New neural network classifier of fall-risk based on the Mahalanobis distance and kinematic parameters assessed by a wearable device.

Fall prevention lacks easy, quantitative and wearable methods for the classification of fall-risk (FR). Efforts must be thus devoted to the choice of an ad hoc classifier both to reduce the size of the sample used to train the classifier and to improve performances. A new methodology that uses a neural network (NN) and a wearable device are hereby proposed for this purpose. The NN uses kinematic parameters assessed by a wearable device with accelerometers and rate gyroscopes during a posturography protocol. The training of the NN was based on the Mahalanobis distance and was carried out on two groups of 30 elderly subjects with varying fall-risk Tinetti scores. The validation was done on two groups of 100 subjects with different fall-risk Tinetti scores and showed that, both in terms of specificity and sensitivity, the NN performed better than other classifiers (naive Bayes, Bayes net, multilayer perceptron, support vector machines, statistical classifiers). In particular, (i) the proposed NN methodology improved the specificity and sensitivity by a mean of 3% when compared to the statistical classifier based on the Mahalanobis distance (SCMD) described in Giansanti (2006 Physiol. Meas. 27 1081-90); (ii) the assessed specificity was 97%, the assessed sensitivity was 98% and the area under receiver operator characteristics was 0.965.