Wearable technology improves quality of life for people with balance disorders

Innovative ‘wearable’ technology designed to help older people with balance disorders can significantly improve patients’ balance, their ability to perform everyday tasks and their social wellbeing compared with the standard home exercise programme, according to results of a UCLH and UCL study.

Balance disorders are very common in older adults and have wide ranging physical, psychological and cognitive impacts.

The HOLOBALANCE technology – for people who are at risk of falls – is made up of wearable technology including accelerometers, soles with sensors on them, ‘smart’ bracelets, motion caption sensors and a head-worn virtual reality display. It can be used at home as well as in clinic and includes a personalised programme of exercises, cognitive tests, gamified training and physical activity planning. The system provides detailed movement and physiological data for the remote assessment of task performance.

For a study looking at the technology, researchers led by UCLH consultant and UCL Professor Doris-Eva Bamiou recruited 145 participants made up of older adults who had a history of falls or were at risk of falling, and middle aged or older individuals with a confirmed diagnosis of a balance disorder.

Participants were randomised either to receive the HOLOBALANCE intervention at home or in clinic, or the standard clinical treatment – a home exercise programme – for 8 weeks. All participants undertook a daily exercise programme intended to improve their balance, with the programme overseen by a physiotherapist.

Results of the study showed 88% of participants who used the HOLOBALANCE technology achieved at least the minimal clinically significant difference in Functional Gait Assessment (FGA) – used to assess postural stability and an ability to perform multiple tasks while walking – compared with 55% in the control group.

82% in the HOLOBALANCE group achieved at least the minimal clinically significant difference in the Mini-BESTest (a standard balance measure) scores compared with 52% in the control group.

There was an average improvement of 25% for FGA and of 36% for MiniBESTest for those with abnormal scores at baseline and eventually trained with the HOLOBALANCE platform. Researchers think the improvement for people with greater disability would be even higher.

In addition participants in the HOLOBALANCE group saw a significant improvement in their social wellbeing with a reduction of total days per month during which the participants’ balance impacted their lives in a negative way by 14.66 days.

There was a high rate of exercise compliance in the intervention group (83%) with improved balance reported by 73%. There were no adverse events during the study suggesting the technology and training is safe. And home based and clinic based interventions appeared feasible regardless of age, sex or education level.

Professor Bamiou said: “Early detailed individualised assessment and treatment interventions for older people with balance disorders is recommended by several guidelines but are not always possible due to lack of resources and specialist knowledge. Our study suggests the HOLOBALANCE technology can help meet this need for personalised and specialist care and thus improve quality of life for these adults.”

The research team said the potential benefit of the platform must be confirmed in a larger, randomised controlled trial.

The HOLOBALANCE project (HOLOgrams for personalised virtual coaching and motivation in an ageing population with BALANCE disorders) involves 13 partners from across Europe and is coordinated by Prof. Dimitrios I. Fotiadis, who is Professor of Biomedical Engineering at the University of Ioannina. It has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 769574.

Visit https://holobalance.eu/.