Feasibility of Using Daily Home Gait Testing to Assess Intervention Effectiveness in Older Adults

TL;DR

A smartphone app was used to track daily gait in older adults during and after a brain stimulation intervention, showing it's feasible for long-term mobility monitoring.

Contribution

Demonstrates the feasibility of using a smartphone app for daily gait assessments in older adults during interventions.

Findings

Participants completed gait assessments on 83% of intervention days and 57% of follow-up days.

The Gait App received an average user satisfaction score of 7.4 out of 10.

The app enabled longitudinal monitoring of gait performance under normal and dual-task conditions.

Abstract

Interventions focused on improving gait performance in older adults typically assess gait within single study visits at baseline and after intervention. This approach fails to account for non-trivial, within-subject daily fluctuations in gait performance. We previously validated a smartphone application (Gait App) enabling older adults to self-administer normal and ‘dual-task’ gait assessments in their own homes. This study examined the feasibility of deploying the Gait App to complete daily gait assessments both during and after a two-week intervention of noninvasive brain stimulation (10, once-daily stimulation sessions over two consecutive weeks) designed to improve dual-task gait in older adults. We enrolled 15 individuals at risk of falls (79±3yrs; 4 females; fear of falling via FES-I: 18-41; SPPB: 4-11). Participants were instructed to utilize the Gait App to complete a brief normal and dual-task gait assessments once a day, at least five days each week, throughout the intervention and over a subsequent 20-day follow-up. Participants successfully completed the assessment on 8.3±3.6 days (83% adherence) during the intervention phase and 11.3±13.7 days (57% adherence) throughout the follow-up period. Participants rated their experience with the Gait App on a scale from 0 (very poor) to 10 (very good), with an average score of 7.4. Six participants gave ratings of 9 or 10. These results demonstrate that the Gait App is feasible for monitoring daily gait performance under both normal and dual-task conditions in older adults at risk of falls, thereby enabling longitudinal assessment of how interventions impact mobility changes in older adults.