Digital mobility outcomes in older adults after fall-induced traumatic brain injury: use, need, and first results

4546

CP Jansen1, P Hartmann1, A Spranger2, J Lemcke2, P Schuss2, JM Bauer1, S Krieg1, A Younsi1,3, C Becker1

1 Heidelberg University, Germany, 2 BG Klinikum Unfallkrankenhaus Berlin, Germany, 3 BG Klinik Ludwigshafen, Germany

Scientific Research

SP - Falls

Major Trauma

View DOI

Abstract

Introduction

The overall incidence of “mild” traumatic brain injury (mTBI) is increasing due to the growing number of older persons. Often, after clinical examination, older adults with mTBI are released from the hospital without any further treatment or recommendations on how to avoid falling. The potential of Digital Mobility Outcomes (DMOs) to improve follow-up care by providing post-TBI guidance and concrete measures is evaluated.

Methods

Adults over the age of 65 with mTBI are currently taking part in this ongoing pilot study.Alongside a mixed-methods assessment of medical history, medication, home environment, motor function, vision, and cognition, walking activity and gait DMOs were collected using a wearable sensor worn on the lower back for seven days during everyday life at home.

Results

So far, eleven patients have been included (mean age 78.9 years; n=7 female). DMOs show a large heterogeneity in this patient collective. Patients took between 668 – 20,716 steps/day (mean: 6,315 ± 1,733), had a range in walking speed between 0.15 – 0.96 m/s (mean: 0.60 ± 0.04), had a maximum walking speed between 0.38 – 1.25 m/s (mean: 0.74 ± 0.07), and a mean number of walking bouts >1 minute between 0 – 43 episodes (mean: 7.6 ± 4.2).

Conclusion

Despite the study still being underway, it has become clear that there is no universal recommendation on how to avoid recurrent falls/TBIs in older adults with a history of fall-induced mTBI. The wide variation in daily mobility is currently not considered in post-treatment recommendations. Head trauma appears to have different underlying causes, as some patients were highly mobile (e.g., average of +20,000 steps/day), whereas others showed marked mobility impairments (e.g., mean walking speed <0.2 m/s).Digital real-world mobility assessment is able to improve post-mTBI treatment recommendations by personalising and stratifying prevention strategies based on older adults’ mobility in daily life.