Name: using a real-time locating system to measure walking activity associated with wandering behaviors among institutionalized older adults
Uploaded: 2019-02-08T13:30:00
Description: Watch this Scientific Journal Video about Using a Real-Time Locating System to Measure Walking Activity Associated with Wandering Behaviors Among Institutionalized Older Adults at JoVE.com

This work was supported by a Career Development Award # [E7503W] and a Merit Award # [RX002413-01A2] from the United States (U.S.) Department of Veterans Affairs Rehabilitation Research and Development Service. The contents of this work do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.

All methods described here have been approved by the Institutional Review Board at the Corporal Michael J. Crescenz VA Medical Center in Philadelphia, PA.
1. Installation and Set-Up of a Real-Time Locating System (RTLS)
<ol>
	<li>Review facility policies, safety, and personal information protections for residents with facility stakeholders. Determine whether written or verbal support on the use of RTLS in the facility is required. In discussions with stakeholders include local protocols and ...

<ol>
	<li>Bowen, M. E., Crenshaw, J., Stanhope, S. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Balance+ability+and+cognitive+impairment+influence+sustained+walking+in+an+assisted+living+facility.">Balance ability and cognitive impairment influence sustained walking in an assisted living facility.</a> Arch Gerontol Geriatr. 77, 133-141 (2018).</li><li>Washburn, R. A., McAuley, E., Katula, J., Mihalko, S. L., Boileau, R. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+physical+activity+scale+for+the+elderly+(PASE):+evidence+for+validity.">The physical activity scale for the elderly (PASE): evidence for validity.</a> J Clin Epidemiol. 52 (7), 643-651 (1999).</li><li>McAuley, E., Mihalko, S. L., Rosengren, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Self-Efficacy+and+Balance+Correlates+of+Fear+of+Falling+in+the+Elderly.">Self-Efficacy and Balance Correlates of Fear of Falling in the Elderly.</a> J Aging Phys Act. 5 (4), 329-340 (1997).</li><li>Boulgarides, L. K., Mcginty, S. M., Willett, J. A., Barnes, C. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Research+Report+Use+of+Clinical+and+Impairment-Based+Tests+to+Predict+Falls+by+Community-Dwelling+Older+Adults.">Research Report Use of Clinical and Impairment-Based Tests to Predict Falls by Community-Dwelling Older Adults.</a> Phys Ther. 83, 328-339 (2003).</li><li>MacRae, P. G., Schnelle, J. F., Simmons, S. F., Ouslander, J. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Physical+Activity+Levels+of+Ambulatory+Nursing+Home+Residents.">Physical Activity Levels of Ambulatory Nursing Home Residents.</a> J Aging Phys Act. 4 (3), 264-278 (1996).</li><li>Ruuskanen, J. M., Parkatti, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mobility+and+Related+Factors+Among+Nursing+Home+Residents.">Mobility and Related Factors Among Nursing Home Residents.</a> J Am Geriatr Soc. 42, 987-991 (1994).</li><li>Resnick, B., Galik, E., Gruber-Baldini, A. L., Zimmerman, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Perceptions+and+Performance+of+Function+and+Mobility+in+Assisted+Living+Communities.">Perceptions and Performance of Function and Mobility in Assisted Living Communities.</a> J Am Med Dir Assoc. 11, 406-414 (2010).</li><li>Beattie, E. R., Song, J., LaGore, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+comparison+of+wandering+behavior+in+nursing+homes+and+assisted+living+facilities.">A comparison of wandering behavior in nursing homes and assisted living facilities.</a> Res Theory Nurs Pract. 19 (2), 181-196 (2005).</li><li>Martino-Saltzman, D., Blasch, B. B., Morris, R. D., McNeal, L. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Travel+behavior+of+nursing+home+residents+perceived+as+wanderers+and+nonwanderers.">Travel behavior of nursing home residents perceived as wanderers and nonwanderers.</a> Gerontologist. 31 (5), 666-672 (1991).</li><li>Cohen-Mansfield, J., Wirtz, P. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Characteristics+of+adult+day+care+participants+who+enter+a+nursing+home.">Characteristics of adult day care participants who enter a nursing home.</a> Psychol Aging. 22 (2), 354-360 (2007).</li><li>Hope, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Wandering+in+dementia:+a+longitudinal+study.">Wandering in dementia: a longitudinal study.</a> Int Psychogeriatr. 13 (2), 137-147 (2001).</li><li>Bowen, M. E., Wingrave, C. A., Klanchar, A., Craighead, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Tracking+technology:+lessons+learned+in+two+health+care+sites.">Tracking technology: lessons learned in two health care sites.</a> Technol Health Care. 21 (3), 191-197 (2013).</li><li>Bowen, M. E., Rowe, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intraindividual+Changes+in+Ambulation+Associated+With+Falls+in+a+Population+of+Vulnerable+Older+Adults+in+Long-Term+Care.">Intraindividual Changes in Ambulation Associated With Falls in a Population of Vulnerable Older Adults in Long-Term Care.</a> Arch Phys Med Rehabil. 97 (11), 1963-1968 (2016).</li><li>Kearns, W. D., Algase, D., Moore, D. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultra+Wideband+Radio:+A+Novel+Method+for+Measuring+Wandering+in+Persons+with+Dementia.">Ultra Wideband Radio: A Novel Method for Measuring Wandering in Persons with Dementia.</a> International Journal of Gerontechnology. 7 (1), 48-57 (2008).</li><li>Alarifi, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultra+Wideband+Indoor+Positioning+Technologies:+Analysis+and+Recent+Advances.">Ultra Wideband Indoor Positioning Technologies: Analysis and Recent Advances.</a> Sensors (Basel). 16 (5), (2016).</li><li>Kearns, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Temporo-spacial+prompting+for+persons+with+cognitive+impairment+using+smart+wrist-worn+interface.">Temporo-spacial prompting for persons with cognitive impairment using smart wrist-worn interface.</a> J Rehabil Res Dev. 50 (10), (2013).</li><li>Jeong, I. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Using+a+Real-Time+Location+System+for+Assessment+of+Patient+Ambulation+in+a+Hospital+Setting.">Using a Real-Time Location System for Assessment of Patient Ambulation in a Hospital Setting.</a> Arch Phys Med Rehabil. 98 (7), 1366-1373 (2017).</li><li>Nasreddine, Z. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Montreal+Cognitive+Assessment,+MoCA:+a+brief+screening+tool+for+mild+cognitive+impairment.">The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment.</a> J Am Geriatr Soc. 53 (4), 695-699 (2005).</li><li>Saczynski, J. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Montreal+Cognitive+Assessment:+Creating+a+Crosswalk+with+the+Mini-Mental+State+Examination.">The Montreal Cognitive Assessment: Creating a Crosswalk with the Mini-Mental State Examination.</a> J Am Geriatr Soc. 63 (11), 2370-2374 (2015).</li><li>Tinetti, M. E., Williams, T. F., Mayewski, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fall+risk+index+for+elderly+patients+based+on+number+of+chronic+disabilities.">Fall risk index for elderly patients based on number of chronic disabilities.</a> Am J Med. 80 (3), 429-434 (1986).</li><li>Contreras, A., Grandas, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Risk+of+falls+in+Parkinson's+disease:+a+cross-sectional+study+of+160+patients.">Risk of falls in Parkinson's disease: a cross-sectional study of 160 patients.</a> Parkinsons Dis. , 362572 (2012).</li><li>Kearns, W. D., Nams, V. O., Fozard, J. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Tortuosity+in+movement+paths+is+related+to+cognitive+impairment.+Wireless+fractal+estimation+in+assisted+living+facility+residents.">Tortuosity in movement paths is related to cognitive impairment. Wireless fractal estimation in assisted living facility residents.</a> Methods Inf Med. 49 (6), 592-598 (2010).</li><li>Tinetti, M. E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+multifactorial+intervention+to+reduce+the+risk+of+falling+among+elderly+people+living+in+the+community.">A multifactorial intervention to reduce the risk of falling among elderly people living in the community.</a> N Engl J Med. 331 (13), 821-827 (1994).</li><li>Bowen, M. E., Craighead, J., Wingrave, C. A., Kearns, W. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Real-Time+Locating+Systems+(RTLS)+to+Improve+Fall+Detection.">Real-Time Locating Systems (RTLS) to Improve Fall Detection.</a> International Journal of Gerontechnology. 9 (4), 464-471 (2010).</li><li>Kearns, W. D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Path+tortuosity+in+everyday+movements+of+elderly+persons+increases+fall+prediction+beyond+knowledge+of+fall+history,+medication+use,+and+standardized+gait+and+balance+assessments.">Path tortuosity in everyday movements of elderly persons increases fall prediction beyond knowledge of fall history, medication use, and standardized gait and balance assessments.</a> J Am Med Dir Assoc. 13 (7), e667-e665 (2012).</li><li>Bowen, M. E., Craighead, J. D., Klanchar, S. A., Nieves-Garcia, V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Multidrug-resistant+organisms+in+a+community+living+facility:+tracking+patient+interactions+and+time+spent+in+common+areas.">Multidrug-resistant organisms in a community living facility: tracking patient interactions and time spent in common areas.</a> Am J Infect Control. 40 (7), 677-679 (2012).</li></ol>

There are several critical steps to be followed prior to beginning the RTLS project that are worth discussion. While a typical common area in a long-term care facility (about 10m x 13m or 1,000 square feet) requires four sensors, this varies based on the environment and the number of sensors required for the project are based on the level of precision required and the environment. Protrusions and glass walls, for example, will require additional sensors. If there are no line of sight issues, four sensors will cover an ev...

An older adult&#39;s ability to perform daily activities of daily living and be physically active is associated with gait quality and balance ability.1 Previous work shows correlations between balance ability and self-reported physical activity among sedentary older adults.2 These correlations remain across older adult populations. For example, among older adults in the community, self-reported activity levels are significantly correlated with balance3 and walking capacity;4 the physical activity of ambulatory long-term care residents is positively correlated with both gait and balance (using the Tinetti Performance Oriented Mobility Assessment).5 Institutionalization is associated with decreased walking activity in later life6 and result in a high prevalence of sedentary behavior in this population.7 In fact, a reported 80% or more of the waking hours of an institutionalized resident is spent sitting or lying down5 and few long-term care residents achieve the recommended 30 minutes of daily moderate activity.7 Inadequate physical activity is associated with de-conditioning, hospitalization and other poor health outcomes in this population. Understanding the walking activity of this population may aid in tailored gait and/or balance interventions to increase physical activity.
Some institutionalized older adults with cognitive impairment (CI) begin walking excessively as a result of disease progression. Wandering occurs when there are little/no breaks in activity over the course of several hours/days. Wandering is associated with fatigue, weight loss, injurious falls, sleep disturbances, getting lost, and death.8 Compared to nursing home residents with no or mild/moderate CI, residents with severe CI demonstrate 20% more activity characterized as wandering, 26% of which are &#34;lapping&#34; behaviors, a type of wandering where a resident circles the room.9 Despite this, it is difficult for health care staff and other observers to distinguish between physical activity and wandering. Intra-individual changes in walking activity can be subtle and wandering is not a behavioral problem to be curbed until the older adult attempts to elope (e.g., escape the facility). Wandering is common; the prevalence of wandering varies from study to study but an estimated 38%10 to 80% of older adults with CI will wander at some point over the course of the disease.11
It is difficult to understand the walking activity of institutionalized older adults as the population is heterogeneous (e.g., varying cognitive levels, health conditions) and activity is difficult to objectively measure. Self-report methods of activity by health care staff better reflect elopement or attempted escapes from the facility, and continuous observation over the long-term is vulnerable to inter-rater errors, time-consuming and expensive.12,13 Real-time locating system (RTLS) technologies have the potential to objectively and continuously measure walking activity among older adults with CI. Notably, there is heterogeneity in the RTLS field and multiple systems may theoretically be used: ultra-wideband (UWB; see attached Table of Materials), infrared + radio frequency, ultrasound and machine vision systems. However, to assess wandering behaviors, a tracking technology that is small and unobtrusive, wireless, capable of wide-area tracking, with no line of sight issues and accuracy to within 20cm is needed and there are few (if any) systems other than a RTLS using UWB that fulfills these requirements. For example, infrared + radio frequency technology rely on creating &#34;zones&#34; which detail when a resident passes through, but is not specific enough to determine wandering behaviors except within a meter or two, which is far too gross for these purposes. Ultrasound and machine vision have issues with identification and reflections; machine vision systems have good resolution but cannot differentiate residents without resorting to using an RFID tag to compensate for the inadequate capabilities of current artificial intelligence. A RTLS utilizing UWB has a wider range and spatial resolution of about 20cm -- versus one meter or more for other systems -- making it the most precise and capable of capturing all activity patterns.14,15 The RTLS using UWB discussed here is also stable, having been designed for 24/7 industrial applications. Researchers and clinicians have previously used this system where precision is essential - to prevent and predict falls, to assess dementia and changes in cognition - in a wide variety of settings -- assisted living, hospital, nursing homes, and rehabilitation units.13,16,17
This paper will detail the protocol of a RTLS using UWB to measure walking activity [walking distance, sustained walking distance, and sustained gait speed (average meters per second/week calculated during sustained walking only)] and paper and pencil tests of CI, gait ability and balance quality, as the latter of which are key components of walking activity. Study findings will focus on using RTLS to distinguish between walking distance, which is associated with physical activity and thus positive health outcomes, and sustained walking distance which is associated with wandering and thus negative health outcomes.

<table border="0" cellpadding="0" cellspacing="0" style="width:700px;" width="701">
	<tbody>
		<tr height="21">
			<td height="21" style="height:21px;width:344px;">UWB Sensor</td>
			<td style="width:71px;">Ubisense</td>
			<td style="width:119px;"></td>
			<td style="width:167px;">There are two product lines to choose from; IP30 is the latest</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:344px;">Tags</td>
			<td style="width:71px;">Ubisense</td>
			<td style="width:119px;"></td>
			<td>There are two types of tags to choose from; if IP30 sensors are chosen, use DFLAT33 mini tags</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:344px;">Timing Distribution Unit</td>
			<td style="width:71px;">Ubisense</td>
			<td style="width:119px;">UBITIMING</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:344px;">Network and Timing Combiner</td>
			<td style="width:71px;">Ubisense</td>
			<td style="width:119px;">UBICOMSPL21</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:344px;">Home Base License</td>
			<td style="width:71px;">Ubisense</td>
			<td style="width:119px;">HOMEBASE</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:344px;">Expert Support</td>
			<td style="width:71px;">Ubisense</td>
			<td style="width:119px;">MANDS2</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:344px;">Project Implmentation Services</td>
			<td style="width:71px;">Ubisense</td>
			<td style="width:119px;">PROJSERV</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:344px;">Smart Factory</td>
			<td style="width:71px;">Ubisense&#160;</td>
			<td style="width:119px;"></td>
			<td>specialized software designed to manage the RTLS</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:344px;">Server</td>
			<td style="width:71px;">Any</td>
			<td style="width:119px;"></td>
			<td>Laptop with at least 8MB RAM</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:344px;">Network Cabling</td>
			<td style="width:71px;">Any</td>
			<td style="width:119px;"></td>
			<td>3rd party or subcontract&#160;</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Tinetti Performance Oriented Mobility Assessment</td>
			<td style="width:71px;"></td>
			<td style="width:119px;"></td>
			<td>Tinetti ME, Williams TF, Mayewski R. Fall risk index for elderly patients based on number of chronic disabilities. The American journal of medicine. Mar 1986;80(3):429-434</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:344px;">The Montreal Cognitive Assessment</td>
			<td style="width:71px;"></td>
			<td style="width:119px;"></td>
			<td>https://www.mocatest.org</td>
		</tr>
	</tbody>
</table>

using a real-time locating system to measure walking activity associated with wandering behaviors among institutionalized older adults

A real-time locating system (RTLS) can be used to track the walking activity of institutionalized older adults in long-term care who are at risk for wandering behaviors. The benefits of a RTLS are objective and continuous measurements of activity. Self-report methods of activity, especially wandering, by health care staff are vulnerable to floor effects and recall bias, and continuous clinical or research observation over the long-term can be time-consuming and expensive. Health care staff also fail to recognize the onset and/or duration of wandering behaviors, which are associated with a variety of adverse health outcomes in this population but amenable to intervention. RTLS technologies can measure the walking activity of institutionalized residents with cognitive impairment over time with a high degree of accuracy. This is particularly useful for the study of wandering, defined as walking for at least 60 seconds with few (if any) breaks in activity. Wandering is associated with disease progression, hospitalizations, falls and death. Previous work suggests older adults with poor balance ability and high sustained walking activity may be particularly susceptible to poor health outcomes. RTLS&#39;s are used to assess cognitive impairment and factors associated with gait and balance; however, supplemental paper and pencil gait/balance tools may be used to further refine risk profiles. This project discusses the use of a RTLS to measure walking activity and also gait quality and balance ability measures on this population.

RTLS raw data require smoothing to improve the location data&#39;s precision (see protocol step 9 under the section, &#34;Use the RTLS Tags to Locate and Track Residents in Real-Time&#34;). Though controlled with default settings in the power plot tab during installation and set-up (see step 1.6.3 in the associated protocol), without additional smoothing there will continue to be noise and jumps. With regard to noise, even when sedentary for several hours, the active RTLS tag continues to...

Watch this Scientific Journal Video about Using a Real-Time Locating System to Measure Walking Activity Associated with Wandering Behaviors Among Institutionalized Older Adults at JoVE.com

Using a Real-Time Locating System to Measure Walking Activity Associated with Wandering Behaviors Among Institutionalized Older Adults

This paper discusses the use of a continuous and objective real-time locating system to measure walking activity associated with wandering behaviors, focusing on older adults with cognitive impairment. Walking activity is measured by walking distance, sustained walking distance, and sustained gait speed. Also assessed are gait quality and balance ability.

A real-time locating system (RTLS) can be used to track the walking activity of institutionalized older adults in long-term care who are at risk for ...

Healthcare staff cannot distinguish between physical activity and wandering, and only identify wandering when a patient is at risk for leaving the facility. Changes in walking activity are associated with cognitive impairment, falls, wandering, and other poor health outcomes. The real-time locating system continuously and objectively tracks walking activity.This includes beneficial physical activity as well as wandering. Wandering is pattern walking that's associated with poor health outcomes. Before assigning a tag to a resident, open the Tag Association tab in the real-time locating system graphic use interface and assign a unique patient ID number to each consenting ambulatory or foot-propelled resident at random.Use the number provided on each tag to link a tag with each patient ID for wireless tracking, leaving the tag positions at origin and confirming that Allowed tag swaps is selected. Choose the type of tag, the mini tag, and click Save. In Location System Config, click View trace messages.Then, Get trace messages to make sure the system is recording events from the tags. Under the Sensor status tab, confirm that all of the sensors are running. In Location System Config, click Review location events.In the window, click Start listening to gather data in real time from tags. To turn on a tag, hold the magnet under the right side of the tag until the light begins to continuously blink. Then attach the activated tags to an area of the body of each resident with a small cross-sectional area for a more limited absorption of the radio frequency energy and to provide a better tracking accuracy.Once a day, visually check all of the sensor light indicators on the real-time location system sensors and tags and all of the system supplementary equipment, and confirm that the tags have not been submerged in water. Also daily, open the Map tab in the graphic user interface of the system and check that all of the tagged residents are visible and being tracked. To view more immediate events, use the Used last button in the Location System Config to adjust the amount of trace data.Set the time to the last 10 or fewer minutes, and click Start listening. When batteries are replaced, click on the associated tag and the Tag battery replaced button in the right-hand corner of the Smart Space Config. If a resident is missing from the tracking area and they are wearing an active tag, the report function can be used to determine the last time the resident was seen by the system by clicking on the daily, weekly, and monthly reports.Here, the travel of one resident over the course of a 24-hour period is shown. It is important to check that there are no jumps through walls and that all of the stationary activity is recorded without jumps. Given that the walking distance is a measure of all of the walking activity and that the sustained walking distance is measured only when the resident walks for at least 60 seconds, it is important to confirm that the walking distance mean data is higher than the sustained walking means for all of the tracked residents.Supplemental paper and pencil, cognitive, and getting balance tools can be used to further refine patient risk profiles. Real-time locating systems can provide continuous and objective measures of walking activity, predictive of falls, wandering, and other adverse events in high-risk patient populations.

Research

JoVE Journal

Behavior

How to Detect Amygdala Activity with Magnetoencephalography using Source Imaging

In trace fear conditioning a conditional  stimulus (CS) predicts the occurrence of the unconditional stimulus (UCS),  which is presented after a brief ...

Community-based Adapted Tango Dancing for Individuals with Parkinson's Disease and Older Adults

Adapted tango dancing improves mobility and balance in older adults and additional populations with balance impairments. It is composed of very simple ...

Substantiating Appropriate Motion Capture Techniques for the Assessment of Nordic Walking Gait and Posture in Older Adults

Nordic walking (NW) has become a safe and simple form of exercise in recent years, and in studying this gait pattern, various data collection techniques ...

Psychophysical Tracking Method to Measure Taste Preferences in Children and Adults

The Monell two-series, forced-choice, paired-comparison tracking method provides a reliable measure of sweet taste preferences from childhood to ...

Using the FishSim Animation Toolchain to Investigate Fish Behavior: A Case Study on Mate-Choice Copying In Sailfin Mollies

Using the FishSim Animation Toolchain to Investigate Fish Behavior: A Case Study on Mate-Choice Copying In Sailfin Mollies

Over the last decade, employing computer animations for animal behavior research has increased due to its ability to non-invasively manipulate the ...

Modified Blood Collection from Tail Veins of Non-anesthetized Mice with a Vacuum Blood Collection System and Eyeglass Magnifier

Blood sample collection is the basis of experimental animal research. It is of importance to obtain adequate blood samples for various research purposes. ...

Highlighting and Reducing the Impact of Negative Aging Stereotypes During Older Adults' Cognitive Testing

As life expectancy increases, aging has become a major health challenge, resulting in a huge effort to better discriminate between normal and pathological ...

Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack

Recent studies have shown that an automated, lifespan-inclusive, transdiagnostic, and clinically based, individualized risk calculator provides a powerful ...

Using a Virtual Reality Walking Simulator to Investigate Pedestrian Behavior

To cross a road successfully, individuals must coordinate their movements with moving vehicles. This paper describes use of a walking simulator in which ...

Lower-Limb Biomechanical Characteristics Associated with Unplanned Gait Termination Under Different Walking Speeds

Gait termination caused by unexpected stimulus is a common occurrence in everyday life. This study presents a protocol to investigate the lower-limb ...