Introduction Comprehensive Geriatric Assessment (CGA) is widely used in the management and assessment of older people living with frailty, however optimal ways of delivering CGA are not well understood. Gait and balance impairments, common in those living with frailty, are assessed in CGA. Advancements in digital technology provide opportunities to improve patient outcomes by digital monitoring, rather than observation-based assessments - which may be less accurate. As part of the Digital and Remote Enhancements for the Assessment and Management of older people living with frailty (DREAM) study, the aim of this review was to identify devices to assess gait and balance remotely, to enhance CGA. Methods Searches were conducted across six databases. Papers published since 2008 were included if: participants were over 65; evaluated gait or balance using wearable technology suitable for community use; presented data on validity, reliability, or acceptability of the device. Results Of 6,203 papers identified, 48 papers were included evaluating 49 devices. 35 evaluations assessed gait, 7 assessed balance, and 7 assessed gait and balance. The most common modality was a single sensor (n= 30) on a participants’ back (n=22). Seven studies assessed more than one aspect of validity, but the majority examined criterion validity (n=35) and reliability (n=12). Good-excellent agreement between the wearable and a comparable method of analysing gait/balance was found in 15 studies. Devices could distinguish between healthy populations and those with Parkinson’s disease (n=8), cognitive impairment (n=4), falls (n=4), mobility disability (n=3) and frailty (n=3). Conclusion Wearable technologies offer accurate and reliable assessment of gait and balance that could be used to enhance CGA. These tools could be applied remotely in domiciliary settings, freeing up healthcare professionals to focus on other components of CGA, such as ensuring the delivery of interventions to address identified gait and balance impairment.

中文翻译：

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1964 年可用于远程测量步态和平衡的可穿戴设备，可用于综合老年评估：范围界定审查

简介 综合老年评估 (CGA) 广泛应用于体弱老年人的管理和评估，但提供 CGA 的最佳方法尚不清楚。步态和平衡障碍在体弱者中很常见，在 CGA 中进行评估。数字技术的进步提供了通过数字监测改善患者治疗结果的机会，而不是基于观察的评估——这可能不太准确。作为数字和远程增强老年人虚弱评估和管理 (DREAM) 研究的一部分，本次审查的目的是确定用于远程评估步态和平衡的设备，以增强 CGA。方法 在六个数据库中进行搜索。2008 年以来发表的论文包括以下条件： 参与者年龄超过 65 岁；使用适合社区使用的可穿戴技术评估步态或平衡；提供有关该设备的有效性、可靠性或可接受性的数据。结果 在已识别的 6,203 篇论文中，包含了 48 篇评估 49 种设备的论文。35 项评估评估步态，7 项评估评估平衡，7 项评估评估步态和平衡。最常见的方式是在参与者 (n=22) 的背部安装单个传感器 (n=30)。七项研究评估了不止一个方面的有效性，但大多数研究都检查了标准有效性 (n=35) 和可靠性 (n=12)。15 项研究发现，可穿戴设备与分析步态/平衡的类似方法之间具有良好的一致性。设备可以区分健康人群和患有帕金森病 (n=8)、认知障碍 (n=4)、跌倒 (n=4)、行动障碍 (n=3) 和虚弱 (n=3) 的人群。结论 可穿戴技术可提供准确可靠的步态和平衡评估，可用于增强 CGA。这些工具可以在家庭环境中远程应用，使医疗保健专业人员能够专注于 CGA 的其他组成部分，例如确保提供干预措施来解决已识别的步态和平衡障碍。