Assessing Frailty in Older Adults Through Cane Usage Using Inertial Measurement Units

Haruki Toda, Takaaki Chin
Purpose:

This study aimed to compare the characteristics of accelerations and angular velocities obtained from an inertial measurement unit (IMU) attached to a cane between older adults with and without frailty.

Methods:

Community-dwelling older adults participated in this study. An IMU was attached to the distal end of the cane using a custom jig fabricated with a 3D printer. Accelerations and angular velocities were recorded at 120 Hz. Participants walked along a 7 m straight walkway at their comfortable speed. A fourth-order Butterworth low-pass filter with a 10 Hz cutoff frequency was applied to the accelerations and angular velocities. The ground contact of the cane, for extracting gait cycles, was detected using the jerk norm of the acceleration. The root mean square (RMS) in the vertical (VT), anteroposterior (AP), and mediolateral (ML) directions were calculated for each gait cycle and then averaged. The power spectrum was computed by applying a Fast Fourier Transform using periodic Hamming windows, and the mean power frequency (MPF) was determined within the 0.5–10 Hz frequency band. Frailty was assessed using the exercise-related section of the KCL. Individuals who answered affirmatively to three or more of the five items were classified as physically frail. Prior to comparing the dependent variables, data normality was verified using the Shapiro–Wilk test. Differences between older adults with and without frailty were analyzed using the Mann–Whitney U test, and effect sizes were calculated.

Results:

Data from 48 older adults, including 15 with frailty and 30 without frailty, were analyzed. The RMS in the VT and AP directions, as well as angular velocity in the AP direction, were significantly lower in older adults with frailty compared to those without frailty. In contrast, the MPF in the VT direction was significantly higher in older adults with frailty. No significant differences were observed in the RMS in the ML direction, MPF in the AP and ML directions, angular velocity in the VT and ML directions, or stride time between older adults with and without frailty.

Conclusion(s):

The use of a cane in older adults with frailty is characterized by distinctive patterns in acceleration, angular velocity, and the frequency response of acceleration in the VT and AP directions. These walking characteristics of frail older adults are reflected in their cane usage.

Implications:

This study suggests that frailty can be effectively assessed on a daily basis using an IMU attached to the cane of older adults.

Funding acknowledgements:
This study was supported by the JSPS KAKENHI Grant Numbers JP 23K16508, Japan.
Keywords:
Frailty
Cane
IMU
Primary topic:
Health promotion and wellbeing/healthy ageing/physical activity
Second topic:
Innovative technology: information management, big data and artificial intelligence
Third topic:
Older people
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
The Hyogo Institute of Assistive Technology
Provide the ethics approval number:
R2303
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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