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Data and Recording

Modern wearable technology and assistive devices are dependent on batteries and though the ever-increasing performance of these in terms of size and length of life is indeed impressive they do still generally require re-charging regularly. If the wearable device is required to store the extensive waveforms output by the accelerometer, it quickly uses up all its stored power, which in the case of wearables, means it must be dismounted from its normal location and plugged into a power source or socket. This implies that it must be replaced by a second such device, or at least battery pack, which for the elderly and infirm is a major barrier to continuous and effective usage.

However the programme in Fall-Safe Assist analyses the waveforms and stores the event it has identified from them as a simple occurrence, thereby both reducing the storage required and the power consumed handling raw waveforms. It also means that a fall is instantly identified rather than relying on continuous communications with the app running on the linked mobile. Steps are similarly recorded as events and passed on to the mobile every hour, which is much more efficient than continuously sending waveform data to the mobile.

The mobile then accumulates this data and forwards it to a clinical system on perhaps a daily basis, as a spreadsheet attached to an email, in its simplest form. The data will also include the time and date of any falls, their direction, force and location, as well as their outcome.

A cloud system, using anonymised data at a clinic or hospital can accumulate all this information and allow it to be used as a source of research material for identifying common factors in falls that might indicate preventive measures that could be taken to alleviate the problem. It will also, for the first time, result in the recording of all falls in the population that is wearing the device and thereby provide a reliable record rather than the very piecemeal and incomplete data sets that are compiled at present, since it is believed that only about 20% of all falls are recorded.

Features of Wearable/Assistive Technology

Motion detection wearable technology includes a triaxial accelerometer that captures motion in its three planes so that it can detect not only that the device – and its wearer – have fallen over, but also in what direction the fall occurred. This piece of information is important in enabling researchers, as well as carers, to identify possible causes. For example a forward fall may indicate a trip, and a backward fall a slip. The immediate area in which the fall took place can then be examined for possible trip/slip hazards. After their removal or whatever, this should make the place safer.

The device’s programme also uses the accelerometer to discover the maximum speed of the fall so that, when multiplied by the faller’s already known weight, the force of the fall can be calculated, using Newton’s Second Law. This is also useful for research purposes because very little is known about the force of actual falls, as opposed to the calculated value, usually given by an estimated average fall speed of 3.4 metres per second. So far, without this facility, it has been impossible to verify this value since elderly people cannot be pushed over, for obvious reasons. The force will obviously indicate the likely severity of the fall which is important both for research purposes into the falls conundrum and for indicating what measures, palliative or otherwise, might be enacted to mitigate their consequences. Such measures could include the use of hip protectors or the installation of shock absorbent flooring – particularly appropriate and economic in healthcare institutions. Indeed the wearing of the device when either of these measures have been effected will help to verify whether or not they are having the desired effect. Up to now all such testing has been based on theoretical values.

In addition to these facilities the falls detection device will be linked to a mobile whose GPS system will add the faller’s location to the fall record. Initially this may be of more use/accurate when the faller is outside, not least because the alarm message sent if the faller does not speedily rise to his/her feet must include the faller’s location to aid the emergency services in getting swiftly to the scene. In fact this provision will shortly become law in all European countries. In the not-too-distant future GPS systems, using newly launched satellites – Galileo, for example – will be available, linked to inertial navigation and wi-fi locators, that give accurate location readings indoors as well. Powerful commercial interests, such as supermarkets and department stores, are crying out for this facility to aid their stock control and assist customers in locating products and/or selling them more of such, not to mention advertising special offers as they pass the chocolates section, for example.

Assistive technology devices, such as Fall-Safe Assist, will also include a step counting function that records all steps taken by the wearer in the previous hour and upload that to the mobile app, which will incorporate it into a histogram that can display all steps taken today, yesterday, in the past week(s) and in past month(s). This pattern of activity will help carers and clinicians to keep an eye on the daily mobility of their patients. Indeed if no steps are recorded for a pre-set period, such as 6 or 12 hours, the app can/will generate an alarm call.

A further facility will use the accelerometer to identify the normal/average amount of sway in the wearer’s walk in order to monitor his/her gait. If, for example, it suddenly increases from say, 10% to 40% that could indicate a problem such as over/under medication, or perhaps the onset of some cognitive malfunction. In that event an alarm will also be sent to the appropriate, pre-defined, authorities, and/or carers, neighbours etc.

Taken together these unique features and facilities will enable the frail and elderly to remain at home, yet still be under the supervision of carers and clinicians. Those most vulnerable to fracture of the hips, because of osteoporosis, will be free from such worries, both of fracture and of being immobile on the floor for hours in the cold awaiting the arrival of assistance. Their loved ones will be able to keep a check on their mobility, or lack of it, and take appropriate action in time to prevent hospitalisation or, as the patient may feel is, incarceration in a care home.

Wearable and Assistive Technology

Market research into wearable and assistive technology indicates that a major – possibly the major – segment of the market will be for devices that include motion detection, such as the variety of smart watches that are becoming available now, of which perhaps the best known and most eagerly anticipated is the Apple Watch. With Apple’s extraordinary marketing behind it, it is likely to be a great success, not least because Apple has a legion of devoted early adopters ready to snap it up in quantity. The publicity from this exercise is likely to legitimise wearable technology in the eyes of many consumers, and also possibly some in the medical profession, not least those who are already looking at potential applications for such devices.

However, at least in the short term, monitoring of steps, for example, using a device attached to the wrist has been found not to be particularly accurate because of the wide variety of possible actions that the wrist and arm undertake. As a software-driven device with a built-in accelerometer, it is of course also possible to make a stab at identifying falls. However when wrist-worn devices have been tested for this application, they have either failed to identify the fall, or have done so, but in the process generate so many false positive alarms that the device has been abandoned, because of its high nuisance value.

Other parts of the body have been used to harbour such technology, for example hanging from the neck in a pendant, but this has several disadvantages in that it is also, though to a lesser degree, free swinging and therefore writing software for it is much harder since a wide variety of conditions must be identified and catered for. Also, there is some stigma attached to such wearable technology being visible outside clothing as it tends to identify the wearer as having a disability and may well conflict with other and more favoured jewellery being worn. If it is concealed under clothing, the button to activate/deactivate the alarm call may well be hard or impossible to reach, particularly after a fall. A pendant worn around the neck also will be harder (perhaps impossible) to programme to identify steps accurately, than something worn at waist or hip level, for example. The lanyard looped around the neck may also present dangers to the wearer from throttling, if it gets caught on something.

Another idea being tested is to make use of the accelerometer, which is invariably present in virtually all smartphones, to identify a fall automatically as well as counting steps. The disadvantage here is that the smartphone will not necessarily be carried on the body all the time, unless the wearer is travelling outside the house. Even then it is likely to be placed in a variety of pockets, breast or trouser etc., which will inevitably affect the accuracy of the device, and may cause it to generate unnecessary false alarms. Most people are unlikely to pick up their smartphone from the bedside table on their way to the bathroom at night – a dangerous trip in every sense of the word.

Clearly an assistive technology device akin to a pendant can be stuck onto the body by tape, or some other method, however this brings into the equation a number of other issues such as hygiene, easy removal, location to be used etc. Wherever it is placed will not suit everyone all the time, and if it is left to the wearer’s discretion it will probably be forgotten or misplaced either on the body, or elsewhere.

The fact that there is, so far, no standard answer to this question indicates that what appears to be such an apparently simple issue is in reality nothing of the kind and is compounded by the usual disadvantage that nobody really wants to carry around a single-purpose device unless they absolutely have to. Who, for example, in developed societies today bothers with a mobile telephone that just has a single telephone function alone? It was tolerated in the 80’s and 90’s when nothing else was available, but no longer.

So, what is required is a device that can be located at hip level ideally, since that is the most stable location on the body and is therefore likely to give the best results when its software is attempting to identify a fall, and also will give much more consistent and accurate results when used to count steps since it is part of, or at least close to, the wearer’s ambulatory system. Now, you could just stick a small device on the hip and hope for the best. However that would run into some of the problems mentioned above and might also cause injury to the wearer in a fall, or indeed be itself damaged in such an event. Clearly the ideal scenario would be if the wearer, who by definition is likely to be a fairly frequent faller, or at least in danger of falling at any time as the result of a variety of medical conditions, was wearing a hip protector to prevent fracture of the hip in just such a fall.

The marketing forecasts for assistive and wearable technology mentioned above have also indicated that the more successful devices are likely to be co-located on/with the body’s area that they are trying to monitor and it would appear that the most promising location for a device that monitors falls and counts steps would be actually in the hip protector device itself. Fall-Safe Assist exactly meets this requirement by being held in a cavity in Hip Impact Protection’s very comfortable and effective hip protectors, called Fall-Safe. These are held in the correct place over the head/neck of the femur by underpants with pockets on either hip. Only one hip protector need contain the Fall-Safe Assist device.



What Our Users Are Saying..

Bernadette Taylor
2016-04-26, 10:45
Dear William,

The hip protectors are great and we like the new material in the underpants.

Thanks again, Bernadette
Geoffrey Hampden-Smith
2016-04-26, 10:39
Dear William. Your package arrived very promptly several days ago. Thank you very much. I am wearing the hip protectors while recuperating from a fall - with the prognosis of a month on crutches. They are very, very comfortable and not noticeable under my track suit. Wearing the pants with the protectors gives me the confidence to do more on crutches and I am hoping that this this will accelerate my re-habilitation.

I am 67 years old and still work in a boatyard. I just wish I was aware of … read more