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Assessing gait and balance after Emergency Department discharge using an Up and Go task with smartphone accelerometry: A prospective feasibility study
ABSTRACT
Background:
Older adults discharged from the emergency department (ED) face elevated risk of falls and functional decline. Smartphones may be a promising modality to conduct remote patient monitoring of mobility after ED discharge, yet its application in this context remains under-explored.
Objective:
To assess the feasibility of using smartphones to measure weekly gait and balance data from older adults over an 11-week period after ED discharge
Methods:
This single-center, prospective observational cohort study recruited patients aged 60 and older from an academic ED. Participants downloaded the GaitMate app to their iPhones, which recorded 3-axis accelerometer data during 11 weekly at-home "Up and Go" functional tasks. The study measured adherence to task completion, quality of transmitted accelerometer data, and participants' perceptions of the app's ease of use and safety.
Results:
Out of 617 approached patients, 149 consented to participate, and 9 dropped out. Overall, participants completed 62% of study tasks. Data quality was optimal in 35% of submissions. At 3-month follow-up, 83% of respondents found the app easy to use, and 95% felt safe performing the tasks at home. Barriers to adherence included the need for assistance, technical issues with the app, and forgetfulness.
Conclusions:
The study demonstrates moderate adherence to smartphone tasks for monitoring mobility among older adults after ED discharge, perceived ease of use and safety of completing at-home gait tasks. Identified barriers highlight the need for improvements in user engagement and technology design. Clinical Trial: NA
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