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STEADY, an ICT based holistic concept for fall prevention and management among the elderly community

Final Report Summary - STEADY (STEADY, an ICT based holistic concept for fall prevention and management among the elderly community)

2-1 Abstract

Today, there is a rising proportion of elderly people worldwide and a trend to an increase of old age dependency ratio. The major cause of dependency within this community is recognized to be the fall accident. According to the World Health Organization (WHO), approximately 28-35% of people aged of 65 and above fall each year, increasing to 32-42% for those over 70 years of age leading to an explosion of social and healthcare expenditures.
In this context, innovation in the Information and Communication Technologies (ICT) field along with new forms of service delivery organization such as home care services represents a viable solution for a better management of the ageing process. Holistic and smart approaches including a health network system to early diagnose movement disability and give early appropriate feedback in terms of rehabilitation strategies minimizing and retarding the ageing effects are more effective than others for individuals, families and care givers.
Thus the proposed innovating STEADY service addresses current limitations of fall management systems and services to meet the need for delivery of support to elder people who might be or are at risk of falling. Therefore the purpose of STEADY is to integrate an infrastructure for the implementation of a comprehensive fall management service by means of innovative usage of available technologies (tele-monitoring, e-care management, rehabilitation assistance by predictive control) and targeted both on preventative and reactive aspects promoting safety and independent living support. The determinants of healthy ageing, the component of fall risks and the best strategies of rehabilitation will be the basis of the project implementation.

2-2 Objectives

The overall goal of the STEADY project was to integrate, deliver and pilot an ICT-based holistic infrastructure allowing in the elderly home setting to:
• assess the fall risk level focusing mainly on the intrinsic factors related to fall,

• early prevent fall through sufficient and timely friendly exercising and gaming interventions according to the fall risk level,

• follow over time the physical status of the person in order to readapt the prevention program if necessary,

• share data flow related to the management plan within a well organized network of formal and informal carers,

• support all concerned stakeholders facing fall risks and falls using the infrastructure through e-learning access.

The intended architecture of the final infrastructure was the following one (Figure 1).

The work objectives that refer to 5 Work-Packages (WP) to achieve the overall goal were the following:

• WP1: Users requirements collection (10 months).

• WP2: Definition of the STEADY infrastructure architecture and service (10 months).

• WP3: Development and integration of the monitoring module, the rehabilitation module and the MBI system. (29 months)

• WP4: Pilot trials and evaluation of the STEADY prototype (12 months)
• WP5:Dissemination and exploitation (48 months)

2-3 Work performed

->Ethical issues and diverse declarations to the French national legal entities relative to the project implementation:

A statement based on the reference research methodology MR001 has been made (08/04/20013) to the CNIL (the national independent administrative body that operates in accordance with the data protection legislation of the 6th January 1978 as amended on the 6th August 2004). This statement of commitment to comply with the law is compulsory in order to be able to process personal data in the framework of biomedical research like the STEADY project. This commitment (STEADY_declaration.pdf) cover all the operations implementing personal data made in the WP1, WP2, WP3, and WP4.
The procedure concerning the implementation of clinical trials for the development of health devices has also begun. An application for a review of the STEADY protocol (WP1, WP3 and WP4) by the “Comité de Protection des Personnes de Tour “was in progress at the time of the project ended as well as to the “Agence Nationale de Sécurité du Medicament et des Produits de santé.” (STEADY_Protocole.pdf). These two organizations are the only ones authorized to give a favorable opinion on the implementation of biomedical research involving people.

->WP1 - Users requirements collection:
A detailed understanding of the context of development of STEADY as well as of the needs and expectations of our prospective users was required to achieve this WP. The work performed during the dedicate period is reported hereafter.
A state of the art has enabled to draw the development context of STEADY, since it is an essential step in order to respond to older consumers’ demands and not to mismatch their needs as it has been done so far. This definition of the context of development has allowed then designing two specific questionnaires to assess the requirements and needs of all the stakeholders expected to make use of the STEADY infrastructure (older people living independently and those providing the service and support: physiotherapist).This two questionnaires were the starting point of our User Centered Design approach for STEADY and were targeted for the dwelling elderly community (Questionnaire_Seniors.pdf) as well as for physiotherapists (Questionnaire_kinesithérapeutes.pdf ).
Finally, the users’ requirements collection has started enabling us to build a data base concerning for:

• the seniors: their lifestyle, their general opinion, involvement and expectation against new technologies and health devices, their opinion and expectation against the STEADY infrastructure and service in particular about its functionalities : the monitoring function, the physical activity function and the communication function.

•the physiotherapists : the characteristic of their usual intervention in the fall prevention domain, the use and their vision of the new technologies in their professional activities, their vision of tele-care and e-health, their vision of the STEADY concept and their preference and expectation in terms of usability.

->WP2- Definition of the STEADY infrastructure architecture and service:
Thanks to the database build in WP1, diverse use case scenarios can be drawn that should have been test along our User Centered Design approach of STEADY.

2-4 Main results

The main results obtain within the dedicated period is the seniors data base concerning the lifestyle, general vision and expectation against new technologies and health devices as well as concerning a particular set of expectations for the STEADY platform. This database still enriches itself even if the project ended.