Mia Folke

Weaknesses in physical ability related to fall risk need to be identified and reversed as early as possible. Eleven physical test exercises have shown to be able to assess weaknesses in four physical abilities related to fall risk. The aim of this study was to evaluate the applicability of predefined pass criteria for the 11 test exercises in older adults and to determine whether the number of test exercises assessing balance and strength could be reduced without loss of relevant information on weakness in physical ability related to fall risk. Fisher’s exact test was performed to evaluate if the number of test exercises can be reduced. The result shows that: (i) The predefined pass criteria for the test exercises are achievable in older adults, (ii) the number of test exercises assessing balance can be reduced but not those assessing strength. It can be concluded that six of the evaluated test exercises are achievable in older adults and can assess weakness in physical ability related to fall risk for them. These six test exercises can identify kinds of weaknesses related to fall risk and assess the severity of the weakness.

Background: Falls are the leading cause of injury for people of most ages, and the prevalence of falls increases with age. Fall risk is associated with the specific physical abilities balance, strength, and neuromuscular ability. This article describes a set of 12 physical exercises to assess these specific physical abilities related to fall risk. Method: A convenience sample of 50 participants (26 men — 20–72 years of age, 24 women — 21–73 years of age) were recruited to this feasibility study to evaluate whether the set of 12 physical exercises and combinations of them can be used as a test to identify early weaknesses and severity of weaknesses in specific physical abilities and to get an indication of whether the physical exercises can identify age-related differences in specific physical abilities. They performed the physical exercises barefoot on a non-slippery floor. A test leader ensured that the participants executed the physical exercises correctly and determined whether the participants passed or failed the physical exercises according to pre-set pass criteria. Results: Eleven of the physical exercises can assess weaknesses in specific physical abilities. In future tests, the physical exercise Short jump should be excluded from the set of physical exercises due to large variations in execution. The 11 participants younger than 30 years of age (8 men, 3 women) did not show any weaknesses. Nineteen of the 29 participants, 30–60 years of age (9 men, 10 women), and all 10 participants above 60 years of age (6 men, 4 women) showed weakness in at least one specific physical ability. Conclusions: Eleven out of the 12 physical exercises evaluated in this feasibility study and combinations of them can be used to identify weaknesses in specific physical abilities related to fall risk. Performance on physical exercises, alone or in combination, can also be used to determine the severity of the weaknesses in the three specific physical abilities. The results indicate that the physical exercises can identify age-related differences in specific physical abilities.

The ubiquity of sensors in smart-homes facilitates the support of independent living for older adults and enables cognitive assessment. Notably, there has been a growing interest in utilizing movement traces for identifying signs of cognitive impairment in recent years. In this study, we introduce an innovative approach to identify abnormal indoor movement patterns that may signal cognitive decline. This is achieved through the non-intrusive integration of smart-home sensors, including passive infrared sensors and sensors embedded in everyday objects. The methodology involves visualizing user locomotion traces and discerning interactions with objects on a floor plan representation of the smart-home, and employing different image descriptor features designed for image analysis tasks and synthetic minority oversampling techniques to enhance the methodology. This approach distinguishes itself by its flexibility in effortlessly incorporating additional features through sensor data. A comprehensive analysis, conducted with a substantial dataset obtained from a real smart-home, involving 99 seniors, including those with cognitive diseases, reveals the effectiveness of the proposed functional prototype of the system architecture. The results validate the system’s efficacy in accurately discerning the cognitive status of seniors, achieving a macro-averaged F₁-score of 72.22% for the two targeted categories: cognitively healthy and people with dementia. Furthermore, through experimental comparison, our system demonstrates superior performance compared with state-of-the-art methods.

Bladder monitoring, including urinary incontinence management and bladder urinary volume monitoring, is a vital part of urological care. Urinary incontinence is a common medical condition affecting the quality of life of more than 420 million people worldwide, and bladder urinary volume is an important indicator to evaluate the function and health of the bladder. Previous studies on non-invasive techniques for urinary incontinence management technology, bladder activity and bladder urine volume monitoring have been conducted. This scoping review outlines the prevalence of bladder monitoring with a focus on recent developments in smart incontinence care wearable devices and the latest technologies for non-invasive bladder urine volume monitoring using ultrasound, optical and electrical bioimpedance techniques. The results found are promising and their application will improve the well-being of the population suffering from neurogenic dysfunction of the bladder and the management of urinary incontinence. The latest research advances in bladder urinary volume monitoring and urinary incontinence management have significantly improved existing market products and solutions and will enable the development of more effective future solutions.

The extraction of relevant features from the photoplethysmography signal for estimating certain physiological parameters is a challenging task. Various feature extraction methods have been proposed in the literature. In this study, we present a novel fiducial point extraction algorithm to detect c and d points from the acceleration photoplethysmogram (APG), namely “CnD”. The algorithm allows for the application of various pre-processing techniques, such as filtering, smoothing, and removing baseline drift; the possibility of calculating first, second, and third photoplethysmography derivatives; and the implementation of algorithms for detecting and highlighting APG fiducial points. An evaluation of the CnD indicated a high level of accuracy in the algorithm’s ability to identify fiducial points. Out of 438 APG fiducial c and d points, the algorithm accurately identified 434 points, resulting in an accuracy rate of 99%. This level of accuracy was consistent across all the test cases, with low error rates. These findings indicate that the algorithm has a high potential for use in practical applications as a reliable method for detecting fiducial points. Thereby, it provides a valuable new resource for researchers and healthcare professionals working in the analysis of photoplethysmography signals.

Today, the health care sector has no test for early age-related deterioration in physical ability. The aim of this study was to evaluate questionnaires, videos and physical tests whose task will be to identify early markers related to an increased fall risk in middle-aged people. If the person is aware of deficits in physical ability related to fall risk, the person can then use that knowledge to perform relevant training that can strengthen the physical ability related to fall risk. Self-efficacy for balance and strength, physical ability related to fall risk and body composition were measured for 36 middle-aged test participants. This study shows that the tested physical exercises were useful for self-assessment of physical ability. Impairment in physical ability could not be identified solely with measurement of body composition, walking speed, questions, videos that show adjustments that are common in people with impaired balance, or an extended version of the Short version of Activities-specific Balance Confidence scale. This study indicates that a combination of questionnaires, videos and physical exercises can evaluate physical ability and act as a method to identify early markers related to increased fall risk. The questionnaire, videos and physical exercises can be implemented in a web tool that could make persons aware that they have decreased physical ability regarding fall risk or that they needlessly make physical compensations when performing daily activities and thus are missing opportunities to strengthen their physical ability every day.

The aim of this pilot study was to investigate the possibility to find a correlation between the output from a portable pedobarography system and the walking intensity expressed as walking speed. The system uses shoe insoles with force sensing resistors and wireless transmission of the data via Bluetooth. The force-time integral, at the toe-off phase of the step, for the force sensors in the forward part of the right foot was used to measure impulse data for 10 subjects performing walks in three different walking speeds. This data was then corrected by multiplication with the step frequency. This pilot study indicates that the portable pedobarography system output shows a linear relationship with the walking intensity expressed as walking speed on an individual level.

The lactate threshold is used by athletes to optimise the intensity during exercise. It is of interest to measure the threshold on the very day and during the present sport activity. Steady state ergometer tests have been performed on 40 individuals to compare the threshold found by an electro acoustic sensor system to the lactate threshold established by blood analyses evaluated with the Dmax method. The correlation coefficient between the threshold found by the sensor system and the one established by blood analyses regarding workload (Watt), heart rate (beats/min), and lactate level (mmol lactate/l blood) at the thresholds were 0.87 (p < 0.001), 0.74 (p < 0.001), and 0.65 (p < 0.001), respectively. The findings in this study indicates that the thresholds of individuals measured by the sensor system show good correlations to the threshold established with the Dmax method from lactate levels in blood samples.

End tidal carbon dioxide measurements with an electro acoustic capnograph prototype have been demonstrated. The aim of this study was to verify that it is possible to obtain an adequate capnogram using the prototype and to investigate the influence of ambient temperature and humidity variations. By simultaneous measurements with a reference capnograph, on subjects performing exercise, hypo- and hyperventilation, P_ETCO₂ readings from the reference were compared with the output signal from the prototype. The capnogram from the prototype correlated well with the reference in terms of breath time. The first parts of the expiration and inspiration phases were steeper for the reference than the prototype. The output signal from the prototype correlated well with the reference P_ETCO₂ readings with a correlation coefficient of 0.93 at varied temperature and relative humidity.

End tidal carbon dioxide measurement with an electro-acoustic sensor is demonstrated. The sensor consists of an acoustic resonator coupled to a low cost electro-acoustic element. By simultaneous measurements with a reference sensor, the new device was tested on subjects performing exercise, hypo- and hyperventilation whereby the CO2concentration ranged from 2.1 to 7.0 kPa. The output from the experimental device correlated well with the reference CO2readings with a correlation coefficient of 0.976. Response time for expiration less than 0.8 seconds was noted. The new device could be useful in situations where selectivity to other gases is not important.