Technology Enabled Medical Precision Observation (TEMPO) to Monitor the Risk of Falls in the Elderly

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Annually, over 18,000 elderly adults die from falls or fall related injuries. With a growing geriatric population, 25% of US healthcare costs will be allocated to medical care for the elderly, with $8.37 billion spent on treatment for debilitating falls. These lethal falls are caused by postural imbalances and movement impairments that result from a degenerating central nervous system. Postural imbalances are traditionally monitored through clinical observations, questionnaires, and validated functional tests [1]. A team of from UVA Medical and School of Engineering and Applied science has set out to address these burdens of measuring postural imbalance by developing a wearable monitoring system that provides patients greater independence and comprehensive readings. This current monitoring system is time consuming, requires the presence of trained medical staff, and can also be inaccurate when relying on patient’s memory of functionality or fall patterns.

Technology Enabled Medical Precision Observation (TEMPO) is attached to the sternum, and uses Microelectromechanical systems (MEMS) to measure movements associated with the Activities of Daily Life (bathing, personal hygiene, grooming, dressing, undressing). MEMS work by converting the measured mechanical signal produced by the body into an electrical output.

In addition, accelerometers and gyroscopes powered by a microchip are also used to measure both frequency and intensity of movements as well as vector and gravitational acceleration. Accelerometers often operate by the piezoelectric effect, generating a voltage when an accelerative force is applied to microscopic crystals, while gyroscopes detect vibrational energy corresponding to its plane of rotation, and the response is measured by the transducer [3,4]. The self-powering microchip that acts as both the power sources and data transceiver in TEMPO, developed by U.Va., may eventually be consolidated to the nanoscale with the help of the ASSIST Center (the Nanosystems Engineering Research Center for Advanced Self-Powered Systems of Integrated Sensors and Technologies). With TEMPO capable of motion capture of up to six degrees of freedom, healthcare professionals can remotely monitor the motion and activity of elderly, independent living patients to predict and prevent falls. 

TEMPO device helps record motion to monitor the risk of falls in elderly patients.

(Photos by Sanjay Suchak / University Communications)

References

  1. Lockhart, Thurmon E., Xuefang Wu, Jian Zhang, and Rahul Soangra. "Wavelet Based Automated Postural Event Detection and Activity Classification with Single IMU (TEMPO)." Biomed Sci Instrum. 49 (2013): 224-33. Web. 7 Oct. 2015.
  2. McNally, Katie, Mitchell Powers, and Rob Smith. "New Microchip Improves Future of Self-Powered Wearable Technology." UVA Today. N.p., 15 June 2015. Web. 07 Oct. 2015.
  3. "A Beginner's Guide to Accelerometers." A Beginner's Guide to Accelerometers. Dimension Engineering Inc., n.d. Web. 07 Oct. 2015.
  4. Bernstein, Jonathan. "An Overview of MEMS Inertial Sensing Technology", Sensors Weekly, February 1, 2003.
  5. Starner, Tom. "Risks of Wearables - Risk & Insurance." Risk & Insurance. N.p., 15 Oct. 2014. Web. 07 Oct. 2015.
  6. DeMichele, Tom. "ObamaCare Pre-exisiting Conditions." Obamacare Facts. N.p., n.d. Web. 21 Dec. 2015.

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With this technology, patient’s gait characteristics can be monitored at less inconvenience and cost to prevent lethal falls. In a study utilizing TEMPO to assess its measurement of ADLs, it was found to be 96% as accurate as data gathered from motion capture laboratories. The self-powered microchip is advantageous in that in can be sustained off energy generated by body heat, movement, or sunlight, increasing sustainability and reducing energy costs. Wavelet transformations performed on the signals generated by TEMPO also help to highlight postural events from the continuous data, quickly synthesizing information [1]. This technology can also be applied to monitor the health of patients with cerebral palsy, Parkinson’s disease and multiple sclerosis [2].

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The primary risk associated with wearable devices that gather data, such as TEMPO, are issues of privacy and data regulation. With cloud-based technology companies, it is still uncertain who has access to or who can see the data collected. If a patient’s gait characteristics suggest they are at an increased risk for falls they may have their insurances rates raised or be denied insurance if they are part of a “grandfathered individual health insurance plan”, meaning that their health insurance is not through their employer and therefore not protected by the Affordable Care Act [6]. Other risks of wearable technology include redness, rashes, or blistering due to the stainless steel casing, materials used in the strap, or adhesives used to assemble the product that come in contact with the skin. This is especially prevalent for geriatric patients with thinning skin and decreased cellular division [5]. 

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