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A Plantar Inclinometer Based Approach to Fall Detection in Open Environments

Chapter · June 2016

DOI: 10.1007/978-3-319-33353-3_1

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A Plantar Inclinometer Based Approach to Fall
Detection in Open Environments

Jianfei Sun, Zumin Wang, Liming Chen, Baofeng Wang, Changqing Ji

and Shuai Tao

Abstract In this paper, we report a threshold-based method of fall detection using

plantar inclinometer sensor, which provides us the information of angle variations
during walking, and of angle status after a fall. The angle variations and status are
collected in three-dimensional space. We analyzed the normal range of angle varia-
tions during walking, and selected the thresholds by testing the distribution of plan-
tar angles of falls. In the experiments, thresholds were selected from plantar angles
of fall status in four directions: forward, backward, left and right. Using the selected
thresholds, we detectd falls of five subjects in different situations for five hundred
times and obtained the average detection rate of 85.4%.

1 Introduction

Fall accident is not only a severe threat to public health, but even fatal for poor
physical elderly people with walking difficulties. With the social aging problems
getting worse these days [7], the number of elderly people living alone gradually
increased and most of them could not get good health services [10, 18]. The elderly
people are usually living alone, which gives rise to risk of fall accident. According
to statistics, more than 33% of people aged 65 years or older have one fall per year
[15]. Sometimes, it is not the fall but the subsequent injury is the threat to the elderly
people [11], and almost 62% of injury-related hospitalizations for seniors are the
results from falling [3]. Sometimes the subsequent injuries like cerebral hemorrhage
happen and they will be lethal if timely rescues are unavailable [8]. Therefore, an

Shuai Tao( ), Jianfei Sun, Zumin Wang, Baofeng Wang, Changqing Ji

Information and Engineering College of Dalian University, Dalian, China
e-mail: taoshuai@dlu.edu.cn
Liming Chen
School of Computer Science and Informatics of De Montfort University, Leicester, UK
e-mail: liming.chen@dmu.ac.uk

1
2 Jianfei Sun, Zumin Wang, Liming Chen, Baofeng Wang, Changqing Ji and Shuai Tao

accurate and real-time fall detection method will make timely rescue possible that
avoids the subsequent injury and danger.
At present, there are several types of method based on different principles can
realize fall monitoring, which were shown but not limited to the contents in Figure
1.

Fig. 1 Three types of method based on different principles for fall detection.

First of all, the vision-based monitoring type, for example uses a MapCam (omni-
camera) to capture images and performs image processing over the images [14], of
which fall monitoring success rate closed to 80%. Wong obtained the rate of 86.19%
in detecting the human faint event using thermal cameras in indoor environment
[21]. An unsupervised method was proposed in [16] for detecting abnormal activ-
ity using the fusion of some simple features. The detection rate of falls was about
66.67%. Williams used a distributed network of smart cameras to detect and localize
falls with a high accurate of 97.5% [20]. But these methods can be used only for in-
door fall monitoring. Furthermore, due to the application of HD panoramic camera
as the sensor [17], it is likely to involve privacy problems. Even without the privacy
problem, the camera will bring more or less discomfort to monitored people.
In our previous study, we used an infrared sensor network locating on the ceiling
to monitor the action of people, with the higher monitoring accuracy (up to a max-
imum of 95.14%) compared with the HD panoramic camera based methods, which
could also solve the personal privacy problems (without camera equipments). But
there are still some limitations, such as the indoor application only and its system is
relatively complex, the setup and maintenance is more difficult.
The third type of fall monitoring method is based on the use of wearable devices,
such as the fall sensor fixed on the waist in early time with small volume and high
sensitivity [6, 5]. But the wearing discomfort and other shortcomings severely limit
its development; the fall detection function was embedded into the smart bracelet
and even vest [1, 2], which could break through the indoor limitation. But the limits
of this type of method are that the elderly people usually forget to wear the equip-
ments and it is difficult to maintain the monitoring precise in daily life.
A Plantar Inclinometer Based Approach to Fall Detection in Open Environments 3

Take the most commonly used smart wristband as an example, it is very easy
and convenient for the stylish and curious young people to accept new things and
wear such smart wristband, but for the majority of elder people, watch-like portable
devices can bring inconvenience and some of the elderly due to loss of memory,
inevitably forget to wear some unnecessary devices. To solve this kind of problems,
some research groups tried to place pressure sensor and three-axis acceleration sen-
sor on the head and the waist to monitor fall and they obtained a sensitivity of
95.71% and a specificity of 97.78% [4], but wearing this equipment is very cumber-
some for elder people and everyday wearing will be a burden.
In this research, we applied the plantar axial inclinometer based human fall mon-
itoring method, which could effectively reduce limitations of present methods, pro-
vide an efficient and stable system with no environmental dependency and a wide
application without violation of privacy issues.
In summary, our fall monitoring system and method the advantages of simple
structure and low computational complexity, so we can easily integrate it into shoes
or insoles. The elderly people will remember to wear them as long as they simply
take on shoes. So compared with other fall detection systems, ours will not only
preserve user privacy but also with low influence and easy applicable for elderly
people.

2 A Plantar Inclinometer Based Approach to Fall Detection

2.1 Plantar Inclinometer Sensor

In the plantar inclinometer, we use the single axis sensor SCA60C − N1000060,
which is a high-precision, reliable and low-price analog sensor. The photograph of
the sensor module is shown in figure 2. The sensor of SCA60C − N1000060 is ap-
plied widely in the research of intelligent control and abnormal alarm [13, 19]. Due
to the character of single axis, in this study, for correctly reflecting the plantar an-
gle, we need to use two SCA60C − N1000060 in the sensor module (shown in figure
2). In the sensor module, two sensors are orthogonal to each other for detecting the
plantar angle data in two axes.
The sensor module can detect the plantar angles from −90◦ to 90◦ , the corre-
sponding output digital quantities are from -0.5 V to 4.5 V. The relationship between
digital value and analog output is shown in figure 3.
In figure 3, we see that the relationship between digital value (voltage) and analog
output (angle) is nonlinear, and similar to sinusoidal vibration, which is shown as
−O f f set
α = arcsin( Vout
Sensitivity ), (1)
where α is the axis angle of the sensor module, Vout is the digital output. When the
angle of the module is 0o (horizontal direction), the value of O f f set is 2.5 V. The
Sensitivity under room temperature is 2 V/g. Therefore, formula (1) can be rewrite
as
4 Jianfei Sun, Zumin Wang, Liming Chen, Baofeng Wang, Changqing Ji and Shuai Tao

Fig. 2 The photograph of the sensor module.

Fig. 3 The relationship between digital value and analog output of the sensor module.

α = arcsin(0.5Vout − 1.25). (2)

By collecting the value of Vout , and calculating by formula (2), we obtain the axis
angles of the module.
Before data collection, we need to connect the sensor module and data process-
ing center (including A/D converter, communication and host system), calibrate the
system for the first time. For the convenience of data processing, we transformed the
angle range of −90◦ -90◦ to 0◦ -180◦ . If the angle values stay in the range of 90◦ ± 1◦
and remain stable when we place the sensor module in horizontal, the system is
calibrated successfully. Then we mounted the sensor module onto a pad, which is
shown in figure 4(a). The pad has a degree of flexibility for winding. After mounting
the sensor module, we calibrated the system for the second time. If the angle values
stay in the range of 90◦ ± 1◦ and remain stable when we place the pad in horizontal,
the system is calibrated successfully.
Then we sticked the pad under the feet, which is shown in figure 4(b), and cal-
ibrated the system for the third time. A volunteer with the pad walked 10 m with
a normal speed. We collected the angle values. After walking, when the volunteer
stays still which is shown in figure 4(c), if the angle values stay in the range of
90◦ ± 1◦ and remain stable, the system is calibrated successfully. After three times
calibration, the experiments could be started.
A Plantar Inclinometer Based Approach to Fall Detection in Open Environments 5

(a) (b) (c)

Fig. 4 The sensor module mounted onto a pad, the pad sticked under the feet, a volunteer wearing
the pad.

We set the x-axis and y-axis of left and right foot shown in figure 5. Therefore,
when a person stands upright, the angles of x-axis and y-axis will both be 90◦ .

Fig. 5 The x-axis and y-axis of left and right foot.

2.2 Data Collection During Falls

The subject in this test is a student in our laboratory, who is heathy and can walk
normally. We detected the right-foot angles during walking and found that the angles
are almost 90◦ when the person is standing, and fluctuate rapidly during walking.
The y-axis has a larger fluctuate range. The variation trend of angles during walking
in ten seconds is shown in figure 6.
We also investigated the variation of right-foot angles (left-foot is symmetrical)
when the subject falls forward and backward. From figure 7, we see that when falls
happen, the angles of both x-axis and y-axis have strenuous vibrations, which are
very different from the situation of walking. Then plantar angle data were collected
6 Jianfei Sun, Zumin Wang, Liming Chen, Baofeng Wang, Changqing Ji and Shuai Tao

Fig. 6 The variation trend of right-foot angles during walking in ten seconds.

after falls in four different situations: forward, backward, left and right for deter-
mining the thresholds.

(a) Fall forward (b) Fall backward

Fig. 7 The variation of right-foot angles (left-foot is symmetrical) when the subject falls forward
and backward.

2.2.1 Forward Falls

The volunteer falls forward to an air bed, stays still naturally, the plantar angle data
are then collected. The distribution of plantar angles after forward falls 120 times is
shown in figure 8(a) and 8(b).
From figure 8, we see that the variation range of plantar angle is limited after
falls happening. For this reason, we could select some thresholds to recognize falls.
When a person falls forward, there will be a wide variation range of x-axis, but a
narrow variation range of y-axis.
A Plantar Inclinometer Based Approach to Fall Detection in Open Environments 7

Fig. 8 The distribution of plantar angles after forward falls 120 times.

2.2.2 Backward Falls

The volunteer falls backward to an air bed, stays still naturally, the plantar angle
data are then collected. The distribution of plantar angles after backward falls 120
times is shown in figure 9(a) and 9(b).

Fig. 9 The distribution of plantar angles after backward falls 120 times.

From figure 9, we see that when a person falls backward, there will be a wide
variation range of x-axis, but a narrow variation range of y-axis. The y-axis angle
direction of backward falls (0◦ -90◦ ) is contrary to forward falls (90◦ -180◦ ).
8 Jianfei Sun, Zumin Wang, Liming Chen, Baofeng Wang, Changqing Ji and Shuai Tao

2.2.3 Left Falls

The volunteer falls to left side to an air bed, stays still naturally, the plantar angle
data are then collected. The distribution of plantar angles after left falls 120 times is
shown in figure 10(a) and 10(b).

Fig. 10 The distribution of plantar angles after left falls 120 times.

From figure 10, we see that the variation range of plantar angle is limited after
falls happening. When a person falls to left side, most of the variation range of x-axis
is 0◦ -120◦ , most of the variation range of y-axis is 0◦ -120◦ .

2.2.4 Right Falls

The volunteer falls to right side to an air bed, stays still naturally, the plantar angle
data are then collected. The distribution of plantar angles after right falls 120 times
is shown in figure 11(a) and 11(b).
From figure 11, we see that the change range of plantar angle is limited after falls
happening. When a person falls to right side, most of the variation range of x-axis
is 60◦ -180◦ , most of the variation range of y-axis is 0◦ -120◦ .
The limitation to the range of plantar angles of falls caused by physiological
structure [9, 12] of people is an important basis for fall detection in this research.

2.3 Fall Detection Method

By observing the collected data of plantar angles, we see that, for x-axis or y-axis
under one of the feet, at least one of them is very large or small. Therefore, based
on this rule, we selected some thresholds for fall detection. The thresholds should
satisfy most of the angle values for fall detection. By statistical analysis, we found
A Plantar Inclinometer Based Approach to Fall Detection in Open Environments 9

Fig. 11 The distribution of plantar angles after right falls 120 times.

that all the angles of at least one axis is in the interval of [57◦ ,131◦ ]. Therefore, the
thresholds of plantar angle for fall detection is set to [57◦ ,131◦ ]. We detect falls by
the formula below.
State = [(57◦ ≥ Rx ∨ Rx ≥ 131◦ ) ∨ (57◦ ≥ Ry ∨ Ry ≥ 131◦ )]
∧[(57◦ ≥ Lx ∨ Lx ≥ 131◦ ) ∨ (57◦ ≥ Ly ∨ Ly ≥ 131◦ )] (3)

In formula (3), when state is 1, a fall happens, if it is 0, there is no fall.

To avoid some false alarms caused by walking or some abnormal legs move-
ments, we improved the method by adding a tally function which is shown in for-
mula (4). When fall status is detected for x times, we recognize it as a real fall. In
the experiment in next section, we set x to 15.

 x
 1, ∑ Staten = x

Fall = n=1 (4)
x
 0, ∑ Staten < x

n=1

3 Experiments of Fall Detection

In the experiment, there are five subjects. The information of subjects are shown
in Table 1. Each subject did five groups of experiments for fall detection in the
horizontal plane (forward, backward, left side, right side and free fall). There are
16 falls in each group and totally 80 falls. In addition, We did another five groups
of experiments for fall detection on a slope. There are 4 falls in each group and
totally 20 falls. The number of falls of each subject in the experiment is 100. The
10 Jianfei Sun, Zumin Wang, Liming Chen, Baofeng Wang, Changqing Ji and Shuai Tao

experiment result of each subject is shown in figure 12. The average detection results
of 500 falls of five subjects are shown in figure 13.

Table 1 The information of five subjects.

Subject Sub. 1 Sub. 2 Sub. 3 Sub. 4 Sub. 5
Gender Male Male Male Male Female
Age 20 22 21 22 24
Height (cm) 180 170 169 168 170
Weight (kg) 67 65 67.5 62 54.5
Detection Rate (%) 78 85 88 88 88

(a) Subjct A (b) Subjct B

(c) Subjct C (d) Subjct D (e) Subjct E

Fig. 12 The experiment results of five subjects.

From figure 13, we see that there are 427 falls detected successfully. The detec-
tion rate was 85.4%. However, the detection rate of backward falls is only 77%. The
most possible reason is that slope brings bad effects to the detection. It could cause
a low detection rate in the situation of backward fall due to the effect on plantar
angles.

4 Discussion

In this paper, we report a method of fall detection using plantar inclinometer sensor,
which provides us the information of angle variations during walking, and of angle
A Plantar Inclinometer Based Approach to Fall Detection in Open Environments 11

Fig. 13 The average detection result of 500 falls.

status after a fall. We analyzed the normal range of angle variations during walking,
and selected the thresholds by testing the distribution of plantar angles. We detectd
falls in different situations by five subjects for 500 times and obtained the average
detection rate of 85.4%.
By comparison with some similar researches in Table 2, it is not difficult to find:
the best success rates were yielded by distributed multi-cameras [20], thermal in-
frared matrix solutions [17] and pressure/acceleration sensor solutions [4], the suc-
cess rates were above 95%; while the thermal infrared matrix fall detection belongs
to environment detection scheme, which is similar to the camera fall detection [14]
that is with larger hardware scale, more complicated algorithm and it is difficult to
be integrated on small scale leading to the restriction to interior application.

Table 2 The detection results compared with some similar research.

Fall detection scheme Detection rate The Complexity The difficulty Environment
of hardware of algorithm
Plantar inclinometer 85.4% [this study] Low Low Indoor/Outdoor
Camera 79.8% [14], 66.67% [16] Medium High Indoor
Distributed multi-cameras 97.5% [20] High High Indoor
Thermal camera 86.19% [21] Medium High Indoor
Pressure and acceleration 95.71% [4] Medium High Indoor/Outdoor
Infrared sensor array 95.14% [17] High High Indoor

The integrated waist/hand acceleration sensors are currently popular fall detec-
tion solutions on the market [6, 5, 1, 2, 4], which are characterized by less hardware
complexity, easy to be integrated on small scale and no interior limitation.
The success rate of most of the products is not high except several solutions ap-
plying multiple sensor types. In order to solve this problem, developers always use
12 Jianfei Sun, Zumin Wang, Liming Chen, Baofeng Wang, Changqing Ji and Shuai Tao

more efficient and complex algorithms, however, which will increase the cost of
hardware due to higher sensitivity, and the complexity of software system. Com-
pared with the solutions above, the main advantages of our system are as follows:
high accuracy, simple hardware, easily to be integrated and without the external
equipment and environment surport. However, there are some deficiencies in the
system: lower sensor accuracy and anti-interference ability; the impedance in sensor
is insensitive to vibrations and it is not possible to achieve fast dynamic detection;
extensible function is limited; the cost of the hardware is relatively high.
Although we obtained a high detection rate of falls, our threshold-based method
is relatively naive, and the subjects are all young people in the experiment. To
solve the problems mentioned above, we will apply machine learning techniques
to build classified models of different activities of elders, and to learn users’ pat-
tern/threshold values. In addition, the difference of angle variation between young
people (the subjects in this study) and elders will be investigated. We expect to in-
crease the proformance by using more advanced methods with the same device of
plantar inclinometer sensors in future study.

Acknowledgements This work was supported by the National Natural Science Foundation of
China (Grant No. 61501076)

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