Abstract
Telerehabilitation services represent a promising option for patients undergoing home-based rehabilitation as a result of stroke or other pathologies. To facilitate recovery following stroke, prompt and constant neural and motion rehabilitation is essential. When a patient returns home after treatment, he or she may experience a high degree of imbalance. It can be challenging to remotely assess fall-risk in the home. This chapter describes a promising new telerehabilitation-based approach to fall-risk detection via a wearable tool, integrated to a global system for mobile communication (GSM) net. The technology is based upon an inertial measurement unit and two medical protocols (i.e., a sit-to-stand clinical application and a posturography clinical application). The approach incorporates a 4-point fall-risk score: 1, no fall- risk to 4, major fall-risk.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Aminian K, Robert P, Buscher EE, et al. Physical activity monitoring based on accelerometry: validation and comparison with video observation. Med Biol Eng Comput. 1999;37(3):304–8.
Available at: http://www.oposrl.it/pdf/molle_codivilla.pdf. Accessed Mar 2009.
Available at: http://www.stroke.org/site/PageNavigator/HOME. Accessed Mar 2009.
Busser HJ, Ott J, Uiterwaal M, et al. Ambulatory monitoring of children’s activities. Med Eng Phys. 1997;19:440–5.
Bussmann HB, Reuvekamp PJ, Veltink PH, et al. Validity and reliability of measurements obtained with an activity monitor in people with and without a transtibial amputation. Phys Ther. 1998;78(9):989–98.
Bussmann JBJ, Tulen JHM, Van Herel ECG, et al. Quantification of physical activities by means of ambulatory accelerometry: a validation study. Psychophysiology. 1998;35:488–96.
Bussmann JB, Van de Laar YM, Neeleman MP, et al. Ambulatory accelerometry to quantify motor behaviour in patients after failed back surgery: a validation study. Pain. 1998;74(2–3):153–61.
Bussmann JBJ, Veltink PH, Koelma F, et al. Ambulatory monitoring of mobility-related activities: the initial phase of the development of an activity monitor. Eur J Phys Rehabil Med. 1995;5:2–7.
Dunne DM, Lyons GM, Grace PA. The feasibility of posture and physical movement detection using accelerometers. Ir J Med Sci. 2000;169:22.
Fahrenberg J, Foerster F, Mueller W, et al. Assessment of posture and motion by multi-channel piezoresistive accelerometer recordings. Psychophysiology. 1997;34:607–12.
Fahrenberg J, Muller W, Foerster F, et al. A multi-channel investigation of physical activity. J Psychophysiol. 1996;10:209–17.
Foerster F, Fahrenberg J. Motion pattern and posture: correctly assessed by calibrated accelerometers. Behav Res Methods Instrum Comput. 2000;32:450–7.
Foerster F, Smeja M, Fahrenberg J. Detection of posture and motion by accelerometry: a validation study in ambulatory monitoring. Comput Hum Behav. 1999;15(5):571–83.
Giansanti D. Investigation of fall-risk using a wearable device with accelerometers and rate gyroscopes. Physiol Meas. 2006;27:1081–90.
Giansanti D, Maccioni G. Comparison of three different kinematic sensor assemblies for locomotion study. Physiol Meas. 2005;26:689–705.
Giansanti D, Maccioni G, Cesinaro S, et al. Assessment of fall-risk by means of a neural network based on parameters assessed by a wearable device during posturography. Med Eng Phys. 2008;30:367–72.
Giansanti D, Maccioni G, Macellari V. The development and test of a device for the reconstruction of 3-D position and orientation by means of a kinematic sensor assembly with rate gyroscopes and accelerometers. IEEE Trans Biomed Eng. 2005;52:1271–7.
Giansanti D, Maccioni G, Macellari V, et al. Towards the investigation of kinematic parameters from an integrated measurement unit for the classification of the rising from the chair. Conf Proc IEEE Eng Med Biol Soc. 2006;1:1742–5.
Giansanti D, Macellari V, Maccioni G. New neural network classifier of fall-risk based on the Mahalanobis distance and kinematic parameters assessed by a wearable device. Physiol Meas. 2008;29:N11–9.
Giansanti D, Macellari V, Maccioni G. Telemonitoring and telerehabilitation of patients with Parkinson’s disease: health technology assessment of a novel wearable step counter. Telemed J E Health. 2008;14:76–83.
Giansanti D, Morelli S, Dionisio P, et al. Design, construction and integration in instrumented walkways of a portable kit for the assessment of gait parameters in tele-rehabilitation. In: Cohn E, Kumar S, editors. Telerehabilitation. London: Springer; 2012.
Giansanti D, Morelli S, Maccioni G, et al. Toward the design of a wearable system for fall-risk detection in telerehabilitation. Telemed J E Health. 2009;15(3):296–9.
Giansanti D, Morelli S, Maccioni G, et al. Design and construction of a portable kit for the assessment of gait parameters in daily-rehabilitation. Rapporti ISTISAN 10/16, Istituto Superiore di Sanità, Roma; 2010.
Giansanti D, Tiberi Y, Maccioni G. Integration of motion sensor monitoring units in stroke gait telerehabilitation programs of continuity of care. Telemed J E Health. 2009;15:105–11.
Kandel ER, Schwart RJ, Jessell TM. Principi di neuroscienze. Milan, Italy: CEA; 2000.
Kiani K, Snijders CJ, Gelsema ES. Computerised analysis of daily life motor activity for ambulatory monitoring. Technol Health Care. 1997;5:307–18.
Kiani K, Snijders CJ, Gelsema ES. Recognition of daily motor activity classes using an artificial neural network. Arch Phys Med Rehabil. 1998;79:147–54.
Lyons GM, Culhane KM, Hilton D, et al. A description of an accelerometer-based mobility monitoring technique. Med Eng Phys. 2005;27(6):497–504.
Uiterwaal M, Glerum EB, Busser HJ, et al. Ambulatory monitoring of physical activity in working situations, a validation study. J Med Eng Technol. 1998;22:168–72.
Van den Berg-Emons HJ, Bussmann JB, Balk AH, et al. Validity of ambulatory accelerometry to quantify physical activity in heart failure. Scand J Rehabil Med. 2000;32(4):187–92.
Veltink PH, Bussmann HBJ, de Vries W, et al. Detection of static and dynamic activities using uniaxial accelerometers. IEEE Trans Rehabil Eng. 1996;4:375–85.
Veltink PH, Bussmann HBJ, Koelma F, et al. The feasibility of posture and movement detection by accelerometry. In: Proceedings of the 15th annual international conference of the IEEE, engineering in medicine and biology society, San Diego, 1993. p. 1230–1.
Acknowledgement
This work was funded by the Istituto Superiore di Sanità (The Italian NIH) in the 3-year long (2006–2008) program entitled “Design and Construction of Innovative Wearable Systems for the Monitoring of Kinematic Parameters.” No competing financial conflicts exist.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag London
About this chapter
Cite this chapter
Giansanti, D., Dionisio, P., Maccioni, G. (2013). Design and Construction of a Wearable Tool for Fall-Risk Detection in Telerehabilitation. In: Kumar, S., Cohn, E. (eds) Telerehabilitation. Health Informatics. Springer, London. https://doi.org/10.1007/978-1-4471-4198-3_18
Download citation
DOI: https://doi.org/10.1007/978-1-4471-4198-3_18
Published:
Publisher Name: Springer, London
Print ISBN: 978-1-4471-4197-6
Online ISBN: 978-1-4471-4198-3
eBook Packages: MedicineMedicine (R0)