A major issue in healthcare today is the limited frequency of measurement and standard data on a particular patient profile. We propose to develop a continuous monitoring system that uses the integration of the Philips Healthcare Wearable Sensing technologies and an infrared structured light sensor to collect patient motion in and around the bed. This sensor platform system in clinical environments will study the patterns of movement of elderly patients in/around bed in correlation with a Comprehensive Geriatric Assessment (CGA). The database of movement will be matched to the CGA, which will include assessment of nutrition, medication, functional and cognitive status.
Mobility is fundamental to successful aging and ultimately reflects health status and quality of life. Mobility limitations in older adults may be due to a specific condition but more often have multi-factorial causes connected to age-related changes in the cardiopulmonary, musculoskeletal, and central and peripheral nervous systems. Much of the research in the area of mobility focused on one aspect of mobility – gait. However during acute events such as trauma or acute illness the elderly experience a precipitous decline in mobility and this decline occurs in the context of low physiological reserve. During hospitalization and subsequent rehabilitation the new aspects of mobility such as ability to move in bed and ability to transfer become one of the determinants of overall health and important prognostic factors. Measurement and analysis systems are essential to evaluate mobility in this setting.
During hospitalization for acute illness, an estimated 23% to 33% of older adults experience low mobility, defined as being limited to a bed or chair. Ambulation occurs infrequently, with only 27% of patients walking in the hallways during hospitalization. On average, hospitalized patients spent most of their measured hospital stay lying, with an average of 20 of every 24 hours being spent in bed. For older adults, the effects of bed rest are profound. One study found a significant decrease in muscle protein synthesis, strength, and lower extremity and whole-body mass in a group of healthy older adults placed on bed rest for 10 days. Low mobility is associated with adverse outcomes, including functional decline, increased risk of falls and need for new nursing home placement, even after controlling for illness severity and co-morbidity. There is a paucity of studies investigating amount of out-of-bed time during rehabilitation, but it is safe to assume that elderly patients spend more time in bed during rehabilitation due to longer recovery times in comparisons to elderly who live in the community. Therefore studying and quantifying patterns of mobility in bed and during transfers from bed to a chair both in hospital and rehabilitation settings will give medical community an important insight into the nature of functional decline during and after acute hospitalization as well as study different trajectories of functional recovery.
The symptoms and signs of disease onset in elderly are frequently non-specific and may manifest with subtle behavioral changes. They may manifest either with patterns of decreased activity or psycho-motor agitation. This is especially relevant in bedridden patients and patients with significant cognitive decline and difficulties with communication.
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