Dimensional reduction of balance parameters in risk of falling evaluation using a minimal number of force-sensitive resistors

Reliability and Validity of Instrumented Timed Up and Go Test in Typical Adults and Elderly: A Systematic Review

OBJECTIVE

To summarize the available literature investigating the reliability and validity of the instrumented Timed Up and Go (iTUG) in typical adults and elderly.

DATA SOURCES

Data were collected from PubMed, Web of Science, and hand searching up until July 15, 2024.

STUDY SELECTION

English-language studies investigating the reliability and validity of the 3-meter version of the iTUG in typical adults and elderly were included. Eligibility was blindly reviewed by 2 reviewers.

DATA EXTRACTION

Data on demographics, settings, reliability, and validity of the iTUG were independently extracted by 2 reviewers. The methodological quality was blindly assessed by 2 reviewers using the Consensus-Based Standards for the Selection of Health Status Measurement Instruments tools, and the certainty of evidence was evaluated by the modified Grading of Recommendations Assessment, Developement and Evaluation (GRADE) approach.

DATA SYNTHESIS

Nineteen studies were included investigating 1729 participants, of which 334 were typical adults and 1395 typical elderly. For intrarater reliability (n=1 study), intraclass correlation coefficient ranged from 0.39 (95% CI, 0.30-0.50) to 0.97 (95% CI, 0.95-0.98), test-retest reliability (n=2 studies) from 0.27 (95% CI, -0.47 to 0.63) to 0.89 (95% CI, 0.78-0.95), and interrater reliability (n=1 study) generally sufficient from 0.929 to 0.99 (CI not reported). One study on criterion validity showed sufficient agreement (intraclass correlation coefficient >0.7) with the criterion standard for most outcome measures, except for 3 outcome measures measuring time of turn. Moreover, 12 studies used iTUG to predict cognitive decline (area under the curve [AUC] = 0.80), maximal mobility performance (R2=0.278), physical function (AUC ≤0.75), or falls [(AUC ≤0.853 (95% CI, 0.759-0.948)].

CONCLUSIONS

iTUG can be a reliable and valid tool for assessing mobility in adults and elderly. However, the complexity and nonstandardization of outcome measures reduce the reliability and validity of iTUG, which needs to be addressed in future research.

Instrumented Timed Up and Go Test (iTUG)-More Than Assessing Time to Predict Falls: A Systematic Review

The Timed Up and Go (TUG) test is a widely used tool for assessing the risk of falls in older adults. However, to increase the test's predictive value, the instrumented Timed Up and Go (iTUG) test has been developed, incorporating different technological approaches. This systematic review aims to explore the evidence of the technological proposal for the segmentation and analysis of iTUG in elderlies with or without pathologies. A search was conducted in five major databases, following PRISMA guidelines. The review included 40 studies that met the eligibility criteria. The most used technology was inertial sensors (75% of the studies), with healthy elderlies (35%) and elderlies with Parkinson's disease (32.5%) being the most analyzed participants. In total, 97.5% of the studies applied automatic segmentation using rule-based algorithms. The iTUG test offers an economical and accessible alternative to increase the predictive value of TUG, identifying different variables, and can be used in clinical, community, and home settings.

Risk of Falling in a Timed Up and Go Test Using an UWB Radar and an Instrumented Insole

Previously, studies reported that falls analysis is possible in the elderly, when using wearable sensors. However, these devices cannot be worn daily, as they need to be removed and recharged from time-to-time due to their energy consumption, data transfer, attachment to the body, etc. This study proposes to introduce a radar sensor, an unobtrusive technology, for risk of falling analysis and combine its performance with an instrumented insole. We evaluated our methods on datasets acquired during a Timed Up and Go (TUG) test where a stride length (SL) was computed by the insole using three approaches. Only the SL from the third approach was not statistically significant (p = 0.2083 > 0.05) compared to the one provided by the radar, revealing the importance of a sensor location on human body. While reducing the number of force sensors (FSR), the risk scores using an insole containing three FSRs and y-axis of acceleration were not significantly different (p > 0.05) compared to the combination of a single radar and two FSRs. We concluded that contactless TUG testing is feasible, and by supplementing the instrumented insole to the radar, more precise information could be available for the professionals to make accurate decision.