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Methodology for Establishing a Community-Wide Life Laboratory for Capturing Unobtrusive and Continuous Remote Activity and Health Data
Chapters
Summary July 27th, 2018
Unobtrusive sensors and pervasive computing technology incorporated into the daily home life of older adults enables meaningful health and activity changes to be recorded continuously for months to years, providing ecologically valid, high frequency, multi-domain data for research or clinical use.
Transcript
This methodology can provide real time, objective, continuous and ecologically valid data for researchers engaged in longitudinal health studies and clinical trials. The advantages of this approach are that it while it requires little to no effort on the part of the research participants, it enables the capture of acute data as well as subtle changing events over time. It is adaptable for multiple-use cases.
This methodology has been substantially deployed to access outcomes most related to functional changes important for research in high-impact chronic conditions such as disorders of mobility or dementia. The protocols intend to be extensible in application of research to collect digital, activity and health data across many different research domains. Prior to deployment, add all the equipment to the console inventory system online.
Assign a name to each device or sensor, along with its serial number and MAC address, allowing it to be stored within the console inventory system. Place a QR or quick response code tag on each piece of equipment enabling specific assignments of home location for the sensors and devices when deployed in the home. Before deployment, all sensors and devices that are to be installed will be assigned to the home by scanning the QR code on the sensor or device.
This will bring up a website that allows sensor or device assignment to that specific home. Install the hub computer with an SD card which contains the hub configuration management tool. Pack all of the now inventoried sensors and equipment and hub computer with installed SD card into an installation kit for home deployment.
Verify that the participant's home has an Internet service provider. Set up the hub computer by inserting the wireless dongle and the primary zigbee coordinator dongle into the hub computer. Insert the ethernet cable into the hub computer in order to connect to the home's Internet connection.
And lastly, plug the hub computer's power cord into a centrally-located room's power socket. Connect and Internet-enabled device to the hub computer's wireless network. Open a web browser in order to access the local Control Panel website.
The Control Panel website will show the status of the hub computer and once the installation is complete, any sensors installed in the home. Run the software configuration tool ensuring the appropriate software is installed. Do this by navigating to the Control Panel and running update.
Navigate to the Control Panel to check that the hub computer is communicating with the main servers. Make sure that the services that allow data to be collected from each installed device and sensor are up and running. Add the sensors to the home, beginning with the motion sensors.
Start by opening the Sensor Placement website from the Control Panel. In the Sensor Placement website create a virtual floor plan of the home by adding the areas that represent rooms in the home. Adding sensors.
And creating linkages between areas and sensors. Add each motion sensor to the personal area network or PAN using a toggle switch located on the sensor page within the Control Panel. At the same time, press a button located near the motion sensor's battery 10 times.
This two-part process activates the sensor. Using the virtual floor plan as a guide, place the motion sensors in their corresponding rooms in the home. The motion sensors should be placed on the walls at head height using tape.
Continuing to use the virtual floor plan as a guide install a row of four restricted field sensors on the ceiling of a straight walkway such as a hallway in order to capture walking speed. Space these walking speed sensors two feet or 61 centimeters apart. Record the exact distance between the restricted field sensors in the Sensor Placement website.
Install door sensors on each egress door again using the virtual floor plan to indicate their physical location. Add the pillbox to the pan by navigating to the devices column within the Control Panel. Turn on the device, because the pillbox connects to the hub computer.
Ensure it is close enough to the hub computer for the signal to be detected. Set up the scale by navigating to the Control Panel opening the left navigation menu, choosing the expand device tab and clicking on the name of the scale. On the scale hold the side button for 10 seconds.
The scale will turn on displaying a start up message. Once the scale appears on the Control Panel, click the setup gear button to start the setup process. Once the setup gear button turns green the scale will continue setting up.
Place the scale in a location that has a flat, solid surface and is easily accessible to the participant. Enter the participant's height and weight when prompted in the Control Panel. If the participant does not have a pacemaker, toggle the pacemaker button in the Control Panel notifying the scale that it can collect certain data.
Once the scale is set up, have the participant weigh themselves, confirming the scale is recording the initial weight that has been entered into the Control Panel. Set up the wrist-worn wearable device by navigating to the wearables setup page within the Control Panel and pressing the reset button located on the back side of the device 10 times. After the wearable device shows up in the list of wearable devices on the Control Panel, click the setup button in order to start the setup process.
Once the wearables account is setup, calibrate the time by using the wheel on the setup page. To finalize the setup, synchronize the wearable by clicking the sync button in the Control Panel. This confirms that device is connecting properly and that the time is set to the same time as the hub computer.
Different devices may require different procedures depending on the manufacturer. Additional sensors and devices may be integrated and deployed into the technology platform in the future. Once all the devices and sensors have been installed in the home confirm that the hub computer is working properly.
Review if data is streaming from each device by navigating to the data collection page on the Control Panel. Walk near the sensors installed in each room of the home in order to see if each sensor is collecting data about recent movements. Check the motion sensors by viewing the live chart of motion sensor data.
Check if the pillbox is transmitting data by opening and closing at least one of the compartment doors a few times. Review the data collection page on the Control Panel to see if this recent activity was measured and collected. In order to check if the scale is transmitting data, weigh yourself.
Review if the scale is properly synced by navigating to the synced column within the devices page in the Control Panel. Check if the wearable device is properly synced and is transmitting data by navigating to the synced column within the wearables devices page in the Control Panel. The plot shows the trajectories of change in walking speed variability captured during multiple transits through home sensor lines.
Variability was defined as the coefficient of variation in a cohort of older adults followed in their homes for over three years. Latent trajectory models identified four distinct groups of walking speed variability. Distinct patterns of change in walking variability were seen more commonly in early and later phases of mild cognitive impairment.
This suggests that walking speed variability can be a marker for MCI progression. This spiral plot demonstrates the display of six months of continuous home activity data for a single volunteer. Data are plotted as a 24-hour clock with midnight at the top and noon at the bottom.
Each day forms one circle. The solid blue circles mark one month boundaries. Colored points indicate sensor activity by room location where red is the bathroom, green is the bedroom, pink is the kitchen and blue is the living room.
Consistent patterns of behavior are observed. Bedtime is usually around 2200 hours as visualized by sensor activity in the bedroom following sensor activity in the bathroom. The participants are up once most nights between 2 a.m.
and 4 a.m. as evidenced by sensor activity in the bedroom and bathroom during that time. Rise time is 0600 hours as observed through sudden sensor activity at that time.
Also apparent is a visit from a housekeeper at 5 p.m. every two weeks evidenced by the increased movement in the kitchen, followed by other rooms during that time. Finally, note the two week period during the fourth month when the volunteer did not leave the apartment during a community congregation restriction due to a flu epidemic.
Once mastered, this technique can be utilized in less than 90 minutes, depending on the size of the home and the number of devices or senors utilized. The system is designed to allow ongoing or future studies to update or deploy new sensors or devices such as other wearables, bed activity sensing systems or home environmental condition sensors. The system has been deployed to hundreds of homes and continues to evolve as technologies advance.
After watching this video, you should have a good understanding about how to deploy and integrate into your research pervasive computing technologies and sensors that will provide a more real time, continuous and ecologically valid set of data for your research.
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