Feature extraction and selection for objective gait analysis and fall risk assessment by accelerometry

BackgroundFalls in the elderly is nowadays a major concern because of their consequences on elderly general health and moral states. Moreover, the aging of the population and the increasing life expectancy make the prediction of falls more and more important. The analysis presented in this article makes a first step in this direction providing a way to analyze gait and classify hospitalized elderly fallers and non-faller. This tool, based on an accelerometer network and signal processing, gives objective informations about the gait and does not need any special gait laboratory as optical analysis do. The tool is also simple to use by a non expert and can therefore be widely used on a large set of patients.MethodA population of 20 hospitalized elderlies was asked to execute several classical clinical tests evaluating their risk of falling. They were also asked if they experienced any fall in the last 12 months. The accelerations of the limbs were recorded during the clinical tests with an accelerometer network distributed on the body. A total of 67 features were extracted from the accelerometric signal recorded during a simple 25 m walking test at comfort speed. A feature selection algorithm was used to select those able to classify subjects at risk and not at risk for several classification algorithms types.ResultsThe results showed that several classification algorithms were able to discriminate people from the two groups of interest: fallers and non-fallers hospitalized elderlies. The classification performances of the used algorithms were compared. Moreover a subset of the 67 features was considered to be significantly different between the two groups using a t-test.ConclusionsThis study gives a method to classify a population of hospitalized elderlies in two groups: at risk of falling or not at risk based on accelerometric data. This is a first step to design a risk of falling assessment system that could be used to provide the right treatment as soon as possible before the fall and its consequences. This tool could also be used to evaluate the risk several times during the revalidation procedure.

[1]  L. Ferrucci,et al.  A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. , 1994, Journal of gerontology.

[2]  R. Baumgartner,et al.  One‐Leg Balance Is an Important Predictor of Injurious Falls in Older Persons , 1997, Journal of the American Geriatrics Society.

[3]  Jens Timmer,et al.  Characteristics of hand tremor time series , 1993, Biological Cybernetics.

[4]  L Fried,et al.  Fear of Falling among the Community-Dwelling Elderly , 1993, Journal of aging and health.

[5]  M. Kangas,et al.  Determination of simple thresholds for accelerometry-based parameters for fall detection , 2007, 2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[6]  Debbie Rand,et al.  How Active Are People With Stroke?: Use of Accelerometers to Assess Physical Activity , 2009, Stroke.

[7]  S. Haugland,et al.  Falls in the elderly , 1992, The Lancet.

[8]  S M Pincus,et al.  Approximate entropy as a measure of system complexity. , 1991, Proceedings of the National Academy of Sciences of the United States of America.

[9]  Gabriele Meyer,et al.  The Tinetti test: Babylon in geriatric assessment. , 2006, Zeitschrift fur Gerontologie und Geriatrie.

[10]  Pedro M. Domingos,et al.  On the Optimality of the Simple Bayesian Classifier under Zero-One Loss , 1997, Machine Learning.

[11]  P. J. Bowman,et al.  Central Nervous System–Active Medications and Risk for Falls in Older Women , 2002, Journal of the American Geriatrics Society.

[12]  Isabelle Guyon,et al.  An Introduction to Variable and Feature Selection , 2003, J. Mach. Learn. Res..

[13]  France Mourey,et al.  Mini motor test: a clinical test for rehabilitation of patients showing psychomotor disadaptation syndrome (PDS). , 2005, Archives of gerontology and geriatrics.

[14]  T. Fukuda,et al.  The stepping test: two phases of the labyrinthine reflex. , 1959, Acta oto-laryngologica.

[15]  Thomas J. Watson,et al.  An empirical study of the naive Bayes classifier , 2001 .

[16]  W. Ondo,et al.  Ambulatory monitoring of freezing of gait in Parkinson's disease , 2008, Journal of Neuroscience Methods.

[17]  Eric Barrey,et al.  Falls in the Elderly : the Need for Teamwork Through a Network , 2002 .

[18]  Roberto Hornero,et al.  Spectral and Nonlinear Analyses of MEG Background Activity in Patients With Alzheimer's Disease , 2008, IEEE Transactions on Biomedical Engineering.

[19]  Sascha Köpke,et al.  Der Tinetti-Test – Babylon im geriatrischen Assessment , 2006 .

[20]  D. Giansanti Investigation of fall-risk using a wearable device with accelerometers and rate gyroscopes , 2006, Physiological measurement.

[21]  S. Lord,et al.  Visual Risk Factors for Falls in Older People , 2001, Age and ageing.

[22]  M. Tinetti Performance‐Oriented Assessment of Mobility Problems in Elderly Patients , 1986, Journal of the American Geriatrics Society.

[23]  Karen W. Hayes,et al.  Measures of adult general performance tests: The Berg Balance Scale, Dynamic Gait Index (DGI), Gait Velocity, Physical Performance Test (PPT), Timed Chair Stand Test, Timed Up and Go, and Tinetti Performance‐Oriented Mobility Assessment (POMA) , 2003 .

[24]  R. Fitzpatrick,et al.  Acceleration patterns of the head and pelvis when walking are associated with risk of falling in community-dwelling older people. , 2003, The journals of gerontology. Series A, Biological sciences and medical sciences.

[25]  Ethan R. Buch,et al.  Effects of Parkinson's disease on visuomotor adaptation , 2003, Experimental Brain Research.

[26]  D. Grossman,et al.  Injury prevention. Second of two parts. , 1997, The New England journal of medicine.

[27]  John P Hirdes,et al.  Restriction in activity associated with fear of falling among community-based seniors using home care services. , 2004, Age and ageing.

[28]  Diane Podsiadlo,et al.  The Timed “Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons , 1991, Journal of the American Geriatrics Society.

[29]  John C. W. Rayner,et al.  Welch's approximate solution for the Behrens-Fisher problem , 1987 .

[30]  Reinhold Haux,et al.  Assessing elderly persons' fall risk using spectral analysis on accelerometric data - a clinical evaluation study , 2008, 2008 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.