title: Long-term mobility monitoring of older adults using accelerometers in a clinical environment.
abstract: OBJECTIVE
  To assess the accuracy of accelerometer-based mobility monitoring during extended measurements on older adults in a clinical setting and to evaluate two different approaches to thresholding.
  
  
  METHODS
  The monitoring device consisted of two Analog Devices ADXL202 accelerometers, an ambulatory data-logger and associated cabling. The monitoring system used custom-designed analysis software to detect activities of daily living, namely duration of sitting, standing, lying and moving during the period monitored. An investigator shadowed the subjects throughout the recording period.
  
  
  METHODS
  This study monitored five older adults, with varying degrees of mobility, resident in a rehabilitation clinic, over four days.
  
  
  METHODS
  The accelerometer data were analysed using a MATLAB program that allowed trunk and thigh threshold angles to be set to distinguish between sitting, standing, lying and moving. Two different approaches to setting these thresholds were investigated: (1) using a midpoint tolerance value of 45 degrees and (2) using a 'best estimate' tolerance value. The analysis program generates a summary of activities, which is then compared line-by-line with the manual summary created by the observer. The result was a hit/miss ratio representative of the system's accuracy.
  
  
  RESULTS
  The detection accuracies for sitting and lying using a mid-point tolerance value were poor, with an average detection accuracy of 75% obtained. The 'best estimate' approach improved the detection accuracies for sitting and lying by approximately 18% to an average value of 93%.
  
  
  CONCLUSIONS
  In a population of older adults, the static activities of sitting, standing and lying and dynamic activities can be distinguished using the technique and threshold values outlined here to a degree of accuracy of 92% and higher.
authors.affiliation: Biomedical Electronics Laboratory, Department of Electronic and Computer Engineering, University of Limerick, National Technological Park, Limerick, Ireland. karen.culhane@ul.ie
authors.forename: K M
authors.initials: KM
authors.lastname: Culhane
authors.forename: G M
authors.initials: GM
authors.lastname: Lyons
authors.forename: D
authors.initials: D
authors.lastname: Hilton
authors.forename: P A
authors.initials: PA
authors.lastname: Grace
authors.forename: D
authors.initials: D
authors.lastname: Lyons
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003625:Data Collection / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D012047:Rehabilitation Centers; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012984:Software