The global trend for increasing life expectancy is resulting in aging populations in a number of countries. This brings to bear a pressure to provide effective care for the older population with increasing constraints on available resources. Providing care for and maintaining the independence of an older person in their own home is one way that this problem can be addressed. The EU Funded Unobtrusive Smart Environments for Independent Living (USEFIL) project is an assistive technology tool being developed to enhance independent living. As part of USEFIL, a wrist wearable unit (WWU) is being developed to monitor the physical activity (PA) of the user and integrate with the USEFIL system. The WWU is a novel application of an existing technology to the assisted living problem domain. It combines existing technologies and new algorithms to extract PA parameters for activity monitoring. The parameters that are extracted include: activity level, step count and worn state. The WWU, the algorithms that have been developed and a preliminary validation are presented. The results show that activity level can be successfully extracted, that worn state can be correctly identified and that step counts in walking data can be estimated within 3% error, using the controlled dataset.

. (2015) Assistive technology to monitor activity, health and wellbeing in old age : The wrist wearable unit in the USEFIL project. Technology and Disability, Abstract. This paper presents the assistive technology used to perform activity monitoring in the USEFIL (Unobtrusive Smart Environments for Independent Living) project, particularly the wrist wearable unit. USEFIL includes a number of activity monitoring devices alongside some condition specific medical devices, a dedicated electronic health record database and communication backend. The system is designed as an assistive technology to provide long-term monitoring for older people in their own home and communicate the data that is gathered into a decision support system that can be used by the older person's carers to improve their care and allow them to remain independent in their own home. The wrist wearable device developed for the USEFIL project, the various health indicators extracted from its inbuilt sensors and how these are used to understand the health and wellbeing of the older person are discussed in this paper.

The growing proliferation of mobile and wearable technology (MWT) offers interesting use cases when applied to health and wellness management. Current trends towards more longer term health and wellness management coupled with global challenges around the provision of healthcare to aging populations with tighter budget constraints, create rich opportunities to exploit this new technology to maintain health and wellness. This paper provides an overview of commonly available MWT and examines how it can be used in health and wellness systems. Case studies are given from two recent research projects and the issues and challenges that arise in the use of MWT are discussed. We conclude that MWT offers some key advantages in some healthcare situations, but that care must be taken to select appropriate technology for each use.

BackgroundThe majority of stroke patients are inactive outside formal therapy sessions. Tailored activity feedback via a smartwatch has the potential to increase inpatient activity. The aim of the study was to identify the challenges and support needed by ward staff and researchers and to examine the feasibility of conducting a randomised controlled trial (RCT) using smartwatch activity monitors in research-naive rehabilitation wards. Objectives (Phase 1 and 2) were to report any challenges and support needed and determine the recruitment and retention rate, completion of outcome measures, smartwatch adherence rate, (Phase 2 only) readiness to randomise, adherence to protocol (intervention fidelity) and potential for effect.MethodsFirst admission, stroke patients (onset < 4 months) aged 40–75, able to walk 10 m prior to stroke and follow a two-stage command with sufficient cognition and vision (clinically judged) were recruited within the Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine. Phase 1: a non-randomised observation phase (to allow practice of protocol)—patients received no activity feedback. Phase 2: a parallel single-blind pilot RCT. Patients were randomised into one of two groups: to receive daily activity feedback over a 9-h period or to receive no activity feedback. EQ-5D-5L, WHODAS and RMI were conducted at baseline, discharge and 3 months post-discharge. Descriptive statistics were performed on recruitment, retention, completion and activity counts as well as adherence to protocol.ResultsOut of 470 ward admissions, 11% were recruited across the two phases, over a 30-week period. Retention rate at 3 months post-discharge was 48%. Twenty-two percent of patients dropped out post-baseline assessment, 78% completed baseline and discharge admissions, from which 62% were assessed 3 months post-discharge. Smartwatch data were received from all patients. Patients were correctly randomised into each RCT group. RCT adherence rate to wearing the smartwatch was 80%. Baseline activity was exceeded for 65% of days in the feedback group compared to 55% of days in the no feedback group.ConclusionsDelivery of a smartwatch RCT is feasible in a research-naive rehabilitation ward. However, frequent support and guidance of research-naive staff are required to ensure completeness of clinical assessment data and protocol adherence.Trials registrationClinicalTrials.gov Identifier, NCT02587585–30th September 2015Electronic supplementary materialThe online version of this article (10.1186/s40814-018-0345-x) contains supplementary material, which is available to authorized users.

The use of walking aids is prevalent among older people and people with mobility impairment. Rollators are designed to support outdoor mobility and require the user to negotiate curbs and slopes in the urban environment. Despite the prevalence of rollators, analysis of their use outside of controlled environments has received relatively little attention. This Letter reports on an initial study to characterise rollator movement. An inertial measurement unit (IMU) was used to measure the motion of the rollator and analytical approaches were developed to extract features characterising the rollator movement, properties of the surface and push events. The analytics were tested in two situations: first, a healthy participant used a rollator in a laboratory using a motion capture system to obtain ground truth. Second, the IMU was used to measure the movement of a rollator being used by a user with multiple sclerosis on a flat surface, cross-slope, up and down slopes and up and down a step. The results showed that surface inclination and distance travelled measured by the IMU have close approximation to the results from ground truth; therefore, demonstrating the potential for IMU-derived metrics to characterise rollator movement and user's pushing style in the outdoor environment.