Date Published: May 15, 2019
Publisher: Public Library of Science
Author(s): Robert J. Dawe, Lei Yu, Sue E. Leurgans, Timothy Truty, Thomas Curran, Jeffrey M. Hausdorff, Markus A. Wimmer, Joel A. Block, David A. Bennett, Aron S. Buchman, Bruce H. Dobkin.
Currently, it is not feasible to obtain laboratory-based measures of joint motion in large numbers of older adults. We assessed the utility of a portable depth-sensing camera for quantifying hip and knee joint motion of older adults during mobility testing in the community.
Participants were 52 older adults enrolled in the Rush Memory and Aging Project, a community-based cohort study of aging. In a subset, we compared dynamic hip and knee flexion/extension obtained via the depth-sensing camera with that obtained concurrently using a laboratory-based optoelectronic motion capture system. Then we recorded participants’ annual instrumented gait assessment in the community setting with the depth-sensing camera and examined the inter-relationships of hip and knee range of motion (ROM) with mobility metrics derived from a wearable sensor and other mobility-related health measures.
In the community, we successfully acquired joint motion from 49/52 participants using the depth-sensing camera. Hip and knee ROMs were related to diverse sensor-derived metrics of mobility performance (hip: Pearson’s r = 0.31 to 0.58; knee: Pearson’s r = 0.29 to 0.51), as well as daily physical activity, conventional motor measures, self-report hip and knee pain and dysfunction, mobility disability, and falls.
The depth-sensing camera’s high rate of successful data acquisition and correlations of its hip and knee ROMs with other mobility measures suggest that this device can provide a cost-efficient means of quantifying joint motion in large numbers of community-dwelling older adults who span the health spectrum.
Numerous studies have demonstrated the utility of motion-tracking technologies for elucidating the biomechanics and gait patterns associated with various types of mobility impairments across much of the lifespan [1,2]. However, these technologies are typically available only in specially equipped laboratories at major medical centers or research institutions, not in community hospitals or clinics. Many older adults, particularly those who are physically frail or have cognitive impairments, are unwilling or unable to undergo such assessments due to the required travel , as well as the testing burden itself. Repeated testing to obtain longitudinal data is also impractical. These testing limitations have led to critical gaps in our knowledge regarding gait biomechanics across the full health spectrum of older adults and their relation to mobility impairments.
We investigated the use of a portable, depth-sensing camera to quantify joint motion of older adults during mobility testing in the community. Using this camera, we successfully acquired three-dimensional motion data from nearly all 52 enrollees. Hip and knee ROMs extracted from the motion recordings were associated with mobility metrics acquired during the same testing session via a wearable sensor. In addition, joint motion metrics were related to a wide range of other mobility-related physical function and health measures. These results support the notion that a portable, depth-sensing camera can be used to expand instrumented gait testing conducted outside the laboratory setting. Further studies using this approach in larger numbers of older adults are needed to elucidate the independent contributions of joint motion and spatiotemporal mobility metrics to late life mobility impairments.