Automatic recognition of falls in gait-slip training: Harness load cell based criteria

• Published in: Journal of biomechanics Vol. 44; no. 12; pp. 2243 - 2249
• Main Authors: Yang, Feng, Pai, Yi-Chung
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 11.08.2011; Elsevier; Elsevier Limited
• Subjects: Accidental Falls - prevention & control; Adult; Age Factors; Aged; Aged, 80 and over; Aging; Automation; Balance loss; Biological and medical sciences; Biomechanics. Biorheology; Body Weight; Equipment Design; Fundamental and applied biological sciences. Psychology; Gait; Harness assistance; Humans; Outcome recognition; Perturbation training; Physical Medicine and Rehabilitation; Postural Balance; Regression Analysis; Reproducibility of Results; Stress, Mechanical; Tissues, organs and organisms biophysics; Vertebrates: body movement. Posture. Locomotion. Flight. Swimming. Physical exercise. Rest. Sports; Walking; Outcome recognition; Balance loss; Perturbation training; Automation; Harness assistance; Prognosis; Gait; Equilibrium; Posture; Biomechanics; Fall; Automatic recognition; Biomedical engineering
• ISSN: 0021-9290; 1873-2380; 1873-2380
• DOI: 10.1016/j.jbiomech.2011.05.039

Over-head-harness systems, equipped with load cell sensors, are essential to the participants' safety and to the outcome assessment in perturbation training. The purpose of this study was to first develop an automatic outcome recognition criterion among young adults for gait-slip training and then verify such criterion among older adults. Each of 39 young and 71 older subjects, all protected by safety harness, experienced 8 unannounced, repeated slips, while walking on a 7m walkway. Each trial was monitored with a motion capture system, bilateral ground reaction force (GRF), harness force, and video recording. The fall trials were first unambiguously indentified with careful visual inspection of all video records. The recoveries without balance loss (in which subjects' trailing foot landed anteriorly to the slipping foot) were also first fully recognized from motion and GRF analyses. These analyses then set the gold standard for the outcome recognition with load cell measurements. Logistic regression analyses based on young subjects' data revealed that the peak load cell force was the best predictor of falls (with 100% accuracy) at the threshold of 30% body weight. On the other hand, the peak moving average force of load cell across 1s period, was the best predictor (with 100% accuracy) separating recoveries with backward balance loss (in which the recovery step landed posterior to slipping foot) from harness assistance at the threshold of 4.5% body weight. These threshold values were fully verified using the data from older adults (100% accuracy in recognizing falls). Because of the increasing popularity in the perturbation training coupling with the protective over-head-harness system, this new criterion could have far reaching implications in automatic outcome recognition during the movement therapy. ► Gold standard is established for identifying harness-assisted recoveries or falls. ► Criteria for young adults are fully (100% accuracy) verified among older adults. ► Criteria provide immediate, automatic recognition of perturbation training outcome.