Evaluation of an inertial sensor system for analysis of timed-up-and-go under dual-task demands.

Functional tests, such as the timed-up-and-go (TUG), are routinely used to screen for mobility issues and fall risk. While the TUG is easy to administer and evaluate, its single time-to-completion outcome may not discriminate between different mobility challenges. Wearable sensors provide an opportunity to collect a variety of additional variables during clinical tests. The purpose of this study was to assess a new wearable inertial sensor system (iTUG) by investigating the effects of cognitive tasks in a dual-task paradigm on spatiotemporal and kinematic variables during the TUG. No previous studies have looked at both spatiotemporal variables and kinematics during dual-task TUG tests. 20 healthy young participants (10 males) performed a total 15 TUG trials with two different cognitive tasks and a normal control condition. Total time, along with spatiotemporal gait parameters and kinematics for all TUG subtasks (sit-to-stand, walking, turn, turn-to-sit), were measured using the inertial sensors. Time-to-completion from iTUG was highly correlated with concurrent manual timing. Spatiotemporal variables during walking showed expected differences between control and cognitive dual-tasks while trunk kinematics appeared to show more sensitivity to dual-tasks than reported previously in straight line walking. Non-walking TUG subtasks showed only minor changes during dual-task conditions indicating a possible attentional shift away from the cognitive task. Stride length and some variability measures were significantly different between the two cognitive tasks suggesting an ability to discriminate between tasks. Overall, the use of the iTUG system allows the collection of both traditional and potentially more discriminatory variables with a protocol that is easily used in a clinical setting.

[1]  Jeffrey M. Hausdorff,et al.  An instrumented timed up and go: the added value of an accelerometer for identifying fall risk in idiopathic fallers , 2011, Physiological measurement.

[2]  M. Morris,et al.  Reliability of measurements obtained with the Timed "Up & Go" test in people with Parkinson disease. , 2001, Physical therapy.

[3]  M. Woollacott,et al.  Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. , 2000, Physical therapy.

[4]  Lorenzo Chiari,et al.  Validity of a Smartphone-based instrumented Timed Up and Go. , 2012, Gait & posture.

[5]  S. Lowe,et al.  Improving Fall Risk Assessment in Home Care: Interdisciplinary Use of the Timed Up and Go (TUG) , 2013, Home healthcare nurse.

[6]  Roy P C Kessels,et al.  Executive functions are associated with gait and balance in community-living elderly people. , 2008, The journals of gerontology. Series A, Biological sciences and medical sciences.

[7]  Ray-Yau Wang,et al.  Dual-task-related gait changes in individuals with stroke. , 2007, Gait & posture.

[8]  F. Horak,et al.  Assessing mobility at home in people with early Parkinson's disease using an instrumented Timed Up and Go test. , 2011, Parkinsonism & related disorders.

[9]  Jeffrey M. Hausdorff,et al.  Can an accelerometer enhance the utility of the Timed Up & Go Test when evaluating patients with Parkinson's disease? , 2010, Medical engineering & physics.

[10]  Kamiar Aminian,et al.  The instrumented timed up and go test: potential outcome measure for disease modifying therapies in Parkinson's disease , 2009, Journal of Neurology, Neurosurgery & Psychiatry.

[11]  Barry R. Greene,et al.  Quantitative Falls Risk Assessment Using the Timed Up and Go Test , 2010, IEEE Transactions on Biomedical Engineering.

[12]  Joe R. Nocera,et al.  Using the Timed Up & Go test in a clinical setting to predict falling in Parkinson's disease. , 2013, Archives of physical medicine and rehabilitation.

[13]  Cédric Annweiler,et al.  Recurrent Falls and Dual Task–Related Decrease in Walking Speed: Is There a Relationship? , 2008, Journal of the American Geriatrics Society.

[14]  H. Dawes,et al.  Cognitive motor interference while walking: A systematic review and meta-analysis , 2011, Neuroscience & Biobehavioral Reviews.

[15]  F. Horak,et al.  iTUG, a Sensitive and Reliable Measure of Mobility , 2010, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[16]  R. Haux,et al.  Predicting in-patient falls in a geriatric clinic , 2009, Zeitschrift für Gerontologie und Geriatrie.

[17]  T. Higuchi,et al.  Multitarget Stepping Program in Combination with a Standardized Multicomponent Exercise Program Can Prevent Falls in Community‐Dwelling Older Adults: A Randomized, Controlled Trial , 2013, Journal of the American Geriatrics Society.

[18]  Kamiar Aminian,et al.  A Novel Approach to Reducing Number of Sensing Units for Wearable Gait Analysis Systems , 2013, IEEE Transactions on Biomedical Engineering.

[19]  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.

[20]  G. Borm,et al.  The effect of cognitive dual tasks on balance during walking in physically fit elderly people. , 2007, Archives of physical medicine and rehabilitation.

[21]  James McNames,et al.  Mobility Lab to Assess Balance and Gait with Synchronized Body-worn Sensors. , 2011, Journal of bioengineering & biomedical science.

[22]  Wiebren Zijlstra,et al.  Sensitivity of sensor-based sit-to-stand peak power to the effects of training leg strength, leg power and balance in older adults. , 2014, Gait & posture.

[23]  F. Horak,et al.  Body-worn motion sensors detect balance and gait deficits in people with multiple sclerosis who have normal walking speed. , 2012, Gait & posture.

[24]  Matthias Gietzelt,et al.  Prädiktion von Stürzen stationärer Patienten in einer geriatrischen Klinik: Eine klinische Studie zur Kombination von Assessmentdaten und einfachen, sensorisch erfassten Gangparametern , 2009 .

[25]  Relationship between functional vision and balance and mobility performance in community-dwelling older adults , 2013, Aging Clinical and Experimental Research.

[26]  Jorunn L Helbostad,et al.  Interstride trunk acceleration variability but not step width variability can differentiate between fit and frail older adults. , 2005, Gait & posture.

[27]  E. Scherder,et al.  Reliability of Six Physical Performance Tests in Older People With Dementia , 2012, Physical Therapy.

[28]  Jeffrey M. Hausdorff,et al.  Dual‐tasking effects on gait variability: The role of aging, falls, and executive function , 2006, Movement disorders : official journal of the Movement Disorder Society.

[29]  D. Strasser,et al.  Analytical Review: Focus on Fall Screening Assessments , 2013, PM & R : the journal of injury, function, and rehabilitation.

[30]  J. Allum,et al.  Effects of biofeedback on trunk sway during dual tasking in the healthy young and elderly. , 2009, Gait & posture.