Are cost-effective technologies feasible to measure gait in older adults? A systematic review of evidence-based literature

Abstract Background Unrestricted by time and place, innovative technologies seem to provide cost-effective solutions for gait assessment in older adults. Objective The objective of this study is to provide an overview of gait assessment for older adults by investigating critical gait characteristics of older adults, discussing advantages and disadvantages of the current gait assessment technologies, as well as device applicability. Methods The Preferred Reporting Item for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed during the review. Inclusion criteria were: (1) Sample consisting of adults older than 60 years; (2) qualitative, quantitative, or mixed-method researches using one or more specific gait assessment technologies; and (3) publication in English between 2000 and 2018. Results In total, twenty-one studies were included. Gait speed, stride length, frequency, acceleration root mean square, step-to-step consistency, autocorrelation, harmonic ratio were reported in the existing literatures to be associated with falls. The enrolled studies address the use of pedometer, wearable accelerometer-based devices, Kinect, Nintendo Wii Balance Board as cost-effective gait assessment technologies. Conclusions Gait parameters and assessment approaches for older adults are diverse. Cost-effective technologies such as a wearable accelerometer-based device, Kinect, and the Nintendo Wii Balance Board provide potential alternatives for gait assessment with acceptable validity and reliability compared with sophisticated devices. The popularity and development of cost-effective devices have made large-scale data collection for gait assessment possible in the daily environment. Further study could involve older adults and their family members/caregivers in use of these technologies to design elderly-friendly products.