Falls account for almost two million emergency department visits per year in the United States and are the leading cause of injury deaths among adults 65 years of age and older. Despite efforts to reduce fall risk factors, about one-third of community-dwelling older adults fall each year in the United States. New methods and devices are needed to prevent falls and to reduce morbidity and mortality related to falls. Presently, it is unknown if there is a measurable change in sway before a person falls as a result of age or medical condition. The purpose of this research is to develop a device that can be used to measure the prefall motion outside of a laboratory setting. To study human prefall motion, we developed a gyroscope-based sensor to test two concepts. The first was that a single-axis gyroscope could be used to directly measure angular position changes due to postural perturbations. The second was that a small widely used microprocessor could be used to distinguish normal from potentially problematic motion. This proof-of-concept prototype counted how many times perturbations occurred that were unlikely to be due to normal activities such as walking and stair climbing. With these basic concepts demonstrated, we sought to expand the device into a more versatile form using the same general approach. A wireless data acquisition system was developed. A fall was induced to allow the study of prefall motion on a healthy subject. The data collected showed a measureable change in postural motion. The developed device provides a viable approach to evaluating postural angular position that can be used outside of a laboratory facility. Further testing and development will involve additional subject testing and expansion of the device to function as an early fall detection or warning system. This research serves as a basis for further work in postural sway and interventions to prevent falls.

1.
Centers for Disease Control and Prevention
, 2003, “
Public Health and Aging: Non-Fatal Injuries Among Older Adults Treated in Hospital Emergency Departments-U.S.
,”
MMWR Morb Mortal Wkly Rep.
0149-2195,
52
, pp.
1019
1022
.
2.
Ganz
,
D. A.
,
Bao
,
Y.
,
Shekelle
,
P. G.
, and
Rubenstein
,
L. Z.
, 2007, “
Will My Patient Fall?
,”
JAMA, J. Am. Med. Assoc.
0098-7484,
297
, pp.
77
86
.
3.
American Geriatrics Society
,
British Geriatrics Society
, and
American Academy Orthopedic Surgeons Panel on Falls Prevention
, 2001, “
Guideline for Prevention in Falls in Older Persons
,”
J. Am. Geriatr. Soc.
0002-8614,
49
, pp.
664
672
.
4.
Allum
,
J. H. J.
,
Honegger
,
F.
, and
Keshner
,
E. A.
, 1993, “
Postural Responses of the Elderly: Comparisons With Vestibular-Deficit Subjects
,”
Sensorimotor Impairment in the Elderly
,
G. E.
Stelmach
and
V.
Hömberg
, eds.,
Kluwer Academic
,
Dordrecht, The Netherlands
.
5.
Era
,
P.
and
Heikkinen
,
E.
, 1985, “
Postural Sway During Standing and Unexpected Disturbance of Balance in Random Samples of Men of Different Ages
,”
J. Gerontol.
0022-1422,
40
(
3
), pp.
287
295
.
6.
Kaufman
,
K. R.
,
Brey
,
R. H.
,
Chou
,
L. -S.
,
Rabatin
,
A.
,
Brawn
,
A. W.
, and
Basford
,
J. R.
, 2006, “
Comparison of Subjective and Objective Measurements of Balance Disorders Following Traumatic Brain Injury
,”
Med. Eng. Phys.
1350-4533,
28
, pp.
234
239
.
7.
Keshner
,
E. A.
and
Kenyon
,
R. V.
, 2004, “
Using Immersive Technology for Postural Research and Rehabilitation
,”
Assist. Technol.
,
16
, pp.
54
62
.
8.
Melzer
,
I.
,
Benjuya
,
N.
, and
Kaplanski
,
J.
, 2004, “
Postural Stability in the Elderly: A Comparison Between Fallers and Non-Fallers
,”
Age Ageing
0002-0729,
33
, pp.
602
607
.
9.
Murray
,
M. P.
,
Seirig
,
A. A.
, and
Sepic
,
S. B.
, 1975, “
Normal Postural Stability and Steadiness: Quantitative Assessment
,”
J. Bone Jt. Surg., Am. Vol.
0021-9355,
57
(
4
), pp.
510
516
.
10.
Schieppati
,
M.
,
Grasso
,
M.
,
Siliotto
,
R.
, and
Nardone
,
A.
, 1993, “
Effect of Age, Chronic Diseases, and Parkinsonism on Postural Control
,”
Sensorimotor Impairment in the Elderly
,
G. E.
Stelmach
and
V.
Hömberg
, eds.,
Kluwer Academic
,
Dordrecht, The Netherlands
.
11.
Schmid
,
M.
,
Conforte
,
S.
,
Camomilla
,
V.
,
Cappozzo
,
A.
, and
D’Alessio
,
T.
, 2002, “
The Sensitivity of Posturographic Parameters to Acquisition Settings
,”
Med. Eng. Phys.
1350-4533,
24
, pp.
623
631
.
12.
Teasdale
,
N.
,
Stelmach
,
G. E.
, and
Breunig
,
A.
, 1991, “
Postural Sway Characteristics of the Elderly Under Normal and Altered Visual and Support Surface Conditions
,”
J. Gerontol.
0022-1422,
46
(
6
), pp.
B238
B244
.
13.
Teasdale
,
N.
,
Lajoie
,
Y.
,
Bard
,
C.
,
Fleury
,
M.
, and
Courtemanche
,
R.
, 1993, “
Cognitive Processes Involved for Maintaining Postural Stability While Standing and Walking
,”
Sensorimotor Impairment in the Elderly
,
G. E.
Stelmach
and
V.
Hömberg
, eds.,
Kluwer Academic
,
Dordrecht, The Netherlands
.
14.
van Wegen
,
E. E. H.
,
van Emmerik
,
R. E. A.
, and
Riccio
,
G. E.
, 2001, “
Active Postural Sway and the Detection of Stability Boundaries
,”
Studies in Perception and Action VI, 11th International Conference on Perception and Action
,
G.
Burton
, and
R. C.
Schmidt
,
Lawrence Erlbaum
,
London, UK
.
15.
Verhagen
,
E.
,
Bobbert
,
M.
,
Inklaar
,
M.
,
van Kalken
,
M.
,
van der Beek
,
A.
,
Bouter
,
L.
, and
van Mechelen
,
W.
, 2005, “
The Effect of a Balance Training Programme on Centre of Pressure Excursion in One-Leg Stance
,”
Clin. Biomech. (Bristol, Avon)
0268-0033,
20
, pp.
1094
1100
.
16.
Woollacott
,
M. H.
,
Moore
,
S.
, and
Hu
,
M. H.
, 1993, “
Improvements in Balance in the Elderly Through Training in Sensory Organization Abilities
,”
Proceedings of the NATO Advanced Research Workshop on Sensorimotor Impairment in the Elderly
,
G. E.
Stelmach
and
V.
Hömberg
, eds.,
Kluwer Academic
,
Boston, MA
.
17.
Woollacott
,
M. H.
, and
Shumway-Cook
,
A.
, 1997, “
Clinical and Research Methodology for the Study of Posture and Balance
,”
Gait Disorders of Aging: Falls and Therapeutic Strategies
,
J. C.
Masdeu
,
L.
Sudarsky
, and
L.
Wolfson
, eds.,
Lippincott-Raven
,
Philadelphia, PA
.
18.
Sipp
,
A. R.
and
Rowley
,
B. A.
, 2007, “
Alternative Devices for the Quantification of Human Motion
,”
Crit. Rev. Biomed. Eng.
0278-940X,
35
(
5
), pp.
413
442
.
19.
Mayagoitia
,
R. E.
,
Nene
,
A. V.
, and
Veltink
,
P. H.
, 2002, “
Accelerometer and Rate Gyroscope Measurement of Kinematics: An Inexpensive Alternative to Optical Motion Analysis Systems
,”
J. Biomech.
0021-9290,
35
, pp.
537
542
.
20.
Najafi
,
B.
,
Aminian
,
K.
,
Loew
,
F.
,
Blanc
,
Y.
, and
Robert
,
Ph.
, 2000, “
Falling Risk Evaluation in Elderly Using Miniature Gyroscope
,”
First Annual International IEEE-EMBS Special Topic Conference on Microtechnologies in Medicine and Biology
, pp.
557
561
.
21.
Tong
,
K.
and
Granat
,
M. H.
, 1999, “
A Practical Gait Analysis System Using Gyroscopes
,”
Med. Eng. Phys.
1350-4533,
21
, pp.
87
94
.
22.
Horak
,
F. B.
and
Nashner
,
L. M.
, 1985, “
Central Programming of Postural Movements: Adaptation to Altered Support-Surface Configurations
,”
J. Neurophysiol.
0022-3077,
55
(
6
), pp.
1369
1381
.
23.
Barra
,
J.
,
Bray
,
A.
,
Sahni
,
V.
,
Golding
,
J. F.
, and
Gresty
,
M. A.
, 2006, “
Increasing Cognitive Load With Increasing Balance Challenge: Recipe for Catastrophe
,”
Exp. Brain Res.
0014-4819,
174
, pp.
734
745
.
24.
Mackinnon
,
C. D.
and
Winter
,
D. A.
, 1993, “
Control of Whole Body Balance in the Frontal Plane During Human Walking
,”
J. Biomech.
0021-9290,
26
(
6
), pp.
633
644
.
25.
Kamen
,
G.
,
Patten
,
C.
,
Du
,
C. D.
, and
Sison
,
S.
, 1998, “
An Accelerometry-Based System for the Assessment of Balance and Postural Sway
,”
Gerontology
0304-324X,
44
, pp.
40
45
.
26.
Allum
,
J. H. J.
and
Carpenter
,
M. G.
, 2005, “
A Speedy Solution for Balance and Gait Analysis: Angular Velocity Measured at the Centre of Body Mass
,”
Curr. Opin. Neurol.
1350-7540,
18
, pp.
15
21
.
27.
Rowley
,
B. A.
and
Bierce
,
A. R.
, 2007, “
A System to Detect Motion in the Sagittal Plane
,”
RESNA Conference Proceedings
.
29.
Mayagoitia
,
R. E.
,
Lötters
,
J. C.
,
Veltink
,
P. H.
, and
Hermens
,
H.
, 2002, “
Standing Balance Evaluation Using a Triaxial Accelerometer
,”
Gait and Posture
0966-6362,
16
, pp.
55
59
.
30.
Luinge
,
H. J.
and
Veltink
,
P. H.
, 2004, “
Inclination Measurement of Human Movement Using a 3-D Accelerometer With Autocalibration
,”
IEEE Trans. Neural Syst. Rehabil. Eng.
1534-4320,
12
(
1
), pp.
112
121
.
33.
Gage
,
W. H.
,
Winter
,
D. A.
,
Frank
,
J. S.
, and
Adkin
,
A. L.
, 2004, “
Kinematic and Kinetic Validity of the Inverted Pendulum Model in Quiet Standing
,”
Gait and Posture
0966-6362,
19
, pp.
124
132
.
34.
Winter
,
D. A.
,
Patla
,
A. E.
,
Prince
,
F.
,
Ishac
,
M.
, and
Gielo-Perczak
,
K.
, 1998, “
Stiffness Control of Balance in Quiet Standing
,”
J. Neurophysiol.
0022-3077,
80
, pp.
1211
1221
.
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