NASA meets Hollywood as new technology helps tackle NHS fraility in older people
The NHS is trialling new wearable sensors, based on technology used by NASA and the CGI film industry, to help identify older patients at risk of falls as part of a new drive to tackle frailty.
The technology will help make one small step a lot easier for the over-65s (although giant leaps may still prove a challenge).
One system, designed to analyse the way a patient walks, was developed in partnership with Intel and tested at University College Dublin’s Institute for Sports and Health. The facility has also worked with eight of Ireland’s Rio Olympics squad, including rowing sensations Gary and Paul O’Donovan whose post-race interviews took the world by storm after the brothers won silver in the lightweight men’s double sculls.
Professor Brian Caulfield, Professor of Physiotherapy at University College Dublin, said: “If people are analysed in a lab, they don’t tend to walk in a normal way, so this technology gives an enormous advantage by moving patients into more familiar surroundings, such as their home or GP surgery.
“This is the exact same technology we have used with professional rugby players, and in testing with the European Space Agency, but it has huge potential to make a significant difference to vulnerable older patients as well.”
The problem of falls is a serious one for many older people across the country. An Age UK report has highlighted that up to one-in-three over 65’s suffer a fall that can cause serious injury or death every year, costing the NHS an estimated £6 million a day and having a serious impact on people’s confidence and quality of life.
To help get to grips with the issue, new measures in the GP contract kick in this month which require routine identification of frailty in patients over 65. Two sites, part of the NHS England Test Beds programme, in London and Sheffield are already trialling this technology that analyses how someone walks so that physiotherapy care can be planned to reduce their risk of a fall.
In Sheffield, the Perfect Patient Pathway Test Bed is testing Kinesis’ QTUG device for patients over 65 who have no recorded falls and score as ‘moderately frail’. The system sees patients walk with the motion sensor attachments on their legs while an app carries out the analysis.
The microelectromechanical (MEMS) gyroscope equipment used in the miniature devices, worn on each shin, are partly based on technological breakthroughs made as part of America’s space programme.
Until recently, human movement analysis has been carried out by the type of optical motion capture system and magnetic tracking systems used in Hollywood CGI films, such as to animate Gollum in the blockbuster Lord of the Rings franchise. Even though they are able to capture 3D movement, they are expensive and only work in a laboratory environment.
The new generation of MEMS sensors are small, light and use very little power, meaning the technology can be used to analyse human motion outside the lab for the first time.
Professor Martin Vernon, National Clinical Director for Older People and Integrated Care at NHS England, said: “It is fantastic that space-age technology, aimed at putting a man on the moon, is now helping vulnerable patients back on earth to live better while steering the NHS away from financial black holes.
“Frailty is an issue that has the potential to affect everyone in their later years but thanks to the work being done by the NHS to harness new diagnosis and treatment methods, the future is looking a lot brighter.
“It’s one small step for Nan, one giant leap for the NHS.”
The QTUG system is being tested in GP and those patients at moderate risk will receive treatment before they fall, a reversal change of current practice which sees patients only referred once they have already taken a tumble.
Meanwhile the Care City Test Bed in North East London is also working with GaitSmart technology, which uses six sensors placed on the calves, thighs and hips to measure the full motion of walking.
The 10 minute test can be used within clinics, care homes, and in the home to measure any individual’s walk and to produce a personalised exercise prescription programme for them. Former England cricketer Darren Gough is just one person to have benefitted from the technology and clinical studies have shown that many individuals with mobility issues, including the frail elderly, can improve their gait and decrease the risk of falls through monitoring and personal exercise programmes.
Once an individual’s gait has been assessed, a remote physio from GaitSmart can prescribe tailored exercises using an online exercise library accessed via a smart device or delivered in the post.
The patient will then be invited back to the GP practice to be reassessed to measure their progress.
Results of the testing are expected in summer 2018 and if they are proven to deliver better patient outcomes at the same or less cost than current practice, wider roll-out will be encouraged.
The recent announcement comes as NHS England publishes joint guidance for GPs with NHS Employers and the BMA’s General Practitioner’s Committee on the frailty requirements of the general practice contract.
Care City and the Perfect Patient Pathway Test Bed will be available to talk more about their work at the NHS Health and Care Innovation Expo being held on 11 and 12 September 2017, in Manchester Central.
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