Human Movement Science, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.
Center for Clinical Neuroplasticity Medical Park Loipl, Bischofswiesen, Germany.
BMC Geriatr. 2022 Mar 23;22(1):244. doi: 10.1186/s12877-022-02902-1.
Frailty is accompanied by limitations of activities of daily living (ADL) and frequently associated with reduced quality of life, institutionalization, and higher health care costs. Despite the importance of ADL performance for the consequence of frailty, movement analyses based on kinematic markers during the performance of complex upper extremity-based manual ADL tasks in frail elderly is still pending. The main objective of this study was to evaluate if ADL task performance of two different tasks in frail elderlies can be assessed by an activity measurement based on an acceleration sensor integrated into a smartwatch, and further to what degree kinematic parameters would be task independent.
ADL data was obtained from twenty-seven elderly participants (mean age 81.6 ± 7.0 years) who performed two ADL tasks. Acceleration data of the dominant hand was collected using a smartwatch. Participants were split up in three groups, F (frail, n = 6), P (pre-frail, n = 13) and R (robust, n = 8) according to a frailty screening. A variety of kinematic measures were calculated from the vector product reflecting activity, agility, smoothness, energy, and intensity.
Measures of agility, smoothness, and intensity revealed significant differences between the groups (effect sizes combined over tasks η = 0.18 - 0.26). Smoothness was particularly affected by frailty in the tea making task, while activity, agility, a different smoothness parameter and two intensity measures were related to frailty in the gardening task. Four of nine parameters revealed good reliability over both tasks (r = 0.44 - 0.69). Multiple linear regression for the data combined across tasks showed that only the variability of the magnitude of acceleration peaks (agility) contributed to the prediction of the frailty score (R = 0.25).
The results demonstrate that ADL task performance can be assessed by smartwatch-based measures and further shows task-independent differences between the three levels of frailty. From the pattern of impaired and preserved performance parameters across the tested tasks, we concluded that in persons with frailty ADL performance was more impaired by physiological deficiencies, i.e., physical power and endurance, than by cognitive functioning or sensorimotor control.
虚弱伴随着日常生活活动（ADL）的限制，并且经常与生活质量下降、住院和更高的医疗保健费用相关。尽管 ADL 表现对虚弱的后果很重要，但基于对虚弱老年人进行复杂上肢基于手动 ADL 任务时运动学标志物的运动分析仍有待研究。本研究的主要目的是评估在虚弱老年人中执行两项不同任务时，基于集成在智能手表中的加速度传感器的活动测量是否可以评估 ADL 任务表现，以及运动学参数在多大程度上与任务无关。
从 27 名年龄在 81.6±7.0 岁的老年人参与者中获得 ADL 数据，他们执行了两项 ADL 任务。使用智能手表收集惯用手的加速度数据。参与者根据虚弱筛查结果分为三组，F（虚弱，n=6）、P（虚弱前期，n=13）和 R（强壮，n=8）。从反映活动、敏捷度、平滑度、能量和强度的向量积中计算出各种运动学度量。
在组间，敏捷度、平滑度和强度的度量均显示出显著差异（任务综合的效应大小η=0.18-0.26）。在泡茶任务中，平滑度特别受到虚弱的影响，而在园艺任务中，活动、敏捷度、另一个平滑度参数和两个强度度量与虚弱有关。九个参数中有四个在两个任务中均具有良好的可靠性（r=0.44-0.69）。跨任务数据的多元线性回归表明，只有加速度峰值幅度的可变性（敏捷度）有助于预测虚弱评分（R=0.25）。
研究结果表明，ADL 任务表现可以通过智能手表测量来评估，并且进一步显示了在三个虚弱水平之间的任务独立性差异。从跨测试任务的受损和保留性能参数的模式中，我们得出结论，在虚弱的个体中，ADL 表现受到生理缺陷（即体力和耐力）的影响比认知功能或感觉运动控制更大。
