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Review
. 2021 Oct 19;21(20):6918.
doi: 10.3390/s21206918.

Detecting Fall Risk and Frailty in Elders with Inertial Motion Sensors: A Survey of Significant Gait Parameters

Luisa Ruiz-Ruiz  1 , Antonio R Jimenez  1 , Guillermo Garcia-Villamil  1 , Fernando Seco  1
Affiliations
Review

Detecting Fall Risk and Frailty in Elders with Inertial Motion Sensors: A Survey of Significant Gait Parameters

Luisa Ruiz-Ruiz et al. Sensors (Basel). .

Abstract

In the elderly, geriatric problems such as the risk of fall or frailty are a challenge for society. Patients with frailty present difficulties in walking and higher fall risk. The use of sensors for gait analysis allows the detection of objective parameters related to these pathologies and to make an early diagnosis. Inertial Measurement Units (IMUs) are wearables that, due to their accuracy, portability, and low price, are an excellent option to analyze human gait parameters in health-monitoring applications. Many relevant gait parameters (e.g., step time, walking speed) are used to assess motor, or even cognitive, health problems in the elderly, but we perceived that there is not a full consensus on which parameters are the most significant to estimate the risk of fall and the frailty state. In this work, we analyzed the different IMU-based gait parameters proposed in the literature to assess frailty state (robust, prefrail, or frail) or fall risk. The aim was to collect the most significant gait parameters, measured from inertial sensors, able to discriminate between patient groups and to highlight those parameters that are not relevant or for which there is controversy among the examined works. For this purpose, a literature review of the studies published in recent years was carried out; apart from 10 previous relevant reviews using inertial and other sensing technologies, a total of 22 specific studies giving statistical significance values were analyzed. The results showed that the most significant parameters are double-support time, gait speed, stride time, step time, and the number of steps/day or walking percentage/day, for frailty diagnosis. In the case of fall risk detection, parameters related to trunk stability or movements are the most relevant. Although these results are important, the total number of works found was limited and most of them performed the significance statistics on subsets of all possible gait parameters; this fact highlights the need for new frailty studies using a more complete set of gait parameters.

Keywords: frailty; gait analysis; inertial sensor.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Human Gait Cycle (GC). The first line under the foot sketches represents the duration in percentage of the GC. Below the different gait events: Heel Strike (HL), Toe-Off (TO), Full Forefoot Load (FFL), Heel Lift (HL). Below are the segmented phases for the right and left feet. The last part indicates the relation between the left and right feet. The gait phase’s duration is approximate and varies between authors; these percentages are accepted in the literature.
Figure 2
Figure 2
Important spatial gait parameters: step length, stride length, and step width. Black and grey shaded colors in footprints represent the right and left feet, respectively.
Figure 3
Figure 3
Specific spatial gait parameters: toe-off angle, heel strike angle and clearance.
Figure 4
Figure 4
Sensors’ body locations and papers’ references.
See this image and copyright information in PMC

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