Fall Detection Devices and Their Use With Older Adults : A Systematic Review
Fall Detection Devices and Their Use With Older Adults : A Systematic Review
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DOI：
10.1519/jpt.0b013e3182abe779
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发表时间：
2014-10-01
影响因子：
2.4
通讯作者：
Demiris, George
中科院分区：
文献类型：
--
作者：
Chaudhuri, Shomir;Thompson, Hilaire;Demiris, George
背景：跌倒对 65 岁及以上成年人的健康和独立性构成重大威胁。由于目前种类繁多、数量众多的被动监测系统越来越多地可用于检测个人何时跌倒，因此需要分析和综合有关其准确检测跌倒的能力的证据，以确定哪些系统最有效。 目标：本文献综述的目的是系统评估跌倒检测设备的设计和实施的当前状态。这篇综述还研究了这些设备在现实世界中的测试程度以及这些设备对老年人的可接受性。数据来源：在 PubMed、CINAHL、EMBASE 和 PsycINFO 上进行了系统的文献综述，从各自的成立日期到 2013 年 6 月 25 日。研究资格标准和干预措施：如果他们讨论了涉及旨在检测成人跌倒的系统的一个或多个项目的文章，则纳入其中。该系统针对的是 65 岁以上的人，但这并不是纳入本次审查的要求。如果文章不是用英语写的，或者研究的是跌倒风险、儿童跌倒检测、跌倒预防或个人应急响应设备，则被排除在外。 研究评估和综合方法：研究最初分为使用敏感性、特异性或准确性评估方法的研究和使用其他方法评估其设备的研究。研究进一步分为可穿戴设备和非可穿戴设备。研究评估了样本中是否包含老年人以及评估是否包括现实世界环境。结果：本次审查确定了 57 个使用可穿戴系统的项目和 35 个使用非可穿戴系统的项目，无论评估技术如何。非可穿戴系统包括摄像头、运动传感器、麦克风和地板传感器。在检查可穿戴系统的项目中，只有 7.1% 的项目报告在现实环境中监测老年人。目前还没有在实验室或现实环境中对以老年人为受试者的非可穿戴设备进行研究。一般来说，老年人似乎对使用此类设备感兴趣，尽管他们表达了对隐私和确切了解设备在特定时间正在做什么的担忧。 局限性：本系统评价仅限于用英文撰写的文章，不包括灰色文献。手动论文筛选和审查过程可能会受到解释偏差的影响。 主要发现的结论和含义： 存在大量描述各种跌倒检测设备的工作。该领域的挑战是创建高度精确且不显眼的设备。从这次审查来看，该技术似乎越来越能够完成这样的任务。现在需要进行更多的实际测试以及这些设备评估的标准化。
Background: Falls represent a significant threat to the health and independence of adults aged 65 years and older. As a wide variety and large number of passive monitoring systems are currently and increasingly available to detect when individuals have fallen, there is a need to analyze and synthesize the evidence regarding their ability to accurately detect falls to determine which systems are most effective.Objectives: The purpose of this literature review is to systematically assess the current state of design and implementation of fall-detection devices. This review also examines to what extent these devices have been tested in the real world as well as the acceptability of these devices to older adults.Data Sources: A systematic literature review was conducted in PubMed, CINAHL, EMBASE, and PsycINFO from their respective inception dates to June 25, 2013.Study Eligibility Criteria and Interventions: Articles were included if they discussed a project or multiple projects involving a system with the purpose of detecting a fall in adults. It was not a requirement for inclusion in this review that the system targets persons older than 65 years. Articles were excluded if they were not written in English or if they looked at fall risk, fall detection in children, fall prevention, or a personal emergency response device.Study Appraisal and Synthesis Methods: Studies were initially divided into those using sensitivity, specificity, or accuracy in their evaluation methods and those using other methods to evaluate their devices. Studies were further classified into wearable devices and nonwearable devices. Studies were appraised for inclusion of older adults in sample and if evaluation included real-world settings.Results: This review identified 57 projects that used wearable systems and 35 projects using nonwearable systems, regardless of evaluation technique. Nonwearable systems included cameras, motion sensors, microphones, and floor sensors. Of the projects examining wearable systems, only 7.1% reported monitoring older adults in a real-world setting. There were no studies of nonwearable devices that used older adults as subjects in either a laboratory or a real-world setting. In general, older adults appear to be interested in using such devices although they express concerns over privacy and understanding exactly what the device is doing at specific times.Limitations: This systematic review was limited to articles written in English and did not include gray literature. Manual paper screening and review processes may have been subject to interpretive bias.Conclusions and Implications of Key Findings: There exists a large body of work describing various fall-detection devices. The challenge in this area is to create highly accurate unobtrusive devices. From this review it appears that the technology is becoming more able to accomplish such a task. There is a need now for more real-world tests as well as standardization of the evaluation of these devices.