The potential of accelerometry-derived gait features for assessing the risk of falls in older adults

Research Objectives: To investigate the usefulness of gait-related spectral features derived from accelerometry to assess the risk of falls in older adults (OA).

Design: Retrospective cohort

Setting: Gait laboratory

Participants: Publicly available data (Physionet.org) collected from 60 community-living OA categorized into either the Control Group (CG, n=34) or the Faller Group (FG, n=26) based on the self-reported history of falls (fallers: ≥ two falls in the previous year).

Interventions: N/A

Main Outcome Measures: A total of 16 spectral features - mean frequency (fmean), median frequency (fmed), peak power spectral density (PSDp), and dominant frequency (fd) were derived from the tri-axial and the vector magnitude (VM) data recorded from a lower back-worn accelerometer during walking. The clinical outcomes included the Dynamic Gait Index (DGI), the Berg Balance Scale (BBS), and the Timed Up and Go (TUG) test.

Results: Mann-Whitney U tests showed that there was a significant difference in mean fd (anterior-posterior (AP) and VM (U=610.5, p=0.012), fmed (AP, VM) (U=590, p=0.028) between the groups. No significant group differences were found in BBS (p=0.285), TUG (p=0.109), and DGI (p=0.258). Pearson’s correlation between the spectral features and the clinical outcomes showed that 13 of 16 spectral features for the FG were significantly correlated (p < 0.05) with the BBS, TUG, and DGI. No significant correlations were observed for the CG (p>0.05), except for fd (BBS), fmean (DGI, TUG), and PSDp (TUG).

Conclusions: The current evidence supports the sensitivity of the accelerometry features to isolate gait characteristics specific to fallers, where the clinical outcomes may suffer from subjectivity, lack of sensitivity, and ceiling effects. For the FG, strong correlations with the clinical outcomes suggest the agreement between the spectral features and the functional status.

Author(s) Disclosures: None.