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      Evaluation of Accelerometer-Based Fall Detection Algorithms on Real-World Falls

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          Abstract

          Despite extensive preventive efforts, falls continue to be a major source of morbidity and mortality among elderly. Real-time detection of falls and their urgent communication to a telecare center may enable rapid medical assistance, thus increasing the sense of security of the elderly and reducing some of the negative consequences of falls. Many different approaches have been explored to automatically detect a fall using inertial sensors. Although previously published algorithms report high sensitivity (SE) and high specificity (SP), they have usually been tested on simulated falls performed by healthy volunteers. We recently collected acceleration data during a number of real-world falls among a patient population with a high-fall-risk as part of the SensAction-AAL European project. The aim of the present study is to benchmark the performance of thirteen published fall-detection algorithms when they are applied to the database of 29 real-world falls. To the best of our knowledge, this is the first systematic comparison of fall detection algorithms tested on real-world falls. We found that the SP average of the thirteen algorithms, was (mean±std) 83.0%±30.3% (maximum value = 98%). The SE was considerably lower (SE = 57.0%±27.3%, maximum value = 82.8%), much lower than the values obtained on simulated falls. The number of false alarms generated by the algorithms during 1-day monitoring of three representative fallers ranged from 3 to 85. The factors that affect the performance of the published algorithms, when they are applied to the real-world falls, are also discussed. These findings indicate the importance of testing fall-detection algorithms in real-life conditions in order to produce more effective automated alarm systems with higher acceptance. Further, the present results support the idea that a large, shared real-world fall database could, potentially, provide an enhanced understanding of the fall process and the information needed to design and evaluate a high-performance fall detector.

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          Most cited references54

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          Movement Disorders Society Scientific Issues Committee report: SIC Task Force appraisal of clinical diagnostic criteria for Parkinsonian disorders.

          As there are no biological markers for the antemortem diagnosis of degenerative parkinsonian disorders, diagnosis currently relies upon the presence and progression of clinical features and confirmation depends on neuropathology. Clinicopathologic studies have shown significant false-positive and false-negative rates for diagnosing these disorders, and misdiagnosis is especially common during the early stages of these diseases. It is important to establish a set of widely accepted diagnostic criteria for these disorders that may be applied and reproduced in a blinded fashion. This review summarizes the findings of the SIC Task Force for the study of diagnostic criteria for parkinsonian disorders in the areas of Parkinson's disease, dementia with Lewy bodies, progressive supranuclear palsy, multiple system atrophy, and corticobasal degeneration. In each of these areas, diagnosis continues to rest on clinical findings and the judicious use of ancillary studies. Copyright 2003 Movement Disorder Society
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            Systematic review of definitions and methods of measuring falls in randomised controlled fall prevention trials.

            to review systematically the range of case definitions and methods used to measure falls in randomised controlled trials. a Cochrane review of fall prevention interventions was used to identify fall definitions in published trials. Secondary searches of various databases were used to identify additional methodological or theoretical papers. Two independent reviewers undertook data extraction, with adjudication by a third reviewer in cases of disagreement. community-dwelling and institutionalised older persons. 90 publications met the predefined inclusion criteria. Of these, 44 provided no definition of the term fall. In the remainder, there were substantial variations in the definition and methods of measuring falls. Reporting periods ranged from 1 week to 4 years with only 41% using prospective data collection methods. the standard of reporting falls in published trials is poor and significantly impedes comparison between studies. The review has been used to inform an international consensus exercise to make recommendations for a core set of outcome measures for fall prevention trials.
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              Evaluation of a threshold-based tri-axial accelerometer fall detection algorithm.

              Using simulated falls performed under supervised conditions and activities of daily living (ADL) performed by elderly subjects, the ability to discriminate between falls and ADL was investigated using tri-axial accelerometer sensors, mounted on the trunk and thigh. Data analysis was performed using MATLAB to determine the peak accelerations recorded during eight different types of falls. These included; forward falls, backward falls and lateral falls left and right, performed with legs straight and flexed. Falls detection algorithms were devised using thresholding techniques. Falls could be distinguished from ADL for a total data set from 480 movements. This was accomplished using a single threshold determined by the fall-event data-set, applied to the resultant-magnitude acceleration signal from a tri-axial accelerometer located at the trunk.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2012
                16 May 2012
                : 7
                : 5
                : e37062
                Affiliations
                [1 ]Department of Electronics, Computer Science and Systems, University of Bologna, Bologna, Italy
                [2 ]Department of Clinical Gerontology, Robert-Bosch-Hospital, Stuttgart, Germany
                [3 ]Laboratory of Movement Analysis and Measurement, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
                [4 ]Tel Aviv Sourasky Medical Center, Laboratory for Gait and Neurodynamics, Movement Disorders Unit and Department of Physical Therapy, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
                [5 ]Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
                Cardiff University, United Kingdom
                Author notes

                Conceived and designed the experiments: FB CB AC JK. Performed the experiments: FB . Analyzed the data: FB CB AC LC KA JMH WZ JK. Contributed reagents/materials/analysis tools: FB CB AC LC KA JMH WZ JK. Wrote the paper: FB CB AC LC KA JMH WZ JK.

                Article
                PONE-D-11-20610
                10.1371/journal.pone.0037062
                3353905
                22615890
                212a6a1e-b8c7-45cb-84bc-730ac9f7c7a7
                Bagalà et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                : 17 October 2011
                : 13 April 2012
                Page count
                Pages: 9
                Categories
                Research Article
                Biology
                Biotechnology
                Bioengineering
                Biomedical Engineering
                Computer Science
                Algorithms
                Engineering
                Bioengineering
                Biomedical Engineering
                Signal Processing
                Signal Filtering
                Mathematics
                Applied Mathematics
                Algorithms
                Statistics
                Medicine
                Geriatrics
                Long-Term Care
                Rehabilitation

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