可穿戴加速度计测量的自由行走步态节奏：评估跌倒风险的传统移动性测量的有前途的替代方法。
Free-Living Gait Cadence Measured by Wearable Accelerometer: A Promising Alternative to Traditional Measures of Mobility for Assessing Fall Risk.
机构信息
Division of Geriatric Medicine and Gerontology, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Center on Aging and Health, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
出版信息
J Gerontol A Biol Sci Med Sci. 2023 May 11;78(5):802-810. doi: 10.1093/gerona/glac013.
BACKGROUND
Wearable devices have become widespread in research applications, yet evidence on whether they are superior to structured clinic-based assessments is sparse. In this manuscript, we compare traditional, laboratory-based metrics of mobility with a novel accelerometry-based measure of free-living gait cadence for predicting fall rates.
METHODS
Using negative binomial regression, we compared traditional in-clinic measures of mobility (6-minute gait cadence, speed, and distance, and 4-m gait speed) with free-living gait cadence from wearable accelerometers in predicting fall rates. Accelerometry data were collected with wrist-worn Actigraphs (GT9X) over 7 days in 432 community-dwelling older adults (aged 77.29 ± 5.46 years, 59.1% men, 80.2% White) participating in the Study to Understand Fall Reduction and Vitamin D in You. Falls were ascertained using monthly calendars, quarterly contacts, and ad hoc telephone reports. Accelerometry-based free-living gait cadence was estimated with the Adaptive Empirical Pattern Transformation algorithm.
RESULTS
Across all participants, free-living cadence was significantly related to fall rates; every 10 steps per minute higher cadence was associated with a 13.2% lower fall rate (p = .036). Clinic-based measures of mobility were not related to falls (p > .05). Among higher-functioning participants (cadence ≥100 steps/minute), every 10 steps per minute higher free-living cadence was associated with a 27.7% lower fall rate (p = .01). In participants with slow baseline gait (gait speed <0.8 m/s), all metrics were significantly associated with fall rates.
CONCLUSION
Data collected from biosensors in the free-living environment may provide a more sensitive indicator of fall risk than in-clinic tests, especially among higher-functioning older adults who may be more responsive to intervention.
CLINICAL TRIAL REGISTRATION
NCT02166333.
背景
可穿戴设备在研究应用中已广泛普及，但关于它们是否优于基于结构化临床评估的证据还很匮乏。在本文中，我们将比较传统的基于实验室的移动性指标和基于新型加速计的自由步行步频测量方法，以预测跌倒率。
方法
我们使用负二项回归，比较了传统的基于临床的移动性指标（6 分钟步行步速、速度和距离，以及 4 米步行速度）和来自参与“理解跌倒减少和维生素 D 研究”的 432 名社区居住的老年人（年龄 77.29±5.46 岁，59.1%为男性，80.2%为白人）的可穿戴加速度计的自由步行步频数据，以预测跌倒率。使用腕戴 Actigraph（GT9X）在 7 天内收集加速度计数据，共 432 名社区居住的老年人（年龄 77.29±5.46 岁，59.1%为男性，80.2%为白人）参与了“理解跌倒减少和维生素 D 研究”。使用每月日历、每季度联系和临时电话报告来确定跌倒情况。使用自适应经验模式变换算法估计自由步行的步频。
结果
在所有参与者中，自由步行的步频与跌倒率显著相关；步频每增加 10 步/分钟，跌倒率降低 13.2%（p=0.036）。基于临床的移动性测量指标与跌倒无关（p>0.05）。在功能更高的参与者（步频≥100 步/分钟）中，自由步行的步频每增加 10 步/分钟，跌倒率降低 27.7%（p=0.01）。在基线步行速度较慢的参与者（步行速度<0.8m/s）中，所有指标与跌倒率均显著相关。
结论
在自由活动环境中从生物传感器收集的数据可能比临床测试更能敏感地反映跌倒风险，尤其是在对干预措施更敏感的功能更高的老年人中。
临床试验注册
NCT02166333。
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