Citation

Ihlen EAF, van Schooten KS, Bruijn SM, van Dieen JH, Vereijken B, Helbostad JL, Pijnappels M. Front. Aging Neurosci. 2018; 10: e44.

Affiliation

Department of Human Movement Sciences, Vrije Universiteit, Amsterdam, Netherlands.

Copyright

(Copyright © 2018, Frontiers Research Foundation)

DOI

10.3389/fnagi.2018.00044

PMID

29556188

PMCID

PMC5844982

Abstract

Age and age-related diseases have been suggested to decrease entropy of human gait kinematics, which is thought to make older adults more susceptible to falls. In this study we introduce a new entropy measure, called phase-dependent generalized multiscale entropy (PGME), and test whether this measure improves fall-risk prediction in community-dwelling older adults. PGME can assess phase-dependent changes in the stability of gait dynamics that result from kinematic changes in events such as heel strike and toe-off. PGME was assessed for trunk acceleration of 30 s walking epochs in a re-analysis of 1 week of daily-life activity data from the FARAO study, originally described by van Schooten et al. (2016). The re-analyzed data set contained inertial sensor data from 52 single- and 46 multiple-time prospective fallers in a 6 months follow-up period, and an equal number of non-falling controls matched by age, weight, height, gender, and the use of walking aids. The predictive ability of PGME for falls was assessed using a partial least squares regression. PGME had a superior predictive ability of falls among single-time prospective fallers when compared to the other gait features. The single-time fallers had a higher PGME (p< 0.0001) of their trunk acceleration at 60% of their step cycle when compared with non-fallers. No significant differences were found between PGME of multiple-time fallers and non-fallers, but PGME was found to improve the prediction model of multiple-time fallers when combined with other gait features. These findings suggest that taking into account phase-dependent changes in the stability of the gait dynamics has additional value for predicting falls in older people, especially for single-time prospective fallers.

Language: en

Keywords

accelerometry; accidental falls; aged; complexity; fall prediction; fall risk; gait assessment; physical activity