Hip Fractures Clinical Trial
Official title:
Remote Monitoring and Analysis of Gait and Falls Within an Elderly Population
The investigators aim to do this initial pilot study as an observational prospective cohort study, evaluating elderly patients who have capacity in National Health Service (NHS) rehabilitation and community hospitals. The patients will each be recorded doing simple activities of daily living in two 2 hour sessions using a discrete wireless device. This will generate anonymous data set that can be used to train and refine our machine learning algorithm.
Phase 1 - Creation The creation of a databank of measurements during stereotypical actions of
daily living.
Population recruited (P1 recruits) Patients to complete a demographic questionnaire based on
historical falls risk data.
Recruited patients allocated to a mobility/independence subgroup based on the information
obtained from the demographic questionnaire completed at the time of recruitment.
Patients may be reclassified to different subgroups to redistribute them according to other
factors including frailty, exercise tolerance, balance etc.
Patients given a structured scripted set of simple activities to carry out (such as walking,
sitting and picking something off the floor etc.) to cover as many activities of daily of
living as possible.
Their actions will be monitored with inertia measurement units (IMU) 1-3 per patient (Each
will be off the shelf European Conformity (CE) approved products no bigger than a modern
smart phone).
Data is transmitted from the IMUs wirelessly to the investigators' laptop, patients will not
be attached or anchored to any secondary devices or cables. The IMUs are attached to the
patients with a comfortable lightweight belt design and or non-invasive leg bands.
These scripted sessions will be repeated 5 to 10 times per subject to create an anonymous
databank (D1). This will form a reference range per subgroup of "truth" data for the
algorithm to search.
Patient identifiable data will be limited to the study questionnaires which will be stored
securely at the corresponding study site.
Phase 2 - Validation The validation of the databank while observing previously recorded and
not previously recorded subjects in an unscripted session.
Population patients included All patients from phase 1, new patients recruited (P2 recruits)
Newly recruited patients (P2) to complete a demographic questionnaire based on historical
falls risk data. These patients will not be immediately allocated to a mobility/independence
subgroup, but labelled as unknown (x).
All patients observed individually during daily activities in an unscripted session. Patient
to wear single IMU sensor which captures mobility data (D2). The activities the subject
undertakes during D2 are manually entered onto timesheet by observer for later cross
referencing.
2.1 Patients (P2) who are previously unrecorded and who are unallocated to a
mobility/independence subgroup have their unscripted data (D2) analysed by the motion
algorithm which stratifies them to a mobility/independence subgroup based on the likeness of
their data to that stored in the databank (D1). They are then allocated to a
mobility/independence subgroup based on their questionnaire data and the two outcomes are
compared to see if they match or differ.
- Can algorithm predict "truth"
2.2 Patients (P1) who have previously been recorded in phase 1 and who are allocated to a
mobility/independence subgroup based on their questionnaire data have their unscripted data
(D2) from phase 2 analysed by the motion algorithm. This then stratifies them again to a
mobility/independence subgroup based on the likeness of their new data (D2) to that stored in
the databank (D1). To see if their outcome remains the same or differs.
- Can algorithm confirm "truth"
(See Appendix B. for diagrammatically representation of phase 1 and phase 2.) During the
unscripted session (D2) any falls or patient reported loss of balance that occurs will be
recorded and time stamped by the observer. These data sets will be labelled as "Falls truth"
or "Balance truth" data respectively and added to the anonymous databank for cross-reference.
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