs No load, 9.0 µS) were significantly larger during load carrying than no load. Research limitations/implications: The findings suggest that carrying loads in both hands yields better gait symmetry and dynamic balance than carrying loads on the dominant shoulder or head. Construction managers/instructors should recommend construction workers to carry loads in both hands to improve their gait symmetry and dynamic balance and to lower their risk of falls. Practical implications: The potential changes in gait and balance parameters during various load carrying methods will aid the assessment of fall risk in construction workers during loaded walking. Wearable insole sensors that monitor gait and balance in real-time would enable safety managers to identify workers who are at risk of falling during load carriage due to various reasons (e.g. physical exertion, improper carrying techniques, fatigue). Such technology can also empower them to take the necessary steps to prevent falls. Originality/value: This is the first study to use wearable insole sensors and a photoplethysmography device to assess the impacts of various load carrying approaches on gait parameters, dynamic balance, and physiological measures (i.e. HR and EDA) while walking on stable and unstable terrains. [ABSTRACT FROM AUTHOR]

Assistive Technology helps to assess the daily living and safety of frail people, with particular regards to the detection and prevention of falls. In this paper, a comparison is provided among different strategies to analyze postural sway, with the aim of detecting unstable postural status in standing condition as precursors of potential falls. Three approaches are considered: (i) a time-based features threshold algorithm, (ii) a time-based features Neuro-Fuzzy inference system, and (iii) a Neuro-Fuzzy inference fed by Discrete-Wavelet-Transform-based features. The analysis was performed across a wide dataset and exploited performance indexes aimed at assessing the accuracy and the reliability of predictions provided by the above-mentioned strategies. The results obtained demonstrate valuable performances of the three considered strategies in correctly distinguishing among stable and unstable postural status. However, the analysis of robustness against noisy data highlights better performance of Neuro-Fuzzy inference systems with respect to the threshold-based algorithm. [ABSTRACT FROM AUTHOR]

Fall detection is an important problem from both the health and machine learning perspective. A fall can lead to severe injuries, long-term impairments or even death in some cases. In terms of machine learning, it presents a severely class imbalance problem with very few or no training data for falls owing to the fact that falls occur rarely. In this paper, we take an alternate philosophy to detect falls in the absence of their training data, by training the classifier on only the normal activities (that are available in abundance) and identifying a fall as an anomaly. To realize such a classifier, we use an adversarial learning framework, which comprises of a spatio-temporal autoencoder for reconstructing input video frames and a spatio-temporal convolution network to discriminate them against original video frames. 3D convolutions are used to learn spatial and temporal features from the input video frames. The adversarial learning of the spatio-temporal autoencoder will enable reconstructing the normal activities of daily living efficiently, thus rendering detecting unseen falls plausible within this framework. We tested the performance of the proposed framework on camera-sensing modalities that may preserve an individual's privacy (fully or partially), such as thermal and depth camera. Our results on three publicly available datasets show that the proposed spatio-temporal adversarial framework performed better than other baseline frame-based (or spatial) adversarial learning methods. [ABSTRACT FROM AUTHOR]

This paper discusses the prevalence of caregivers' concern, its impact on fall prevention strategies, falls risk awareness among older persons, clinical points, and study potential. Older persons suffering from fall-related psychological concerns such as fear of falling has been well established in previous research, however little is known about caregivers' falls concern in its relationship with the risk of older persons falling. In Singapore, families are regarded as the fundamental support system for older people. The potential influence of caregivers' concern on the outcome of fall prevention strategies and falls risk awareness of older persons is expected given their significant involvement in the older persons' care. However, it is difficult to accurately appreciate the impact of caregivers' falls concern on the risk of falls among older persons in the local community given the Singaporean cultural differences and the dearth of Singaporean research on caregiver's concern. It is promulgated in this paper that further research should address the impact of caregivers' falls concern on fall-related issues associated with caring for an older person at risk of falling. [ABSTRACT FROM AUTHOR]

This paper examines the feasibility and control authority of an electronically controlled cold-gas thruster (CGT) as a backpack-worn device for fall prevention for individuals at fall risk. The CGT is comprised of a pressurized air tank combined with a custom electrically actuated high-flow-capacity valve and servo-controlled nozzle, which are employed together to create a thrust intended to arrest an impending fall. In this paper, the authors present the design of the CGT prototype and experimentally investigate its prospective control authority for the purposes of correcting an impending fall. [ABSTRACT FROM AUTHOR]

Short stick exercises have been attracting attention from the viewpoint of preventing falls and improving the health of elderly people and are generally performed under the guidance of instructors and nursing staff at nursing homes. However, in situations such as the COVID-19 pandemic, where people should refrain from unnecessary outings, it is advisable that individuals perform short stick exercises at home and record their exercise implementation status. In this paper, we propose an inertial measurement unit (IMU)-sensor-based short stick exercise tracking method that can automatically record the types and amounts of exercises performed using a short stick equipped with an IMU sensor. The proposed method extracts time-domain and frequency-domain features from linear acceleration and quaternion time-series data obtained from the IMU sensor and classifies the type of exercise using an inference model based on machine learning algorithms. To evaluate the proposed method, we collected sensor data from 21 young subjects (in their 20s) and 14 elderly subjects (79-95 years old), where the participants performed three sets (10 times per set) of eight basic types of short stick exercises (five types for elderly people). As a result of evaluating the proposed method using this data set, we confirmed that when LightGBM was used as the learning algorithm, it achieved F values of 90.0 and 86.6% for recognizing the type of exercise for young and elderly people, respectively. [ABSTRACT FROM AUTHOR]

Background: Falls are common among older people, and General Practitioners (GPs) could play an important role in implementing strategies to manage fall risk. Despite this, fall prevention is not a routine activity in general practice settings. The iSOLVE cluster randomised controlled trial aimed to evaluate implementation of a fall prevention decision tool in general practice. This paper sought to describe the strategies used and reflect on the enablers and barriers relevant to successful recruitment of general practices, GPs and their patients.Methods: Recruitment was conducted within the geographical area of a Primary Health Network in Northern Sydney, Australia. General practices and GPs were engaged via online surveys, mailed invitations to participate, educational workshops, practitioner networks and promotional practice visits. Patients 65 years or older were recruited via mailed invitations, incorporating the practice letterhead and the name(s) of participating GP(s). Observations of recruitment strategies, results and enabling factors were recorded in field notes as descriptive and narrative data, and analysed using mixed-methods.Results: It took 19 months to complete recruitment of 27 general practices, 75 GPs and 560 patients. The multiple strategies used to engage general practices and GPs were collectively useful in reaching the targeted sample size. Practice visits were valuable in engaging GPs and staff, establishing interest in fall prevention and commitment to the trial. A mix of small, medium and large practices were recruited. While some were recruited as a whole-practice, other practices had few or half of the number of GPs recruited. The importance of preventing falls in older patients, simplicity of research design, provision of resources and logistic facilitation of patient recruitment appealed to GPs. Recruitment of older patients was successfully achieved by mailed invitations which was a strategy that was familiar to practice staff and patients. Patient response rates were above the expected 10% for most practices. Many practices (n = 17) achieved the targeted number of 20 or more patients.Conclusions: Recruitment in general practice settings can be successfully achieved through multiple recruitment strategies, effective communication and rapport building, ensuring research topic and design suit general practice needs, and using familiar communication strategies to engage patients.Trial Registration: The trial was prospectively registered on 29 April 2015 with the Australian New Zealand Clinical Trial Registry www.anzctr.org.au (trial ID: ACTRN12615000401550). [ABSTRACT FROM AUTHOR]

In our daily lives, we engage in a variety of tasks that rely on our senses, such as seeing. Blindness is the absence of the sense of vision. According to the World Health Organization, 2.2 billion people worldwide suffer from various forms of vision impairment. Unfortunately, blind people face a variety of indoor and outdoor challenges on a daily basis, limiting their mobility and preventing them from engaging in other activities. Blind people are very vulnerable to a variety of hazards, including falls. Various barriers, such as stairs, can cause a fall. The Internet of Things (IoT) is used to track falls and send a warning message to the blind caretakers. One of the gaps in the previous works is that they were unable to differentiate between falls true and false. Treating false falls as true falls results in many false alarms being sent to the blind caretakers and thus, they may reject the IoT system. As a means of bridging this chasm, this paper proposes an intelligent shoe that is able to precisely distinguish between false and true falls based on three sensors, namely, the load scale sensor, the light sensor, and the Flex sensor. The proposed IoT system is tested in an indoor environment for various scenarios of falls using four models of machine learning. The results from our system showed an accuracy of 0.96%. Compared to the state-of-the-art, our system is simpler and more accurate since it avoids sending false alarms to the blind caretakers. [ABSTRACT FROM AUTHOR]

Taijiquan is one of the first batches of national intangible cultural heritages, which has a history of more than 300 years. It has gradually gained global recognition for its unique healthcare and rehabilitation effects. Studies from countries around the world have shown that bad behaviors and lifestyles, such as smoking, alcoholism, overeating, lack of exercise, and irregular life patterns, have become one of the main causes of chronic, noncommunicable diseases. For example, a lack of exercise can lead to obesity, and obesity can cause various cardiovascular diseases, cerebrovascular diseases, and the occurrence of related chronic diseases. Taijiquan is traditional boxing with the core idea of Taiji and yin-yang dialectics in Chinese traditional Confucian and Taoist philosophy and pays attention to both internal and external cultivation and the combination of hardness and softness. It is the way of Taiji, the principle of nature, the body of Wushu, and the method of fitness. It is the crystallization of the wisdom of the Chinese nation. Taijiquan can improve the balance function of the human body. It not only has an obvious intervention effect on the prevention of falls in the elderly but also has a good rehabilitation training effect on some patients with motor dysfunction. It absorbed the essence of boxing and was organically combined with China's traditional culture in the long-term development process, forming a philosophy boxing that combines health preservation, fitness, skill attack, self-cultivation, entertainment, and medical body. According to the demand analysis of the current situation of Taijiquan teaching, this paper analyzes the characteristics of Taijiquan standard movement based on perceptual IoT Network motion capture, and it explores the characteristics of Taijiquan cloud hand movement from the perspective of kinematics. [ABSTRACT FROM AUTHOR]

Improving quality of life in geriatric patients is related to constant physical activity and fall prevention. In this paper, we propose a wearable system that takes advantage of sensors embedded in a smart device to collect data for movement identification (running, walking, falling and daily activities) of an elderly user in real-time. To provide high efficiency in fall detection, the sensor's readings are analysed using a neural network. If a fall is detected, an alert is sent though a smartphone connected via Bluetooth. We conducted an experimental session using an Arduino Nano 33 BLE Sense board in inside and outside environments. The results of the experiment have shown that the system is extremely portable and provides high success rates in fall detection in terms of accuracy and loss. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore the equalities’ dimension of falls prevention services in light of the Equality Act 2010 and its protected characteristics. Research and policy are discussed in light of the Act and public services’ duties to be aware of their responsibilities.Design/methodology/approach An initial research review was undertaken in 2012 and updated in 2016.Findings The research on falls prevention services does not always collect data on users of the service and services do not always collect data about their users that would enable them to build a picture of their users in line with the Equality Act 2010.Practical implications Services and commissioners will need to be able to show that the services funded by the public purse are accessible, acceptable and appropriate to the UK’s increasingly diverse older population. This paper describes some of the existing resources and research papers that contain elements of attention to the protected characteristics of the Equality Act 2010.Originality/value This is an update on a research review undertaken in 2012. [ABSTRACT FROM AUTHOR]

Background: Little is known about associations between performance-based measurements and self-reported scales, nor about ceiling effects or sensitivity to change to evaluate effects in the target population for self-managed exercise interventions. This study aimed to explore the feasibility of using performance-based outcomes for gait speed, functional leg strength and balance, and self-reported outcomes of falls-efficacy and functional ability in two self-managed falls prevention exercise interventions for community dwelling older adults.Methods: Independent living, community-dwelling older adults (n = 67) exercised with one of two self-managed falls prevention exercise programmes, a digital programme (DP) or a paper booklet (PB) in a 4-month participant preference trial. Pre- and post-assessments, by blinded assessors, included Short Physical Performance Battery (SPPB) and 30s Chair stand test (30s CST). Participants completed self-reported questionnaires: Activities-specific and Balance Confidence scale (ABC), Iconographical Falls Efficacy Scale (Icon-FES), Late-Life Function and Disability Instrument Function Component (LLFDI-FC). In addition, improvement in balance and leg strength was also self-rated at post-assessment. Participants' mean age was 76 ± 4 years and 72% were women.Results: Ceiling effects were evident for the balance sub-component of the SPPB, and also indicated for ABC and Icon-FES in this high functioning population. In SPPB, gait speed, 30s CST, and LLFDI-FC, 21-56% of participants did not change their scores beyond the Minimal Clinically Important Difference (MCID). At pre-assessment all performance-based tests correlated significantly with the self-reported scales, however, no such significant correlations were seen with change-scores. Improvement of performance-based functional leg strength with substantial effect sizes and significant correlations with self-reported exercise time was shown. There were no differences in outcomes between the exercise programmes except that DP users reported improved change of leg strength to a higher degree than PB users.Conclusion: The LLFDI-FC and sit-to-stand tests were feasible and sensitive to change in this specific population. The balance sub-component of SPPB and self-reported measures ABC and Icon-FES indicated ceiling effects and might not be suitable as outcome measures for use in a high functioning older population. Development and evaluation of new outcome measures are needed for self-managed fall-preventive interventions with high functioning community-dwelling older adults. [ABSTRACT FROM AUTHOR]

Injuries due to unintentional falls cause high social cost in which several systems have been developed to reduce them. Recently, two trends can be recognized. Firstly, the market is dominated by fall detection systems, which activate an alarm after a fall occurrence, but the focus is moving towards predicting and preventing a fall, as it is the most promising approach to avoid a fall injury. Secondly, personal devices, such as smartphones, are being exploited for implementing fall systems, because they are commonly carried by the user most of the day. This paper reviews various fall prediction and prevention systems, with a particular interest to the ones that can rely on the sensors embedded in a smartphone, i.e., accelerometer and gyroscope. Kinematic features obtained from the data collected from accelerometer and gyroscope have been evaluated in combination with different machine learning algorithms. An experimental analysis compares the evaluated approaches by evaluating their accuracy and ability to predict and prevent a fall. Results show that tilt features in combination with a decision tree algorithm present the best performance. [ABSTRACT FROM AUTHOR]

Soil excavation is a fundamental step of building and infrastructure development. Despite strong enforcement of construction best practices and regulations, accidents in construction industry are comparatively higher than other industries. Likewise, significant increase in injuries and fatalities are recently reported on geotechnical activities such as excavation pits and trenches. Academic researchers and industry professionals have currently devoted vital attention to acquire construction safety in preconstruction phase of the project. They have developed various algorithms to enhance safety in preconstruction phase such as automated generation of scaffolding and its potential risk analysis, checking BIM model for fall risks, and limited access zone allocation in wall masonry. However, safety in geotechnical works at preconstruction phase is yet unexplored. This paper proposed automatic safety rule compliance approach for excavation works leveraging algorithmic modeling tools and BIM technologies. The focused approach comprises of the following three modules: information extraction and logic design (IELD), information conversion and process integration (ICPI), and automodeling and safety plan generation (ASPG). Specifically, the scope of the paper is limited to major risks such as cave-ins, fall, safety egress, and prohibited zones risks. A set of rules-based algorithms was developed in commercially available software using visual programming language (VPL) that automatically generates geometric conditions in BIM and visualizes the potential risks and safety resources installation along with their quantity take-off and optimized locations. A case study has been presented to validate the proof of concept; automated modeling tool for excavation safety planning generated the required results successfully. It is anticipated that the proposed approach has potential to help the designers through automated modeling and assist decision makers in developing productive and practical safety plans compared to the conventional 2D plans for excavation works at the preconstruction phase. Moreover, it is realized that the same approach can be extended to other rule-dependent subjects in construction. [ABSTRACT FROM AUTHOR]

In this paper, we propose a lying posture discrimination algorithm to monitor the behavior pattern of a person lying in bed. Using FSR (force sensing resistor) sensors arranged in a grid structure, three major body parts such as head, shoulder, and hips are identified, and six lying positions are determined based on these body parts. Head, shoulder, and hips are relatively high in pressure and are easy to distinguish due to low movement. In addition, we have effectively limited the search space to identify the above body parts based on standard body dimensions. Experimental results show that there is a correlation between pressure distribution and lying posture. The results of this study can be applied to the monitoring of sleep posture and can also be used as an aid to prevent fall accidents and the occurrence of pressure ulcers of elderly patients who are unable to move. [ABSTRACT FROM AUTHOR]

Background: The aim of this paper is to describe the utility of various recruitment modalities utilized in the Working to Increase Stability through Exercise (WISE) study. WISE is a pragmatic randomized trial that is testing the impact of a 3-year, multicomponent (strength, balance, aerobic) physical activity program led by trained volunteers or delivered via DVD on the rate of serious fall-related injuries among adults 65 and older with a past history of fragility fractures (e.g., vertebral, fall-related). The modified goal was to recruit 1130 participants over 2 years in three regions of Pennsylvania.Methods: The at-risk population was identified primarily using letters mailed to patients of three health systems and those over 65 in each region, as well as using provider alerts in the health record, proactive recruitment phone calls, radio advertisements, and presentations at community meetings.Results: Over 24 months of recruitment, 209,301 recruitment letters were mailed, resulting in 6818 telephone interviews. The two most productive recruitment methods were letters (72% of randomized participants) and the research registries at the University of Pittsburgh (11%). An average of 211 letters were required to be mailed for each participant enrolled. Of those interviewed, 2854 were ineligible, 2,825 declined to enroll and 1139 were enrolled and randomized. Most participants were female (84.4%), under age 75 (64.2%), and 50% took an osteoporosis medication. Not having a prior fragility fracture was the most common reason for not being eligible (87.5%). The most common reason provided for declining enrollment was not feeling healthy enough to participate (12.6%).Conclusions: The WISE study achieved its overall recruitment goal. Bulk mailing was the most productive method for recruiting community-dwelling older adults at risk of serious fall-related injury into this long-term physical activity intervention trial, and electronic registries are important sources and should be considered. [ABSTRACT FROM AUTHOR]

Fall prevention is one of the most important functions of walking assistance devices for user's safety. It is preferable that these devices prevent the user from being in the state where the risk of falling is high rather than helping them recovering from falling motion. During turning, when the user is in the tandem stance, a state where both legs form a line along walking direction, a support base that is surrounded by two legs becomes small, and a stability margin becomes small. This paper therefore aims to prevent the tandem stance by using nonwearable robot “intelligent cane” for the elderly or physically challenged person. Generally, the behavior of the lower limb follows the upper body turning. This paper therefore introduces a cane robot control method which constrains the behavior of user's upper body. By adjusting an admittance parameter of the robot according to the positions of a support leg, the robot resists to turn while a support leg is on the same side of the turning direction. A swing leg on the turning direction side therefore freely moves to the turning direction, while a swing leg on the opposite direction side of turning hardly move to the turning direction. [ABSTRACT FROM PUBLISHER]

The overall demographic profile of current societies point to a significant growth of the elderly people. Associated with the increase of the average hope of life and consequent increase in chronic diseases, there is the need for protection and daily care. Increasing investments in technology, such as Ambient Assisted Living (AAL) solutions, promote the quality of live extending the time people can live in their desired environment. This paper proposes the design, deployment, and real testbed of an e-health wearable monitoring system based on the integration of several AAL tools and platforms for elderly's bio-signals monitoring. This solution includes electrocardiography (ECG), respiration rate, beats per minute, body temperature, and falls detention and notification. The paper also describes, in detail, the real pilot and analyzes some early results concerning the users quality of experience, and the found results are very promising. [ABSTRACT FROM AUTHOR]

Medical technology makes an inevitable trend for the elderly population, therefore the intelligent home care is an important direction for science and technology development, in particular, elderly in-home safety management issues become more and more important. In this research, a low of operation algorithm and using the triangular pattern rule are proposed, then can quickly detect fall-down movements of humanoid by the installation of a robot with camera vision at home that will be able to judge the fall-down movements of in-home elderly people in real time. In this paper, it will present a preliminary design and experimental results of fall-down movements from body posture that utilizes image pre-processing and three triangular-mass-central points to extract the characteristics. The result shows that the proposed method would adopt some characteristic value and the accuracy can reach up to 90 % for a single character posture. Furthermore the accuracy can be up to 100 % when a continuous-time sampling criterion and support vector machine (SVM) classifier are used. [ABSTRACT FROM AUTHOR]

Introduction: The risk for outdoor falls tends to increase during winter due to icy road conditions. Several Swedish municipalities have introduced programs that provide their senior citizens with a pair of ice cleats in an attempt to tackle this problem. In this paper, we perform a process evaluation to identify potential barriers to the success of these programs and analyze the logic of their design. Methods: We sent a survey to all 290 Swedish municipalities to collect data on the characteristics of ice cleat distribution programs. We also performed focus-group interviews with older adults to gain insight into their thoughts about ice cleat programs. We synthesized our data with existing literature on ice cleats and behavior change theory to populate a logic model to identify and analyze hidden assumptions and potential flaws using program theory analysis. Results: On average, about 40% of the eligible population living in the intervention municipalities collected a pair of ice cleats. While we identified some other, but mostly minor, barriers to implementation, the main barrier appears to be a lack of scale (i.e., insufficient procurement and distribution of ice cleats), as 90% of all purchased ice cleats were eventually distributed. While previous research suggests that ice cleats can decrease injury risks if worn, we find that there is limited evidence on the effects of distribution on ice cleat use. Our interviewees emphasized the potential utility of ice cleats for staying safe and active during winter but stressed that ice cleats need to be user-friendly and of high-quality to increase the likelihood that a distribution program encourages behavior change. Conclusion: Existing ice cleat distribution programs appear to have reached a meaningful share of the targeted population. Additional research is required to assess their effects on ice cleat use and injury rates. [ABSTRACT FROM AUTHOR]

This paper examines whether involvement in an observational study may prompt participants to change their exercise behaviors. Data were collected from 394 older community dwellers in Victoria, Australia using a baseline survey, and 245 of these participated in a follow-up survey one year later. Survey domains were drawn from constructs of relevant health behavior models. Results showed that the proportion of respondents who were currently participating in exercises to prevent falls at follow-up was 12% higher than at baseline (Wilcoxon p value < .001). Twenty-nine percent reported they had changed their perceptions about falls and their risk of falls, with comments focused on threat appraisal. Forty-four percent reported having taken strategies to reduce their risk of falling, with comments based on implementation of different preventive strategies. Respondents who held favorable views toward exercises for the prevention of falls appear to change their behaviors that might address falls when participating in observational studies. [ABSTRACT FROM AUTHOR]

Purpose: The home-based rehabilitation of elderly patients improves their autonomy, independence and reintegration into society. Hence, a suitable environment plays an important role in rehabilitation, as do different assistance technologies. The majority of accidents at home involving elderly people occur in the bathroom. Therefore, the planning of the layout of facilities is important in this potentially dangerous area. This paper proposes an approach towards designing and optimizing the layout of facilities in the bathroom, based on logistical and nonlogistical relationships.Methodology: A fuzzy-based analytical hierarchical process (fuzzy-AHP) is then proposed for a comprehensive evaluation of the alternatives for this layout plan. This approach was applied to the home of a 71 years old female patient, who was experiencing home-based rehabilitation. After the initial designing and optimizing of the layout of the facilities in her bathroom, a plan could then be created for her particular needs.Findings: The results of this research could then enable the home-based rehabilitation of elderly patients to be more effective.Value: This paper develops a new approach to design and optimize the layout of facilities in bathroom for the elderly. Implications for Rehabilitation Develop a new approach to design and optimize the layout of facilities in bathroom.Provide a mathematical and more scientific approach to home layout design for home-based rehabilitation.Provide new opportunities for research, for both the therapist and the patient to analyse the home facility layout. [ABSTRACT FROM AUTHOR]

Background: Despite advances in laboratory-based supervised fall risk assessment methods (FRAs), falls still remain a major public health problem. This can be due to the alteration of behavior in laboratory due to the awareness of being observed (i.e., Hawthorne effect), the multifactorial complex etiology of falls, and our limited understanding of human behaviour in natural environments, or in the' wild'. To address these imitations, a growing body of literature has focused on free-living wearable-sensor-based FRAs. The objective of this narrative literature review is to discuss papers investigating natural data collected by wearable sensors for a duration of at least 24 h to identify fall-prone older adults.Methods: Databases (Scopus, PubMed and Google Scholar) were searched for studies based on a rigorous search strategy.Results: Twenty-four journal papers were selected, in which inertial sensors were the only wearable system employed for FRA in the wild. Gait was the most-investigated activity; but sitting, standing, lying, transitions and gait events, such as turns and missteps, were also explored. A multitude of free-living fall predictors (FLFPs), e.g., the quantity of daily steps, were extracted from activity bouts and events. FLFPs were further categorized into discrete domains (e.g., pace, complexity) defined by conceptual or data-driven models. Heterogeneity was found within the reviewed studies, which includes variance in: terminology (e.g., quantity vs macro), hyperparameters to define/estimate FLFPs, models and domains, and data processing approaches (e.g., the cut-off thresholds to define an ambulatory bout). These inconsistencies led to different results for similar FLFPs, limiting the ability to interpret and compare the evidence.Conclusion: Free-living FRA is a promising avenue for fall prevention. Achieving a harmonized model is necessary to systematically address the inconsistencies in the field and identify FLFPs with the highest predictive values for falls to eventually address intervention programs and fall prevention. [ABSTRACT FROM AUTHOR]