Despite extensive preventive efforts, falls continue to be a major source of morbidity and mortality among elderly. Real-time detection of falls and their urgent communication to a telecare center may enable rapid medical assistance, thus increasing the sense of security of the elderly and reducing some of the negative consequences of falls. Many different approaches have been explored to automatically detect a fall using inertial sensors. Although previously published algorithms report high sensitivity (SE) and high specificity (SP), they have usually been tested on simulated falls performed by healthy volunteers. We recently collected acceleration data during a number of real-world falls among a patient population with a high-fall-risk as part of the SensAction-AAL European project. The aim of the present study is to benchmark the performance of thirteen published fall-detection algorithms when they are applied to the database of 29 real-world falls. To the best of our knowledge, this is the first systematic comparison of fall detection algorithms tested on real-world falls. We found that the SP average of the thirteen algorithms, was (mean±std) 83.0%±30.3% (maximum value = 98%). The SE was considerably lower (SE = 57.0%±27.3%, maximum value = 82.8%), much lower than the values obtained on simulated falls. The number of false alarms generated by the algorithms during 1-day monitoring of three representative fallers ranged from 3 to 85. The factors that affect the performance of the published algorithms, when they are applied to the real-world falls, are also discussed. These findings indicate the importance of testing fall-detection algorithms in real-life conditions in order to produce more effective automated alarm systems with higher acceptance. Further, the present results support the idea that a large, shared real-world fall database could, potentially, provide an enhanced understanding of the fall process and the information needed to design and evaluate a high-performance fall detector.

Falls among older people are a widely documented public health problem. Automatic fall detection has recently gained huge importance because it could allow for the immediate communication of falls to medical assistance. The aim of this work is to present a novel wavelet-based approach to fall detection, focusing on the impact phase and using a dataset of real-world falls. Since recorded falls result in a non-stationary signal, a wavelet transform was chosen to examine fall patterns. The idea is to consider the average fall pattern as the “prototype fall”.In order to detect falls, every acceleration signal can be compared to this prototype through wavelet analysis. The similarity of the recorded signal with the prototype fall is a feature that can be used in order to determine the difference between falls and daily activities. The discriminative ability of this feature is evaluated on real-world data. It outperforms other features that are commonly used in fall detection studies, with an Area Under the Curve of 0.918. This result suggests that the proposed wavelet-based feature is promising and future studies could use this feature (in combination with others considering different fall phases) in order to improve the performance of fall detection algorithms.

Sufficient capacity and quality of performance of complex movement patterns during daily activity, such as standing up from a bed, is a prerequisite for independent living and also may be an indicator of fall risk. Until now, the transfer from lying-to-sit-to-stand-to-walk (LSSW) was investigated by functional testing, subjective rating or for activity classification of subtasks. The aim of this study was to use a single body-fixed inertial sensor to describe the complex movement of the LSSW transfer. Fifteen older patients of a geriatric rehabilitation clinic (median age 81 years) and ten young, healthy persons (median age 37 years) were instructed to stand up from bed in a continuous movement and to start walking. Data acquisition was performed using an inertial measurement unit worn on the lower back. Parameters extracted from the sensor outputs were able to correctly classify the subjects into a correct group with sensitivity and specificity between 90% and 100%. ICCs of the descriptive parameters ranged between 0.85 and 0.95 in the cohort of older patients. The different strategies adopted to transfer from lying to standing up were estimated through an extended Kalman filter. The results obtained in this study suggest the usability of the instrumented LSSW test in clinical settings.

In human movement modeling, the problem of multi-link kinematics estimation by means of inertial measurement units has been investigated by several authors through efficient sensor fusion algorithms. In this perspective a single inertial measurement unit per link is required. This set-up is not cost-effective compared with a solution in which a single-axis accelerometer per link is used. In this paper, a novel fast technique is presented for the estimation of the sway angle in a multi-link chain by using a single-axis accelerometer per segment and by setting the boundary conditions through an ad hoc algorithm. The technique, based on the windowing of the accelerometer output, was firstly tested on a mechanical arm equipped with a single-axis accelerometer and a reference encoder. The technique is then tested on a subject performing a squat task for the knee flexion-extension angle evaluation by using two single-axis accelerometers placed on the thigh and shank segments, respectively. A stereo-photogrammetric system was used for validation. RMSEs (mean ± std) are 0.40 ± 0.02° (mean peak-to-peak range of 147.2 ± 4.9°) for the mechanical inverted pendulum and 1.01 ± 0.11° (mean peak-to-peak range of 59.29 ± 2.02°) for the knee flexion-extension angle. Results obtained in terms of RMSE were successfully compared with an Extended Kalman Filter applied to an inertial measurement unit. These results suggest the usability of the proposed algorithm in several fields, from automatic control to biomechanics, and open new opportunities to increase the accuracy of the existing tools for orientation evaluation.