Assessing gait and balance after Emergency Department discharge using an Up and Go task with smartphone accelerometry: A prospective feasibility study (Preprint)

BACKGROUND Older adults discharged from the emergency department (ED) face elevated risk of falls and functional decline. Smartphones may be a promising modality to conduct remote patient monitoring of mobility after ED discharge, yet its application in this context remains under-explored. OBJECTIVE To assess the feasibility of using smartphones to measure weekly gait and balance data from older adults over an 11-week period after ED discharge METHODS This single-center, prospective observational cohort study recruited patients aged 60 and older from an academic ED. Participants downloaded the GaitMate app to their iPhones, which recorded 3-axis accelerometer data during 11 weekly at-home "Up and Go" functional tasks. The study measured adherence to task completion, quality of transmitted accelerometer data, and participants' perceptions of the app's ease of use and safety. RESULTS Out of 617 approached patients, 149 consented to participate, and 9 dropped out. Overall, participants completed 62% of study tasks. Data quality was optimal in 35% of submissions. At 3-month follow-up, 83% of respondents found the app easy to use, and 95% felt safe performing the tasks at home. Barriers to adherence included the need for assistance, technical issues with the app, and forgetfulness. CONCLUSIONS The study demonstrates moderate adherence to smartphone tasks for monitoring mobility among older adults after ED discharge, perceived ease of use and safety of completing at-home gait tasks. Identified barriers highlight the need for improvements in user engagement and technology design. CLINICALTRIAL NA