title: Assessing Upper Extremity Motion: An Innovative Method to Identify Frailty.
abstract: OBJECTIVE
  To objectively identify frailty using wireless sensors and an innovative upper extremity motion assessment routine that does not rely on gait.
  
  
  METHODS
  Validation study.
  
  
  METHODS
  Southwestern tertiary academic medical center, Tucson, Arizona.
  
  
  METHODS
  Convenience subsample of the Arizona Frailty Cohort, a community-dwelling older adults (≥65; n = 117; 50 nonfrail, 51 prefrail, 16 frail).
  
  
  METHODS
  Wireless sensors were attached to the upper arm and forearm with bands, and subjects performed repetitive elbow flexion for 20 seconds on each side. Information was extracted on objective slowness, weakness, exhaustion, and flexibility measures, and associations between parameters and Fried frailty categories were determined.
  
  
  RESULTS
  Speed of elbow flexion (slowness) was 29% less in prefrail and 59% less in frail than in nonfrail controls (P < .001), power of movement (weakness) was 61% less in prefrail and 89% less frail (P < .001), and speed variation (exhaustion) was 35% more in prefrail and 272% more in frail (P < .001). Using elbow flexion parameters in regression models, sensitivity and specificity of 100% were achieved in predicting frailty and sensitivity of 87% and specificity of 95% in predicting prefrailty compared to Fried frailty category.
  
  
  CONCLUSIONS
  The suggested innovative upper extremity frailty assessment method integrates low-cost sensors, and the physical assessment is easily performed in less than 1 minute. The uniqueness of the proposed technology is its applicability in older nonambulatory individuals, such as those in emergency settings. Further improvement is warrant to make it suitable for routine clinical applications.
authors.affiliation: Department of Surgery, College of Medicine, Interdisciplinary Consortium on Advanced Motion Performance and Southern Arizona Limb Salvage Alliance, Tucson, Arizona.
authors.forename: Nima
authors.initials: N
authors.lastname: Toosizadeh
authors.affiliation: Arizona Center on Aging, University of Arizona, Tucson, Arizona.
authors.forename: Jane
authors.initials: J
authors.lastname: Mohler
authors.affiliation: Department of Surgery, College of Medicine, Interdisciplinary Consortium on Advanced Motion Performance and Southern Arizona Limb Salvage Alliance, Tucson, Arizona.|Arizona Center on Aging, University of Arizona, Tucson, Arizona.
authors.forename: Bijan
authors.initials: B
authors.lastname: Najafi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over / Q000502:physiology*; D001130:Arizona; D015331:Cohort Studies; D005260:Female; D005542:Forearm / Q000502:physiology*; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods*; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D016059:Range of Motion, Articular / Q000502:physiology*; D012782:Shoulder / Q000502:physiology*; D013647:Task Performance and Analysis
keywords: frailty; geriatric; immobile; kinematics; upper limb