title: Towards holistic free-living assessment in Parkinson's disease: Unification of gait and fall algorithms with a single accelerometer.
abstract: Technological developments have seen the miniaturization of sensors, small enough to be embedded in wearable devices facilitating unobtrusive and longitudinal monitoring in free-living environments. Concurrently, the advances in algorithms have been ad-hoc and fragmented. To advance the mainstream use of wearable technology and improved functionality of algorithms all methodologies must be unified and robustly tested within controlled and free-living conditions. Here we present and unify a (i) gait segmentation and analysis algorithm and (ii) a fall detection algorithm. We tested the unified algorithms on a cohort of young healthy adults within a laboratory. We then deployed the algorithms on longitudinal (7 day) accelerometer-based data from an older adult with Parkinson's disease (PD) to quantify real world gait and falls. We compared instrumented falls to a self-reported falls diary to test algorithm efficiency and discuss the use of unified algorithms to impact free-living assessment in PD where accurate recognition of gait may reduce the number of automated detected falls (38/week). This informs ongoing work to use gait and related outcomes as pragmatic clinical markers.
authors.forename: Alan
authors.initials: A
authors.lastname: Godfrey
authors.forename: Alan
authors.initials: A
authors.lastname: Bourke
authors.forename: Silvia
authors.initials: S
authors.lastname: Del Din
authors.forename: Rosie
authors.initials: R
authors.lastname: Morris
authors.forename: Aodhan
authors.initials: A
authors.lastname: Hickey
authors.forename: Jorunn L
authors.initials: JL
authors.lastname: Helbostad
authors.forename: Lynn
authors.initials: L
authors.lastname: Rochester
mesh_terms: D061725:Accelerometry / Q000379:methods*; D000058:Accidental Falls; D000203:Activities of Daily Living; D000368:Aged; D000465:Algorithms; D005684:Gait / Q000502:physiology*; D006801:Humans; D010300:Parkinson Disease / Q000503:physiopathology*