September/October 2012

Innovative Sensor to Stop Falls

By Lindsey Getz
Aging Well
Vol. 5 No. 5 P. 26

Recent data suggest that fall accidents are on the rise among the older adult population. In fact, according to the Centers for Disease Control and Prevention (CDC), each year one in three adults aged 65 and older experiences a fall. Falls are now the leading cause of injury-related deaths among this population and the most common cause of nonfatal injuries and hospital admissions for trauma.

However, researchers at Virginia Tech and the University of Virginia are looking to change these disturbing fall statistics. With a $1.2 million grant from the National Science Foundation’s Smart Health and Wellbeing program, they are creating a portable fall prediction monitoring system for the early detection of fall risk that can provide diagnosis and treatment before a fall occurs.

With the aid of the grant, a device is in the development stages that could be worn by older adults to measure potentially small declining changes in gait, posture, and mobility—all major indicators that can help point to a future fall. The sensor will function for several days between battery recharging, collecting long-term data during everyday wear, explains Thurmon Lockhart, PhD, an associate professor in the Virginia Tech Grado department of industrial and systems engineering and a researcher involved with the grant. An early prototype of the sensor has already been built and tested under a previous National Science Foundation-funded project.

In-clinic studies have used a wristwatch-sized node worn on both the wrists and the ankles as well as the sacrum to collect data. The product’s wearability is important, and researchers are contemplating incorporating these sensors into a faux piece of jewelry. The final product will also develop a monitoring system called ROOP-Alert (for Remote Observation Operating Platform). Lockhart says it will bridge gait and posture analysis, body sensor networks, low-power radio-frequency wireless communication, and gerontology. Once the device has collected the necessary information, data-processing algorithms will provide a mobility analysis and fall risk assessment for each patient. Physicians will be able to determine which of their patients are at the greatest risk of falling and then implement fall prevention measures.

While the research is still new, the long-term hope is that this portable monitoring system will become widely available. With the technology, primary care physicians or gerontologists could make fall risk assessment a routine part of their patients’ care. “Down the road, this technology could be used in a variety of settings,” says Karen Roberto, PhD, a professor of human development at Virginia Tech and director of the Center for Gerontology and the Institute for Society, Culture, and Environment, who is also involved in the research grant. “The dream is that it could be incorporated into a routine exam the way many other tests have become standard preventive measures. Fall prevention would become routine.”

A Serious Silent Danger
While modern medicine puts a lot of focus on disease prevention and has made many advances in that area, falls remain a huge problem, and the issue requires more attention. Lockhart has been involved in several lines of research regarding falls and has become passionate on the subject. “In the US, as well as other countries, we are approaching such a significant portion of the elderly population experiencing falls that it’s on the verge of becoming a pandemic,” says Lockhart, who is also the director of the Virginia Tech Locomotion Research Laboratory and has worked with dozens of companies invested in preventing falls, including UPS. “When we look at a fall accident, we look at it from various points of view, including a number of characteristics, or change of characteristics, affecting the outcome of the fall. So when people come into the lab, we measure information such as their gait speed, strength, and reactive/recovery time. Then we make them slip and fall and see what happens.”

One of the bigger issues surrounding slips and falls is that elders often don’t mention them to others. The CDC estimates that of all the falls occurring each year, fewer than one-half of those patients actually talk to their healthcare providers about fall incidents. “It’s a hidden problem for a lot of people,” Roberto says. “They may keep that information to themselves because they worry it would signal a lack of independence; or maybe they’ve just decided it wasn’t a big deal. But even if the person doesn’t get hurt, that initial fall may be a sign that they have a greater propensity to fall in the future, and that future fall could be much more costly.”

Roberto says there is also growing fear around falling. Many older adults are aware of the statistics or have a friend who has fallen and they become afraid as a result. “That fear of falling—whether you’ve actually fallen or not—may cause people to limit their activities,” Roberto says. “In the long run, that can be detrimental on emotional and physical levels.”

Making Changes
While the new remote monitoring technology is still in its early phases, there are other important intervention solutions that can be considered in the meantime. “There are prevention opportunities out there, such as strengthening programs and balance programs, that can help the patient with their musculoskeletal integrity,” Lockhart says. “Task has to be taught as well. For instance, carrying a pillow, even though it’s very light, still changes your gait. The patient can be taught safer ways to perform tasks, such as a better way to hold the pillow.”

But Lockhart says it’s not just about exercise and balance training, as there’s more to falls than the musculoskeletal system. “Nutrition, the vestibular system, vision, and personal habits all also influence fall accidents,” he says. “So there has to be some risk assessment. We can test vision, and we can ask the patient some important questions.”

Roberto says physicians can’t expect that patients will be forthcoming about a fall. “You have to ask the direct questions,” she says. “And it’s not just about falling to the ground. Even a trip or slip can indicate some instability. Once the physician knows there is some likelihood that this person could fall, then they can talk about prescribing exercise and improving balance. Medications can also come into play. If part of the exam reveals that a medication has side effects that may lead to a greater likelihood of falls, then they can discuss what options there might be in switching those medications or at least becoming more aware of those side effects.”

Lockhart says once a patient falls, the risk of falling again is very high. He believes this new technology will help reduce that risk and may even help reduce the risk of that initial fall. Lockhart says that result could be significant. “I believe we could really help some people, and that is the reason for this program: helping save lives.”

— Lindsey Getz is a freelance writer based in Royersford, Pennsylvania.