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Background: Early detection of gait impairments in older adults allows the early uncovering of fall risk and/or cognitive deficits, resulting in timely interventions. Dual-task paradigms have been shown to be more sensitive than single-task conditions for the detection of subtle yet relevant gait impairments., Research Question: Can a system - encompassing a pair of instrumented insoles and a customized mobile app - transparently and accurately study ecological walking activities in single- and dual-task conditions, with the aim of detecting early and subtle age-related alterations of gait?, Methods: The system was tested on 19 older adults during outdoor walking (two identical single-task trials and two motor-cognitive dual-task trials with the user engaged in a simple phone call and in a cognitive-demanding phone call). A single-task cognitive trial was included. Relative reliability of the gait parameters provided by the insoles during single-task walking was investigated (Intraclass Correlation Coefficient). The effect of dual tasking on both motor (Friedman test) and cognitive (Wilcoxon signed-rank test) domains was studied. To study usability, the system was tested on 5 older adults in real-life environment over 3 months., Results: Most of the parameters showed excellent reliability. Independently from the cognitive demand, walking while talking resulted in increased gait cycle and step time, with a prolonged stance phase due to an augmented double-support. Variability of gait cycle and stance phase increased only during the most demanding dual-task. Dual tasking resulted in a reduced cognitive score. Usability feedback were excellent, with users reporting to understand the usefulness of the devised system and to feel at ease when using the system and the insoles., Significance: This work paves the way toward fruitful applications of the devised system to achieve accurate and ecological monitoring of daily-life walking activities, with the final aim of detecting early and subtle alterations of gait., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Telemonitoring is one of the most expedient answers to the strong need for preventive care imposed by the rapidly aging society. We propose an innovative solution to the detection of early signs of frailty by presenting a serious game controlled by a smart sensorized soft plastic ball, designed to achieve continuous home-based monitoring of muscle weakness in older adults. Design, development, and testing of the smart ball and of the game interface devised to guide the monitoring procedure are presented. Reliability and concurrent validity of the system in measuring maximal grip strength against the clinical standard Jamar ® were evaluated. Serious game usability and acceptance were investigated on 26 elderlies. Smart ball and Jamar measurements were well correlated (0.76 and 0.80 for dominant and non-dominant hands) and test-retest reliability of pressure measurements was excellent (intraclass correlation coefficient >0.94). The serious game was well accepted by the 96.1 percent of participants, who provided a strongly positive usability score (87.7/100). The smart ball-driven serious game demonstrated excellent reliability and good validity in measuring grip strength. The proposed smart ball-driven serious game can be used for home self-monitoring of grip strength in elderlies.

We present the development of a novel smart ink pen instrumented with force and motion sensors designed for the quantitative and ecological assessment of daily-life handwriting. This work aims at testing the pen’s sensors and algorithms and the use of the smartpen to detect age-related changes in writing and tremor parameters during daily-life handwriting. A comparison against reference instruments was carried out to validate the pen tip force during static and dynamic conditions, the pen’s tilt angle, and the algorithm for the segmentation of the force signal into strokes. The smartpen was tested on 43 healthy adults divided into three age groups (young, middle-old, and old) during unconstrained handwriting on paper. The validation of the pen’s sensors and algorithms reported excellent results. A solid test–retest reliability was found in the writing and tremor indicators extracted from both young and old adults. As for the age-related analysis, the older age groups were characterized by an increase of temporal writing measures, a more uniform writing pressure, and more repetitive and predictable tremor oscillation components. The greatest accomplishment of our smart ink pen is the ability to combine the advantages of the digitizing tablet technology with the natural “feel,” the ease of use, and the ecological validity of the traditional pen-and-paper approach. The proposed solution represents an important step toward a simple, ecologically valid, reliable quantitative assessment of daily-life handwriting. Our smartpen is particularly suitable for daily-life telemonitoring applications in a number of important health-related fields. [ABSTRACT FROM AUTHOR]