远程计时起立行走评估日常生活活动可揭示手术后移动能力的变化。

Remote timed up and go evaluation from activities of daily living reveals changing mobility after surgery.

机构信息

Philips Research Europe, High Tech Campus 34, 5656AE, Eindhoven, The Netherlands. Author to whom any correspondence should be addressed.

出版信息

Physiol Meas. 2019 Apr 3;40(3):035004. doi: 10.1088/1361-6579/ab0d3e.

DOI:10.1088/1361-6579/ab0d3e

PMID:30840937

Abstract

BACKGROUND

Mobility impairment is common in older adults and negatively influences the quality of life. Mobility level may change rapidly following surgery or hospitalization in the elderly. The timed up and go (TUG) is a simple, frequently used clinical test for functional mobility; however, TUG requires supervision from a trained clinician, resulting in infrequent assessments. Additionally, assessment by TUG in clinic settings may not be completely representative of the individual's mobility in their home environment.

OBJECTIVE

In this paper, we introduce a method to estimate TUG from activities detected in free-living, enabling continuous remote mobility monitoring without expert supervision. The method is used to monitor changes in mobility following total hip arthroplasty (THA).

METHODS

Community-living elderly (n = 239, 65-91 years) performed a standardized TUG in a laboratory and wore a wearable pendant device that recorded accelerometer and barometric sensor data for at least three days. Activities of daily living (ADLs), including walks and sit-to-stand transitions, and their related mobility features were extracted and used to develop a regularized linear model for remote TUG test estimation. Changes in the remote TUG were evaluated in orthopaedic patients (n = 15, 55-75 years), during 12-weeks period following THA.

MAIN RESULTS

In leave-one-out-cross-validation (LOOCV), a strong correlation (ρ = 0.70) was observed between the new remote TUG and standardized TUG times. Test-retest reliability of 3-days estimates was high (ICC = 0.94). Compared to week 2 post-THA, remote TUG was significantly improved at week 6 (11.7 ± 3.9 s versus 8.0 ± 1.8 s, p < 0.001), with no further change at 12-weeks (8.1 ± 3.9 s, p = 0.37).

SIGNIFICANCE

Remote TUG can be estimated in older adults using 3-days of ADLs data recorded using a wearable pendant. Remote TUG has discriminatory potential for identifying frail elderly and may provide a convenient way to monitor changes in mobility in unsupervised settings.

摘要

背景

行动障碍在老年人中很常见，会降低生活质量。老年人在手术后或住院后，行动水平可能会迅速变化。计时起立行走测试（TUG）是一种常用于评估功能性移动能力的简单测试，但需要经过训练的临床医生监督，导致评估频率较低。此外，在临床环境中进行 TUG 评估可能无法完全代表个体在其家庭环境中的移动能力。

目的

本文介绍了一种从日常生活中检测到的活动中估计 TUG 的方法，可实现无需专家监督的连续远程移动监测。该方法用于监测全髋关节置换术后（THA）的移动能力变化。

方法

社区居住的老年人（n=239，65-91 岁）在实验室中进行了标准化的 TUG 测试，并佩戴了一个可穿戴吊坠设备，该设备至少记录了 3 天的加速度计和气压传感器数据。提取日常生活活动（ADL），包括散步和坐站转换，以及与这些活动相关的移动特征，用于开发远程 TUG 测试估计的正则化线性模型。在接受 THA 的骨科患者（n=15，55-75 岁）中，在术后 12 周期间评估了远程 TUG 的变化。

主要结果

在留一法交叉验证（LOOCV）中，新的远程 TUG 与标准化 TUG 时间之间观察到很强的相关性（ρ=0.70）。3 天的测试-再测试可靠性较高（ICC=0.94）。与 THA 后第 2 周相比，第 6 周远程 TUG 显著改善（11.7±3.9s 对 8.0±1.8s，p＜0.001），第 12 周无进一步变化（8.1±3.9s，p=0.37）。