Binghamton University develops app to help study and prevent falls in older adults

Researchers at Binghamton University, State University of New York’s Motion Analysis Research Laboratory have developed an app to help study and prevent falls in older adults.

Most adults in their prime quickly realize that their overall ability to maintain balance is not what it used to be. One in four adults age 65 and older in the United States is likely to suffer a fall, the leading cause of fatal and nonfatal injuries in this age group.

But it doesn’t have to be -? and a Binghamton University study is working to prevent falls, using something that’s in almost everyone’s pocket.

We can use a phone not only for assessment, but also for intervention. In this case, we can ask someone to stand still with the phone in their pocket or record standing up looking straight ahead. The phone itself will use accelerometers to see how much body sway is occurring. The scale is small. We can actually see that amount of movement and understand how stable the person is while standing.”

Vipul Lugade, associate professor of physical therapy and one of the co-principal investigators of this study

Lugade is the director of the Motion Analysis Research Laboratory (MARL), where the first step of this research into preventing falls in the elderly using smartphones was recently completed.

“As you get older, you have to be aware of your body’s ability to maintain balance while standing and walking,” Lugade said. “The ability to do two tasks at once is compromised as you get older. Older adults either have an inability to pay attention to both tasks at once or an inability to switch between tasks.”

The MARL intervention study began in June 2022 and aimed to investigate some of these issues. Among the lab’s state-of-the-art equipment are a 12-camera motion analysis system, a Biodex system dynamometer (for individual muscle recovery), a portable GAITRite system (electronic treadmill for measurement) and eye tracking glasses.

Most important in this study is a Computerized Dynamic Posturography (CDP) system, which measures “static sway” by analyzing leg pressure, force and motor responses while the user stands on a belt on a locked or moving platform .

Using this specialized motion capture tool, the researchers examined walking speed and balance. Improvements, especially in walking speed, have been shown to reduce the risk of falls. If subjects show improvement after using the smartphone-based program, the intervention could be considered clinically effective.

This is helpful, as the main goal for this stage of the research is to find out if the smartphone app they have developed is even a usable tool to help seniors with balance-related deficiencies. By completing regular exercise programs and weekly balance assessments at home, these participants get the most out of the program -? and is it an improvement or even a change from a paper version of the test?

Of the 31 participants who participated, 29 older adults completed all exercises and tests and were reassessed at the end of the study. This high completion rate showed virtually no difference in online and paper applications.

“The app is a viable alternative to paper and can be used safely to deliver balance interventions on a person’s phone,” said Suzanne O’Brien, the second co-principal investigator and associate professor of physical therapy. “We want to take some next steps to use the app to do exercises and prevent falls in the elderly in this [rural] area. Later, we would like to do the same in certain groups of patients, such as Parkinson’s disease and stroke.”

Connecting with participants was an important aspect of the study. A separate metric included individuals’ likelihood and happiness of completing the app-based practice. To that end, O’Brien completed weekly phone check-ins during the four-week study, and testers were in the room during all office visits to ensure participants’ safety.

Although some participants reported physical and mental fatigue as well as muscle pain from the exercises and tests, the overall study found that older adults were able to use the smartphone app and that its development could be a benefit for balance and the well-being of patients.

The researchers in this study, however, did not stop at collecting this data. Their secondary goal is to ensure that what they have collected can now be used by the community in addition to doctors and people who can benefit from the interventions.

Along with Lijun Yin, professor of computer science at Binghamton, the team began work on a computer dashboard that looks at performance metrics and compares users to the “normal” range. The long-term idea would be to collect data at a national level so that the user can compare across demographics such as age and gender. Clinicians across the country could use the model to focus on outcomes across their entire patient population to provide the best possible care, and someday may even push updates automatically—from real-time records of patient outcomes and adjusted for performance.

The team has received seed grants from the Binghamton University Transdisciplinary Areas of Excellence-Data Science to continue this work and has applied for external funding, including one from the National Institutes of Health. They hope in the next steps of the project to tweak some aspects for more accurate results: for example, increasing the sample size or using some of the funding to target potential participants from underrepresented communities who may need the interventions but don’t have access to smartphones.