title: Could In-Home Sensors Surpass Human Observation of People with Parkinson's at High Risk of Falling? An Ethnographic Study.
abstract: Self-report underpins our understanding of falls among people with Parkinson's (PwP) as they largely happen unwitnessed at home. In this qualitative study, we used an ethnographic approach to investigate which in-home sensors, in which locations, could gather useful data about fall risk. Over six weeks, we observed five independently mobile PwP at high risk of falling, at home. We made field notes about falls (prior events and concerns) and recorded movement with video, Kinect, and wearable sensors. The three women and two men (aged 71 to 79 years) having moderate or severe Parkinson's were dependent on others and highly sedentary. We most commonly noted balance protection, loss, and restoration during chair transfers, walks across open spaces and through gaps, turns, steps up and down, and tasks in standing (all evident walking between chair and stairs, e.g.). Our unobtrusive sensors were acceptable to participants: they could detect instability during everyday activity at home and potentially guide intervention. Monitoring the route between chair and stairs is likely to give information without invading the privacy of people at high risk of falling, with very limited mobility, who spend most of the day in their sitting rooms.
authors.affiliation: Faculty of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK; NIHR CLAHRC Wessex, University of Southampton, Southampton SO17 1BJ, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Stack
authors.affiliation: School of Systems Engineering, University of Reading, Reading RG1 5AQ, UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: King
authors.affiliation: School of Systems Engineering, University of Reading, Reading RG1 5AQ, UK.
authors.forename: Balazs
authors.initials: B
authors.lastname: Janko
authors.affiliation: Faculty of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Burnett
authors.affiliation: Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Hammersley
authors.affiliation: Faculty of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK.
authors.forename: Veena
authors.initials: V
authors.lastname: Agarwal
authors.affiliation: Faculty of Engineering, University of Bristol, Bristol BS8 1TH, UK.
authors.forename: Sion
authors.initials: S
authors.lastname: Hannuna
authors.affiliation: Faculty of Engineering, University of Bristol, Bristol BS8 1TH, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Burrows
authors.affiliation: Faculty of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK.
authors.forename: Ann
authors.initials: A
authors.lastname: Ashburn
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D056902:Clinical Alarms; D005260:Female; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D004856:Postural Balance