4.7 Article

Fall Risk Assessment for the Elderly Based on Weak Foot Features of Wearable Plantar Pressure

Publisher

IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC
DOI: 10.1109/TNSRE.2022.3167473

Keywords

Foot; Feature extraction; Footwear; Older adults; Risk management; Trajectory; Pressure sensors; Single foot COP; fall risk assessment; weak foot; gait symmetry; gait temporal consistency; wearable plantar pressure; machine learning

Funding

  1. Technology Program of Guangzhou [202002030354, 202002030262]
  2. Science and Technology Project of Zhongshan [2019AG024, 2020B2053]
  3. Natural Science Foundation of Guangdong Province [2018A030310407]
  4. Guangzhou Key Laboratory of Body Data Science [201605030011]
  5. Major Science and Technology Projects in Guangdong Province [2016B010108008]

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The high fall rate of the elderly poses significant challenges to families and the medical system, making early risk assessment and intervention necessary. In this study, in-shoe plantar pressure sensors were used for long-term fall risk assessments due to their portability. By proposing a definition of weak foot and extracting multi-dimensional weak foot features, the study addressed the sensitivity problem of single foot features and facilitated the extraction of temporal consistency related features. Results showed that the fall risk assessment models based on these features had good generalization performance and were practical and reliable in real-life monitoring situations.
The high fall rate of the elderly brings enormous challenges to families and the medical system; therefore, early risk assessment and intervention are quite necessary. Compared to other sensor-based technologies, in-shoe plantar pressure sensors, effectiveness and low obtrusiveness are widely used for long-term fall risk assessments because of their portability. While frequently-used bipedal center-of-pressure (COP) features are derived from a pressure sensing platform, they are not suitable for the shoe system or pressure insole owing to the lack of relative position information. Therefore, in this study, a definition of weak foot was proposed to solve the sensitivity problem of single foot features and facilitate the extraction of temporal consistency related features. Forty-four multi-dimensional weak foot features based on single foot COP were correspondingly extracted; notably, the relationship between the fall risk and temporal inconsistency in the weak foot were discussed in this study, and probability distribution method was used to analyze the symmetry and temporal consistency of gait lines. Though experiments, foot pressure data were collected from 48 subjects with 24 high risk (HR) and 24 low risk (LR) ones obtained by the smart footwear system. The final models with 87.5% accuracy and 100% sensitivity on test data outperformed the base line models using bipedal COP. The results and feature space shown the novel features of wearable plantar pressure could comprehensively evaluate the difference between HR and LR groups. Our fall risk assessment models based on these features had good generalization performance, and showed practicability and reliability in real-life monitoring situations.

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