Validation and application of wearable sensors for capturing kinematic responses to real-world losses of balance among balance-impaired older adults

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The broad objective of this application is to establish a methodology to measure kinematic (i.e. bodily movement) responses to losses of balance (LOBs) in the real-world during daily life. Falls are the leading cause of injuries and injury-related deaths among older adults, with tripping and slipping being responsible for an estimated 60% of these falls. Numerous laboratory studies have shown that these falls generally result from an age-related decline in balance recovery responses to these LOBs. Unfortunately, technical challenges have limited our ability to assess LOB responses outside the lab, and therefore has allowed a disconnect to persist between lab studies of trips and slips and actual trips and slips in the real-world. We recently developed a novel technique to capture the kinematics of real-world LOBs and their context using wearable sensors and voice recorders. Aim 1 of this application will investigate the feasibility of this technique for extended use by asking balance-impaired community-dwelling older adults to wear the system daily during their waking hours for three weeks. Aim 2 will involve a laboratory validation of this technique by inducing trips and slips among Aim 1 participants while measuring LOB response kinematics simultaneously with the wearable sensor system and a gold-standard optoelectronic motion capture system. Aim 3 will use wearable sensor data from Aims 1 and 2 to begin to explore differences between real-world and laboratory LOB responses. The ability to capture detailed kinematics of LOB responses and their context in the real-world would have a profound and fundamental impact on fall prevention efforts. First, it would clarify any differences between laboratory and real-world LOBs to enhance the generalizability of lab studies to the real-world. Second, it would overcome well-known limitations of using memory recall when evaluating the frequency and characteristics of real-world falls. Third, it would greatly enhance the critical evaluation of fall prevention interventions and their mechanisms to maximize training benefits. Fourth, it would assist researchers developing algorithms to automatically detect real-world LOBs among individuals using wearable sensors.