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

这项工作得到了美国 (美国) 颁发的职业发展奖 # [e7503w] 和 # [RX002413-01A2] 的优异奖的支持。退伍军人事务部康复研究和发展处。这项工作的内容并不代表美国退伍军人事务部或美国政府的意见。

这里描述的所有方法都得到了宾夕法尼亚州费城下士 michael j. crescenz va 医疗中心机构审查委员会的批准。
1. 实时定位系统的安装和设置 (rtls)
<ol><li>与设施利益相关者一起审查设施政策、安全和对居民的个人信息保护。确定是否需要书面或口头支持在设施中使用 rtls。在与利益攸关方的讨论中, 包括地方协议和程序 (例如, 当地设施技术豁免、工会签签等) 和项目时间表?...

<ol>
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在开始 rtls 项目之前, 有几个关键步骤值得讨论。虽然长期护理设施中的典型公共区域 (约10米 x13 米或 1, 000 平方英尺) 需要四个传感器, 但这取决于环境, 项目所需的传感器数量取决于所需的精度水平和环境.例如, 突起和玻璃墙将需要额外的传感器。如果没有视线问题, 四个传感器将覆盖更大的区域。还要考虑到, 一个设施的某些地区可能不需要全面覆盖。标签的更新速率也很重要, 因为较高的更新...

老年人从事日常生活活动和身体活动的能力与步态质量和平衡能力有关。1先前的研究显示了久坐老年人的平衡能力与自我报告的体育活动之间的相关性。2这些相关性在老年人口中仍然存在。例如, 在社区老年人中, 自我报告的活动水平与平衡3和行走能力显著相关;4流动长期护理住院医师的体育活动与步态和平衡呈正相关 (使用 tinetti 性能导向移动性评估)。5制度化与晚年行走活动减少有关6并导致这一人群中久坐行为的高发率。7事实上, 据报道, 一个机构居民醒着的时间有80% 或更多是坐着或躺着的 , 很少有长期护理的居民达到建议的每天30分钟的适度活动。7体育活动不足与这一人群的去调理、住院和其他健康不良结果有关。了解这些人群的步行活动可能有助于量身定制的步态和平衡干预措施, 以增加体育活动。
一些将有认知障碍 (ci) 的年龄老年人因疾病进展而开始过度行走。流浪发生在几个小时的活动很少中断的时候。流浪与疲劳、体重减轻、跌倒受伤、睡眠障碍、迷路和死亡有关。8与没有或没有适度 ci 的养老院居民相比, 患有重度 ci 的居民表现出更多20% 的活动, 其中26% 是 "拍打" 行为, 一种是居民在房间里打转的流浪行为。9尽管如此, 保健工作人员和其他观察员很难区分体育活动和流浪。步行活动的个体内变化可能是微妙的, 流浪不是一个行为问题, 直到老年人试图私奔 (例如, 逃离设施)。流浪是很常见的;流浪的流行率因研究而异, 但估计38% 的 10%至 8 0% 的患有 ci 的老年人会在疾病过程中的某个时候流浪。11
很难理解机构收容的老年人的步行活动, 因为人口是异质的 (例如, 认知水平、健康状况各不相同), 活动也很难客观衡量。保健工作人员的自我报告活动方法更好地反映了私奔或试图逃离该设施的情况, 长期持续观察容易受到两次间错误的影响, 耗时和昂贵。12,13种实时定位系统 (rtls) 技术有可能客观、持续地测量患有 ci 的老年人的行走活动。值得注意的是, rtls 领域存在异质性, 理论上可以使用多个系统: 超宽带 (uwb; 见所附材料表)、红外 + 射频、超声波和机器视觉系统。然而, 为了评估流浪行为, 需要一种小型且不显眼、无线、能够进行广域跟踪的跟踪技术, 在20厘米内没有视线问题和精度, 除了使用 uwb 的 rtls 之外, 几乎没有其他系统 (如果有的话)。满足这些要求。例如, 红外 + 射频技术依赖于创建 "区域", 这些区域详细说明居民通过时的情况, 但不够具体, 无法确定除一两米内的流浪行为外的流浪行为, 这对这些目的来说太粗糙了。超声和机器视觉在识别和反射方面存在问题;机器视觉系统具有良好的分辨率, 但如果不使用 rfid 标签来弥补当前人工智能能力的不足, 就无法区分居民。使用 uwb 的 rtls 具有约20厘米的更宽范围和空间分辨率----而其他系统的范围和空间分辨率为一米或1米以上----使其成为最精确的, 能够捕获所有活动模式。14,15此处讨论的使用 uwb 的 rtls 也很稳定, 专为 24/工业应用而设计。研究人员和临床医生以前使用过这种系统, 在这个系统中, 精确是必不可少的--预防和预测跌倒, 评估痴呆和认知的变化--在各种各样的环境中--辅助生活、医院、养老院和康复单位。13,16,17
本文将详细介绍使用 uwb 测量行走活动的 rtls 的协议 [步行距离、持续步行距离和持续步态速度 (仅在持续行走过程中计算的平均 second/week)] 以及纸和铅笔测试 ci,步态能力和平衡质量, 因为后者是步行活动的关键组成部分。研究结果将侧重于使用 rtls 来区分与体育活动有关的步行距离, 从而与积极的健康结果, 以及与流浪从而与消极健康结果有关的持续步行距离。

<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

实时定位系统 (rtls) 可用于跟踪长期护理的机构收容老年人的行走活动, 这些老年人有流浪行为的风险。rtls 的好处是客观和持续地衡量活动。保健人员的自我报告活动方法, 特别是流浪, 容易受到地板影响和回忆偏见的影响, 长期持续的临床或研究观察可能既耗时又昂贵。保健工作人员也没有认识到流浪行为的发生和/或持续时间, 这些行为与这一人群中的各种不利健康结果有关, 但容易接受干预。rtls 技术可以高度准确地测量有认知障碍的机构住院居民的行走活动。这对于流浪的研究特别有用, 它的定义是步行至少 60秒, 很少 (如果有的话) 中断活动。流浪与疾病进展、住院、跌倒和死亡有关。此前的研究表明, 平衡能力差、步行活动频繁的老年人可能特别容易受到健康结果不佳的影响。rtls 用于评估认知障碍以及与步态和平衡相关的因素;但是, 补充纸张和铅笔 gait/平衡工具可用于进一步细化风险状况。该项目讨论了使用 rtls 来衡量步行活动的问题, 以及对这一人群的步态质量和平衡能力措施。

rtls 原始数据需要平滑以提高位置数据的精度 (请参阅 "使用 rtls 标记实时定位和跟踪居民" 一节下的协议步骤 9)。虽然在安装和设置过程中使用电源绘图选项卡中的默认设置进行控制 (请参阅相关协议中的步骤 1.6.3), 但如果不进行额外的平滑, 则会继续出现噪音和跳转。关于噪音, 即使久坐数小时, 活动 rtls 标记也会继续记录运动, 尤其是当居民移动其肢体时, 标记所在的位?...

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

本文讨论了使用连续和客观的实时定位系统来测量与流浪行为相关的行走活动, 重点是老年人的认知障碍。步行活动是通过步行距离、持续步行距离和持续步态速度来衡量的。评估的还有步态质量和平衡能力。

利用实时定位系统测量被培养的老年人的游走行为相关的步行活动

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 ...

医护人员无法区分体力活动和流浪，只有在患者面临离开医院的风险时，才能识别流浪。步行活动的变化与认知障碍、跌倒、流浪和其他不良健康结果有关。实时定位系统持续、客观地跟踪行走活动。这包括有益的身体活动以及流浪。流浪是模式行走，与不良的健康结果有关。在将标签分配给居民之前，请打开实时定位系统图形使用界面中的"标记关联"选项卡，并随机为每个同意的门诊或足部推进住院患者分配唯一的患者 ID 号。使用每个标签上提供的编号将标签与每个患者 ID 链接，以便进行无线跟踪，将标记位置留在原点，并确认已选择"允许标记交换"。选择标记的类型、迷你标记，然后单击"保存"。在"位置系统配置"中，单击"查看跟踪消息"。然后，获取跟踪消息以确保系统正在从标记记录事件。在"传感器状态"选项卡下，确认所有传感器都在运行。在"位置系统配置"中，单击"查看位置事件"。在窗口中，单击"开始侦听"以从标记实时收集数据。要打开标签，请将磁铁放在标签的右侧下，直到指示灯开始持续闪烁。然后将激活的标签连接到每个居民身体的一个区域，具有一个很小的横截面区域，以便更有限地吸收射频能量，并提供更好的跟踪精度。每天一次，目视检查实时位置系统传感器和标签以及所有系统辅助设备上的所有传感器指示灯，并确认标签未被淹没在水中。此外，每天，打开系统图形用户界面中的"地图"选项卡，并检查所有标记的居民是否可见和被跟踪。若要查看更直接的事件，请使用"位置系统配置"中的"使用最后一个"按钮调整跟踪数据量。将时间设置为最后 10 分钟或更少，然后单击"开始收听"。更换电池时，单击智能空间配置右侧角的关联标签和标签电池更换按钮。如果居民从跟踪区域丢失，并且他们佩戴着活动标签，则报告功能可用于通过单击每日、每周和每月报告来确定系统最后一次看到该居民的时间。此处显示一名居民在 24 小时内的旅行。重要的是要检查有没有跳跃通过墙壁，并记录所有静止活动没有跳跃。鉴于步行距离是衡量所有步行活动的指标，并且只有在居民步行至少 60 秒时才能测量持续步行距离，因此必须确认步行距离平均数据高于所有受跟踪居民的持续步行距离。补充纸和铅笔，认知和获得平衡工具可用于进一步完善患者的风险配置文件。实时定位系统可以提供行走活动、瀑布、游荡和其他高危患者群体不良事件的连续和客观测量。

Research

JoVE Journal

Behavior

How to Detect Amygdala Activity with Magnetoencephalography using Source Imaging

如何检测杏仁核活动脑磁图源成像

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

科研

行为学

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

充实适当的运动捕捉技术的越野行走步态中老年人的评估和姿势

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

心理跟踪方法来衡量儿童和成人的口味偏好

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

利用fishsim动画工具链调查鱼类行为--以鱼翅钼中的选物复制为例

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

真空采血系统和眼镜放大镜从非麻醉小鼠尾静脉中修饰采血

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

Brain State-dependent Brain Stimulation with Real-time Electroencephalography-Triggered Transcranial Magnetic Stimulation

脑状态依赖性脑刺激与实时脑脑图触发颅内磁刺激

The effect of a stimulus to the brain depends not only on the parameters of the stimulus but also on the dynamics of brain activity at the time of the ...

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

在老年人认知测试中突出和减少消极衰老成见的影响

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

使用 CogStack 基于电子健康记录的实时精神病风险检测和警报系统的实施

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

使用虚拟现实步行模拟器调查行人行为

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