In order to meet the challenges imposed to health care systems by rapidly ageing populations, new technical systems have to be developed for saving costs or for improving care quality without increasing costs. In geriatrics, the field of medicine dealing predominantly with the illnesses of elderly and multimorbid patients, such challenges are especially demanding due to an increasing number of patients and a decreasing number of caregivers.
The ultimate aim of a geriatric treatment is to recover and maintain an independent lifestyle of patients. In order to provide meaningful rehabilitation or aid, the functional status of patients has to be estimated first. This happens within the so-called geriatric assessment by use of standardized assessment tests. Such tests are designed to recognize limited functional or cognitive abilities in various domains compared to typical abilities respectively typical assessment tests scores of healthy elderly people. An explanation for recognized deficits is not given. Instead, additional, more detailed tests have to be performed in order to explain results. However, geriatric assessment tests are most often only applied after patients have arrived in a care facility. This means that physicians get in contact with patients after an acute incident already taken place and no longer after the patients left the facility. Enabling physicians to gain assessment results directly in peoples’ homes and comparing the results to the available reference values may enable early prevention and more sustainable rehabilitation.
Estimation of mobility is an important part of each geriatric assessment due to its known relationship to self-care ability and general health state. In the field of mobility a more detailed test most often means performing a gait analysis. However, in geriatrics a gait analysis is only merely performed since experts and expensive equipment are required. Additionally, gait analysis takes a lot of time especially since required equipment is often only found in special gait laboratories. Therefore, for assessment and diagnosis of mobility in the field of geriatrics a technical system is required that on the one hand supports execution of assessment tests in order to save time and objectify the tests’ execution. On the other hand, such a system needs to be able to perform a detailed gait analysis in order to explain possible problems found without drastically increasing required time for the execution compared to current assessment times.
Therefore, the Ambient Timed Up & Go (aTUG) approach has been developed. aTUG supports the execution of the frequently used Timed Up & Go (TUG) assessment test (1) by use of ambient sensor systems, i.e. a laser range scanner and four force sensors. For ease of clinical use, all sensors have been integrated into a single apparatus, i.e. a chair that also incorporates a battery and a display for mobile use (2). Recorded sensor information is used to compute the duration of the complete test and its components. The results are documented in a standardized format on the basis of the Clinical Document Architecture (CDA). Additionally, sensor recordings can be used to perform a detailed gait analysis of patients.
In summary, using aTUG or technical devices for automated assessments in general a physician gets more objective, more detailed, and digitally documented assessment results from the TUG test and additionally a gait analysis with no extra time required compared to an execution of TUG without technical support.