Accidental falls are frequent causes of serious injury and a health risk for the elderly population, creating a real problem for independent living. The number of medical alert systems or personal emergency response systems (PERS) aimed at detecting falls and offering prompt support has increased dramatically over recent years. In the seventies, PERS were basically push-button devices worn around the neck that called for help by signaling a base station connected to a landline, which in turn would alert an emergency response center. Moreover, manual alarms are inappropriate where loss of consciousness follows the fall. In recent years, emerging technologies have paved the way for more reliable and performance-driven fall detection systems based on sensor technology, GPS localization and wireless communication technologies.
Three main categories of fall detection methods for the elderly exist:
Vision-based systems are the most common solutions used in nursing institutions. These systems have the advantage that the user is being watched 24 hours a day, so a fall is unlikely to be missed. However, its major setbacks are that they compromise patients’ privacy and cameras have to be installed in every room.
Ambient-based methods such as Alert1’s In-Home Medical Alert rely on sensors (pressure, acoustic or even passive infrared motion sensors) installed in the home or hospital environment to detect falls. These systems are less intrusive than vision-based methods but their operation is limited to those places where the sensors have been previously installed. Furthermore, their main drawback is that thay are too sensitive and may trigger false alarms . Both vision and ambient-based device approaches require a pre-built infrastructure, enabling their use in hospitals and houses, but they are not suitable for outdoor use.
In this category, manual alarms that allow the person to summon help following a fall are most common. But they are clearly unsuitable for individuals who are physically or cognitively impaired. Thus, existing wearable and user-activated fall detection systems have been improved to incorporate accelerometers and gyroscopes that analyze unusual misalignment in the body’s position to determine if a fall has occurred. In 2009, Halo Monitoring became the first company to provide a wearable device to send an automatic alert in the event of a fall. Since then, advances in smartphone technology combine fall detection with user localization via a GPS-based method. This automatic fall detection technology has only recently been integrated into medical alert systems for home use. Philips Lifeline medical alert system exists in the standard “press of a button” format as well as a mobile system format, GoSafe, which can also be used outdoors.
How Philips GoSafe works
The main advantage of wearable-based systems is that they are not intrusive like vision-based systems and are more accurate than ambient-based methods. Moreover, the devices are lightweight and waterproof. The major disadvantage is that, like ambient-based methods, the sensitivity of wearable devices triggers false alarms.
Innovative miniaturized solutions on the horizon
Vigilio S.A is a dynamic start-up company that has developed Vigi’Fall, the first miniaturized, automatic, fall detection patch.
Vigi’Fall at work
Commercialized in November 2012, the Vigi’Fall is very reliable (>98%) in managing the high rate of false alarms encountered with other wearable systems on the market: its software allows it to analyze the nature of a fall (with or without impact) and the resulting posture of the patient, thus differentiating between real falls and false alarms. Unlike other fall detectors, Vigi’Fall can detect all types of falls including brutal and soft falls. "The practicality and acceptability of the Vigi’Fall patch under real life conditions have been validated through a multicenter randomized clinical study," explained Dr. Jean-Eric Lundy, CEO and Founder of Vigilio S.A. "Results show that after a 6-month follow-up, significantly more individuals in the group equipped with the Vigi’Fall patch remain at home compared to the group without the patch, who were institutionalized (87% vs 53%, p<0.04)."
Kinesis Health Technologies is the start-up company behind Kinesis QTUG (Quantitative Timed Up and Go), a state-of-the-art technology using body-worn, tri-axial gyroscopes and accelerometers that stream data wirelessly via Bluetooth to a touchscreen tablet device.
The system allows for earlier detection of mobility impairment and risk of falls among older adults and aims to advance the field of falls prevention, an important aspect of falls management that current technology doesn't address. In fact, by screening for gait and mobility impairment, QTUG can identify individuals at risk , thereby facilitating early intervention and reducing the risk of a fall. The patented system, intended for use by physicians or community care nurses in a supervised environment, is now available in the U.S. and Europe for use by clinical facilities and physiotherapists.
A smartwatch for prevention
In collaboration with The Fondation Suisse pour les Téléthèses (FST) Lab, researchers from the University of Geneva are developing the first fall detection system that works on a base station-independent smartwatch, F2D. This device uses a novel fall detection algorithm which takes into account the residual movement of the user in order to match a fall pattern to a real fall, thus increasing the fall detection accuracy. Unlike established systems, which require a base station and an alarm central, F2D works completely independently to anticipate and prevent falls. Therefore the individual is protected both at home and outside. A prototype of the F2D smartwatch is scheduled for the end of the year. Finally, FATE (FAll DeTector for the Elderly) is an ongoing European funded research project that should contribute significantly to the progress of fall detection technology.
This project seeks to validate an innovative information and communication technology (ICT)-based solution for the accurate detection of falls among the elderly. The device uses technology similar to airbags in cars that are triggered when sudden acceleration is detected. The wearable detector is being tested and validated in trials involving real-life scenarios, in Spain, Italy and Ireland.