Detection of Near Falls Using Wearable Devices a Systematic Review

• Research commodity
• Open Access
• Published: 14 November 2021

Are wearable devices constructive for preventing and detecting falls: an umbrella review (a review of systematic reviews)

• Elizabeth Jane Shortisⁱ &
• Paula Jane Whittaker¹

BMC Public Health book 21, Commodity number:2091 (2021) Cite this article

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Abstract

Groundwork

Falls are a mutual and serious health outcome facing the global population, causing an estimated 646,000 deaths per year globally. Clothing devices typically combine accelerometers, gyroscopes and even barometers; using the data collected and inputting this into an algorithm that decides whether a fall has occurred. The purpose of this umbrella review was to provide a comprehensive overview of the systematic reviews on the effectiveness of wearable electronic devices for falls detection in adults.

Methods

MEDLINE, Embase, Cochrane Database of Systematic Reviews (CDSR), and CINAHL, were searched from their inceptions until April 2019 for systematic reviews that assessed the accurateness of wearable technology in the detection of falls.

Results

Seven systematic reviews were included in this review. Due to heterogeneity between the included systematic reviews in their methods and their reporting of results, a meta-analysis could not be performed. Nigh devices tested used accelerometers, often in combination with gyroscopes. Iii systematic reviews reported an average sensitivity of 93.1% or greater and an average specificity of 86.4% or greater for the detection of falls. Placing sensors on the torso, foot or leg appears to provide the highest accurateness for falls detection, with multiple sensors increasing the accuracy, specificity, and sensitivity of these devices.

Conclusions

This review demonstrated that habiliment device engineering offers a low-cost and accurate way to finer detect falls and summon for assist. There are pregnant differences in the effectiveness of these devices depending on the type of device and its placement. Further high-quality research is needed to confirm the accuracy of these devices in frail older people in real-world settings.

Peer Review reports

Groundwork

Clarification of the condition

Falls are a mutual and serious health issue facing the global ageing population [ane]. Globally, falls are the 2nd leading cause of unintentional death injury after route traffic accidents, causing an estimated 646,000 deaths each year [2]. Frequency of falls increases with historic period and increased fragility, with studies showing that upwardly to 28–35% of adults over the age of 64 falls every year [3]. This equates to a serious human cost including loss of independence, pain, and mortality.

In improver to the physical impact of falling, falls can crusade post-autumn anxiety syndrome (fearfulness of falling) [four]. This tin lead to a lack of confidence in older people in their power to walk safely, resulting in cocky-imposed activity restrictions leading to further turn down in both their physical and mental health [v].

A 2013 systematic review and meta-analysis (Deandrea et al. 2013) showed that at that place are several stiff predictors for falls adventure: a history of falls, apply of walking aids and inability [half dozen]. Accurate identification of those at adventure of falls is important then that interventions that discover falls tin can be targeted appropriately.

Description of the intervention

A 2017 Cochrane review identified exercise programmes, and multifactorial interventions integrating assessment with individualised intervention and dwelling rubber interventions (i.e. anti-slip shoes) as the most effective interventions for preventing falls in older people [7]. The National Institute for Clinical Excellence (Overnice) in England'south guidance on falls prevention does not mention whatever technological interventions [8]. Despite electric current interventions to prevent falls, this public health challenge demands innovate solutions due to its debilitating outcome on the quality of life of older adults. Age UK advocates the use of telecare for falls detection [9].

Article of clothing engineering science for falls detection is an emerging technology. This wearable technology typically includes an accelerometer and an algorithm with some more complicated sensors including barometric sensors [ten]. These systems are unremarkably used due to their low cost and relatively high sensitivity; nonetheless, it is important to consider which type of technology to use and their location on the torso [11]. These sensors range from sensors in shoes to sensors that you can wear on your wrist, forearm, waist, pelvis, neck, sternum, chest, thigh, cruris, shank, knee and ankle [11]. These sensors typically use the data collected by the accelerometer or barometer and input them into an algorithm that decides whether a autumn has occurred [12]. Once the device has decided that a fall is probable, current devices are unremarkably designed so that this triggers an alert (phone phone call, text message, email) to a nominated person, caregiver or emergency service so that they can receive medical attention [13]. Autonomously from this alert-based falls detection approach, these types of sensors have also been used every bit part of falls risk assessments to assist assess how at risk an individual is of falling then that effective, targeted interventions can be prescribed to that individual [14].

Why it is important to do this review

Falls detection is a widely researched topic with several systematic reviews published in the final v years. Recent systematic reviews on the utilize of wearable engineering for falls have examined the most effective type of these sensors for falls detection, their use in older adults, their utilize in Parkinson'south illness and their use in detecting near falls [x, eleven, thirteen,14,15,xvi,17].

An umbrella review is required to summarise the show of the ability of wear electronic devices to detect falls accurately and to guide further inquiry in this field.

Aims

The aim of this umbrella review was to consummate an umbrella review of the literature on the effectiveness of wear electronic devices for falls detection in adults. All outcomes in included systematic reviews will be considered including falls detection, falls prevention, assessing the gamble of falling, reduction in hospital admission and reduction in fractures due to falls.

Methods

Registry of umbrella review protocol

This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [xviii]. The review protocol was established prior to the comport of the review and was registered at the International Prospective Register of Systematic Reviews (PROSPERO) (registration number CRD42019133954 – available from: http://www.crd.york.ac.great britain/PROSPERO/display_record.php?ID=CRD42019133954).

Literature search

Four electronic databases, MEDLINE, Embase, Cochrane Database of Systematic Reviews (CDSR), CINAHL, were searched from their inceptions until April 2019. Articles were searched using Boolean combinations of the post-obit keywords or equivalent Medical Subject field Heading (MeSH) terms: accidental falls AND (wearable electronic devices OR wearable engineering science OR vesture device OR wear sensor OR smartwatch). The searches were express to include systematic reviews only co-ordinate to the Scottish Intercollegiate Guidelines Network (SIGN) grading organization for systematic reviews [nineteen]. No language or other restrictions were applied to the initial search. The principal search strategy can exist establish in Appendix 1. A full electronic search strategy for each database is available on request.

A grey literature search was conducted by searching OpenGrey and Google search engines. The reference lists of the included studies were searched, and a forrad commendation search was conducted of all included studies to identify any further relevant reviews. The following topic expert groups were contacted to request requests from any unpublished or yet to be published reviews: Age UK, National Falls Prevention Coordination Group (NFPCG) and Public Health England, National Falls Prevention Coordination Group.

Inclusion criteria

Papers were considered suitable for this review if they met all the following criteria. Reviews must be original systematic reviews or meta-analyses with no date of publication limits. Articles must exist published in English with the full-text article available. Articles must use adults (> = 18 years of historic period) with or without chronic disease (including Parkinson'due south disease and stroke). Articles may include whatever intervention that is focussed on vesture electronic devices. Manufactures that measured reduction in falls (e.chiliad., reduction in hospital access, reduction in fractures, improved quality of life) or manufactures that measured the effectiveness of wearable technology in autumn prevention or falls detection should exist included.

Paper selection and data extraction

Post-obit the search strategy detailed above, titles and abstracts of the studies were screened independently according to the inclusion criteria by the 1st (DJW) reviewer and second reviewer (EJS). The full texts of studies that were included based on titles and abstracts were retrieved and independently assessed for eligibility by the two reviewers. Whatever discrepancies betwixt the 1st and 2nd reviewer were resolved by discussion with the 3rd (PJW) reviewer.

The following data were extracted independently by the 1st and second reviewers, and checked for accuracy by the 3rd reviewer: number and year of publication of included studies, databases searched, review objectives, population characteristics, sample size, types of devices, main results, and outcome measures (meet Table 1).

Table 1 Methodology of included systematic reviews and meta-analyses

Total size table

Data synthesis

Aggregated data was used to undertake a narrative synthesis, and this was used to describe and evaluate the body of literature and tabulated in an excel spreadsheet (encounter Table 1). Additional meta-analysis was not possible due to large heterogeneity between included studies. The narrative synthesis was based on the extracted data and was drafted by the 1st reviewer with the 2nd reviewer checking the information synthesis of the 1st reviewer. Any discrepancies were resolved past consensus give-and-take chaired by the 3rd reviewer with the 3rd reviewer making the terminal conclusion.

Risk of Bias and relative quality cess

2 reviewers independently assessed the methodological quality of the included systematic reviews using the AMSTAR2 checklist for systematic reviews [20]. Any discrepancies were resolved by consensus discussion chaired by the 3rd reviewer with the 3rd reviewer making the final decision.

This paper includes a summary of the findings of the relative quality assessment (see Table 2) for transparency and to reveal the methodological issues in the included systematic reviews that future studies in this field should take into consideration when producing their articles in guild to produce more valid scientific evidence.

Table 2 Results of the Relative Quality Assessment of the Included Systematic Reviews

Full size table

AMSTAR 2 [xx] is a commonly used musical instrument for critically appraising systematic reviews and looks at 16 items in total. AMSTAR 2 does not generate an overall score but generates a rating of overall confidence: critically low, low, moderate, and loftier. The relative quality assessment of studies will be considered in my discussion and conclusion.

Results

Studies included

Following the search strategy described above, 12 records were identified through database searching and 18 records were identified through other sources (greyness literature search, checking reference lists, likewise as forward citation searching). After removing iv duplicates, 26 records were screened past title and abstract and 15 records were removed later on screening the titles and abstracts against the inclusion/exclusion criteria, which left 11 papers to be read in full text.

Later on reading the full-text, four papers were excluded due to inclusion/exclusion criteria. Wang et al [21] was excluded from full-text review due to not being a systematic review. Chiefly, three reviews [22,23,24] were excluded on full-text review equally their effect measures were not relevant. Therefore, vii papers were included in this review [13,14,15,xvi,17, 25, 26]. A flowchart of the study selection process is shown in Fig. ane.

Fig. 1

PRISMA flowchart outlining the study selection process (Adapted from the PRISMA argument [eighteen])

Full size image

Characteristics of included systematic reviews

The vii included systematic reviews included from four to 57 studies (mean ± standard deviation: 24.43 ± 17.57 participants), which were relevant to the review questions, giving a cumulative number of studies of 161 (run into Table 1). Chaudhuri et al [16] included 82 articles; however, only 57 articles met the inclusion criteria of using wearable devices every bit the intervention and so 35 articles from this systematic review were not included in this umbrella review. Silva de Lima [15] included 27 articles with 4 studies meeting the inclusion criteria of this umbrella review.

All the studies included adults (aged > = 18 years of age) only and did not include any studies that investigated fall detection in children. In that location was a varied success in the reporting of demographic details nigh individuals in the included studies and so information technology was not possible to excerpt meaningful information about the demographics of individuals included in the studies within the included systematic reviews. Montesinos et al [10] had more than strict population criteria with the exclusion of patients with severe cognitive or motor impairment. Silva de Lima [xv] only included patients with a diagnosis of Parkinson'south disease.

The boilerplate number of participants per report included in the systematic reviews ranged from seven to 93 participants per study (hateful ± standard departure: 49.17 ± 35.01 participants per study). The total number of participants in all included studies within each systematic review ranged from 170 to 1896 total participants (mean ± standard departure: 829.fifty ± 683.32 total number of participants). Chaudhuri et al [sixteen] provided no information nigh the sample sizes in their included studies.

V reviews only included articles in which the total-text was available in English [10, 13,fourteen,fifteen,sixteen,17]. Montesinos et al. included manufactures written in English, Italian, Spanish or French [10]. Rucco et al. did non study their language restrictions for inclusion/exclusion; notwithstanding, the 42 included articles were all bachelor as full-text manufactures in English [11].

Types of wearable devices in included systematic reviews

Accelerometers were the most commonly used type of device used in the included reviews for falls detection. Out of the 161 included studies, 43 studies used accelerometers only and another 34 studies used accelerometers in combination with other technology. The most commonly used combination was accelerometer and gyroscope devices (20 studies). Other types of devices were too used, and these include photographic camera/laser (eleven studies), accelerometer and pressure/strength sensors (9 studies), consoles (4–viii studies), wireless networks (two studies) and three or more devices in combination (xiii studies). Chaudhuri et al. [16] did not provide specific data on types of wearable devices.

Habiliment devices for falls detection and their effectiveness

Due to heterogeneity in the methods between the included systematic reviews and their reporting of results measuring different outcomes, a meta-analysis could not be performed.

Three systematic reviews reported an average sensitivity of 93.1% or greater and an average specificity of 86.4% or greater [fifteen,xvi,17]. Another systematic review reported a large range for sensitivity betwixt 16.7–100% and a large range for specificity betwixt forty and 100% [14]. Three studies did non report sensitivity or specificity information [xi, thirteen, 16]. Accurateness data were too heterogeneous and under-reported to comment on. Four studies compared habiliment device locations and found that the trunk, lower back and foot or leg were the nigh accurate [ten, 11, xvi, 17]. Ane systematic review constitute that accuracy was improved past increasing the number of clothing devices [17].

Quality appraisal methods of studies included within included systematic reviews

Five of the included systematic reviews made no attempt to assess the chance of bias in the private studies they included (See Tabular array 2) [11, 13,fourteen,xv,16]. Pang et al [17] used a self-designed relative quality assessment tool for included studies which, although cannot exist validated, seemed comprehensive. Pang et al. ranked their studies out of seven which resulted in a median score = 3/7 and an boilerplate score of two.6/7 (low to moderate quality studies). Montesinos et al [10] used a checklist adapted from Downs and Blackness for included studies. This checklist constitute that there was external validity for all included studies; yet, the internal validity of 6 (out of thirteen) of the included studies was unclear due to unreported variables.

Quality appraisement of included systematic reviews

The seven systematic reviews included in this umbrella review were assessed by the AMSTAR2 [20] checklist which ranks systematic reviews from critically low, low, moderate and high quality. Four systematic reviews [xi, xiii,14,xv] were ranked critically low quality, meaning that there is more than 1 critical flaw and should not exist relied on to provide an accurate and comprehensive summary of the available studies. 1 systematic review, Chaudhuri et al [16], was ranked low quality which means that it has one critical flaw and may not provide an authentic and comprehensive summary of the available studies that accost the question of interest. 2 systematic reviews [x, 17] were ranked moderate quality which means that in that location is more than one weakness, only no crucial flaws, and it may provide an authentic summary of the results of the bachelor studies that were included in the review.

All the systematic reviews asked advisable enquiry questions (covered PICO) and had a comprehensive literature search strategy. Simply Pang et al [17], reported a protocol established before the behave of their review. Only Chaudhuri et al [16] reported performing their written report selection in duplicate; however, some systematic reviews may have done this but not reported it in their terminal paper.

Montesinos et al [10] was the only systematic review that performed a meta-analysis. The other systematic reviews cited heterogeneity in study designs and outcome measures every bit the reasons for being unable to undertake a meta-analysis. Other common limitations of studies were low sample sizes and a lack of peer-review.

Discussion

This umbrella review summarised the scientific literature focussing on the use of wearable electronic devices for falls detection and prevention. Three of the included reviews focussed mainly on falls detection, two focussed mainly on falls risk assessment, one focussed on falls direction and i focussed on assessing the most widely adopted technologies in this field [10, 11, 13,14,15,16, 27].

Summary of evidence

Most reviews reported that wearable devices are an effective, low-cost tool for detecting falls and sending a indicate to call for help. The most effective sensors are placed on the body or human foot/leg with multiple sensors increasing the accuracy, specificity, and sensitivity of these devices. All the same, these results must be viewed cautiously every bit many reviews reported a lack of high-quality studies in the field and a lack of "real earth" testing of these devices in older people. The included reviews also call for "nonobstructive" devices that are low-cost and maintain users' privacy. The use of habiliment devices every bit office of a falls risk cess has, yet not been validated but is another potential hereafter apply of these devices.

The show with regards to older adults, specifically, is less clear equally more than studies are needed to wait at detecting falls in fragile older people who can be more difficult to recruit into studies. Also, the current algorithms that these devices run are quite accurate, but more work is needed here every bit information technology is vital to reduce false-positive rates with these devices to avoid 'alarm fatigue'.

Montesinos et al [10] was rated highly as a moderate quality systematic review and was the simply systematic review to perform a meta-analysis. The statistical analysis reported meaning, very strong, positive associations in three different triads of characteristic category, task, and sensor placement:

• Angular velocity – walking – shins.

• Linear acceleration – tranquility standing – lower back

• Linear dispatch – stand to sit/sit to stand – lower back

Montesinos el at recommended these every bit the optimal combinations when using habiliment devices to discriminate between fallers and non-fallers. Furthermore, they found four statistically significant features that were observed with fallers which included: step time, Coefficient of Variation (CV) for step time, CV for footstep time, CV for clinical back up time. These statistically significant findings should exist considered when developing a standardized, valid evaluation tool for these devices that this umbrella review recommends to futurity researchers. Information technology is important to note that there are lots of studies on article of clothing devices for falls detection; however, there is petty agreement about the best blazon and blueprint of the device with regards to the blazon of sensor, number of sensors and a betoken processing algorithm.

Strengths of this review

This review has several strengths and is the first umbrella review of its kind. The research methods were extensive and are detailed in the method department of this review besides as a link to the protocol which was established prior to the conduct of the review. An all-encompassing, peer-reviewed, search strategy was conducted, thoroughly searching the 4 virtually relevant bibliographic databases with no date-of-publication restrictions. This newspaper includes a comprehensive quality assessment of the included systematic reviews. Therefore, this umbrella review provides a comprehensive and methodologically strong overview of the currently published research on this topic. The PRISMA checklist tin can be institute fastened every bit Appendix 2.

Limitations of this review

This umbrella review must exist interpreted within the context of its limitations. Firstly, this review is at risk of linguistic communication bias since this review is based exclusively on studies reported in English. However, all studies plant through searching were available in English. Furthermore, in that location is potential that publication bias has subconscious potentially relevant trials and their results from this review. The outcome of this should be limited by the extensive search strategy and the fact that none of the authors has declared any competing interests with this review.

The main limitations of this review come from major methodological weaknesses in the included systematic reviews. Just two reviews [10, 17] were ranked as moderate quality with the other reviews ranking as depression or critically low quality. Common problems in the methods of the included systematic reviews include no protocol established prior to the comport of the review, not performing study selection and data extraction in duplicate and no take a chance of bias assessment for private studies that were included in the included reviews.

Only Montesinos et al [10] was able to conduct a meta-assay and the other systematic reviews were non able to due to the often small number of included studies and heterogeneous methodologies of those studies. Heterogeneity in included studies mainly stems from the fact there is not a validated way to evaluate wearable devices, with lots of dissimilar outcome measures that make it hard to draw conclusions from. There was also much variation in the studies in measured parameters, cess tools, sensor sites, tasks and assessing falls.

Implications for future research

The literature in this field is even so in its infancy and more high-quality studies are needed. Rucco et al. demonstrated that the topics of hazard cess, falls monitoring, and falls prevention in older people are of increasing interest to researchers, with "an almost linear growth of the published manuscripts" [11].

The heterogeneity in the study designs has been discussed at length in this review and must exist standardized for future reviews. There needs to be a set of validated outcomes when assessing these devices for falls detection that are agreed upon and used equally the standard in future research.

A recent Cochrane review described that most studies in this field fail to specify a definition of falls; thus, leaving the interpretation to report participants and researchers [28]. Due to the heterogeneity in the interpretation of "a autumn", the validity of the studies could exist brought into question. This umbrella review establish many different interpretations of falls in the included systematic reviews and, in addition to the evidence in the Cochrane review, would strongly recommend that hereafter studies provide an operational definition of a fall with clear inclusion/exclusion criteria.

This umbrella review has revealed some important questions and areas of interest that researchers in this field should investigate:

• Are habiliment devices as effective equally proven in previous studies if tested in "real world" settings with a large sample size of older adults?

• What is the most effective organisation design that older adults volition have for use in daily living?

• Tin can vesture devices exist used to enable alerts of deteriorating balance command?

• How, practically, could wearable devices be integrated with a comprehensive falls hazard assessment?

• How can the gap between clinical functionality and user feel of these devices be improved?

• An effective, validated, tool for evaluating wearable devices for falls detection that can exist replicated in future loftier-quality studies.

• What are the most effective algorithms to use combined with these article of clothing technologies?

• Is there potential for these devices to be used in unlike types of falls experienced by people with stroke, MS, historic period-related frailty, and other weather condition associated with ageing?

Implications for do

In society to recommend widespread implementation, healthcare providers demand more than prove that assesses the cost-benefit that these devices provide and how they could be implemented on a large-calibration.

These devices are accurate and depression-cost and may exist increasingly purchased by individuals. Personal emergency response systems (PERS) are a currently commonly used commercial solution to problems like this and allow a way for individuals to press a button and contact an emergency centre [29]. Vesture devices for falls detection take an reward in that they will still call for help if the user is rendered unable to exercise and so themselves as it does not rely on the user pressing a button. This is specially important given that a recent cohort study found that upwardly to 4/five older adults wearing PERS did not actuate information technology to call for assistance when they had a fall [thirty].

Conclusions

This review has demonstrated that wear device technology is effective at detecting falls and is a promising emerging field of telemedicine that tin can offer a low-price and authentic way to detect falls and summon for assist. Their use for falls prevention needs to be further examined with the literature showing hope for their use as part of a falls risk cess which and then tin can be used to categorise risk and guide interventions. This review also found that there are pregnant differences in the effectiveness of these devices depending on the type of device and where information technology is placed on the trunk. The current evidence would propose that researchers should be testing these devices on the trunk of the body or on the legs/shin and most devices use accelerometers, frequently in combination with gyroscopes.

Farther loftier-quality studies in this field are needed and researchers should consider common flaws reported in this review. This review found meaning heterogeneity in the report designs and methods betwixt reviews and studies. Several studies reported difficulties in recruiting older adults; notwithstanding, testing these devices on older adults in 'real-world environments' is essential if we are going to understand their effectiveness for older adults. A standardized evaluation tool for wear devices with standardised effect measures would amend the validity of research in this field. Older adults have been reported to want a low-cost device which they tin can understand how it works and which is highly accurate.

Availability of data and materials

Not applicable.

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Acknowledgements

The authors would like to thank Lesley Patterson for her contributions to the initial stage of this review and her aid with the search strategy.

Funding

This research received no external funding.

Author information

Affiliations

1. Division of Population Health, Health Services Research & Primary Care, Faculty of Biology, Medicine and Wellness, University of Manchester, Room two.545, Stopford Building, Oxford Road, Manchester, M13 9PT, United kingdom of great britain and northern ireland

   Daniel Joseph Warrington, Elizabeth Jane Shortis & Paula Jane Whittaker

Contributions

DJW and EJS independently screened the titles and abstracts of the studies co-ordinate to the inclusion criteria. DJW and EJS also independently extracted and analysed the information from these studies. PJW resolves whatever disputes in the paper pick and checked the accurateness of the data extraction and assay. All authors read and canonical the final manuscript.

Respective author

Correspondence to Daniel Joseph Warrington.

Ethics declarations

Ethics blessing and consent to participate

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Competing interests

The authors declare that they have no competing interests.

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Appendices

Appendix 1

MEDLINE (master search strategy)

1. 1.

   Wearable Electronic Devices/

2. two.

   wearable electronic device.kw.

3. 3.

   habiliment device.kw.

4. four.

   (article of clothing$4 adj3 electronic adj device$1). ab, ti.

5. 5.

   (wearable$iv adj3 technolog$3). ab, ti.

6. 6.

   (wear$4 adj3 device$1). ab, ti.

7. vii.

   (vesture$4 adj3 sensor$1). ab, ti.

8. 8.

   (smart adj picket$2). ab, ti.

9. 9.

   1 or 2 or 3 or 4 or 5 or vi or seven or 8

10. 10.

    Accidental Falls/pc [Prevention & Control]

11. 11.

    Adventitious Falls/

12. 12.

    Accident Prevention/

13. 13.

    11 and 12

14. 14.

    accidental falls.kw.

15. 15.

    falls prevention.kw.

16. 16.

    (fall$3 adj2 incidence$one). ab, ti.

17. 17.

    (autumn$3 adj2 forestall$3). ab, ti.

18. xviii.

    (accidental$ii adj1 fall$3). ab, ti.

19. 19.

    10 or 13 or 14 or 15 or xvi or 17 or xviii

20. 20.

    9 and 19

21. 21.

    Meta-Analysis every bit Topic/

22. 22.

    meta analy$.tw.

23. 23.

    metaanaly$.tw.

24. 24.

    Meta-Analysis/

25. 25.

    (systematic adj (review$one or overview$1)).tw.

26. 26.

    exp. Review Literature as Topic/

27. 27.

    21 or 22 or 23 or 24 or 25 or 26

28. 28.

    cochrane.ab.

29. 29.

    cochrane.ab.

30. 30.

    (psychlit or psyclit). ab.

31. 31.

    (psychinfo or psycinfo). ab.

32. 32.

    (cinahl or cinhal). ab.

33. 33.

    science commendation alphabetize.ab.

34. 34.

    bids.ab.

35. 35.

    cancerlit.ab.

36. 36.

    28 or 29 or 30 or 31 or 32 or 33 or 34 or 35

37. 37.

    reference list$. ab.

38. 38.

    bibliograph$. ab.

39. 39.

    bibliograph$. ab.

40. forty.

    relevant journals.ab.

41. 41.

    transmission search$. ab.

42. 42.

    37 or 38 or 39 or 40 or 41

43. 43.

    selection criteria.ab.

44. 44.

    information extraction.ab.

45. 45.

    43 or 44

46. 46.

    Review/

47. 47.

    45 and 46

48. 48.

    Comment/

49. 49.

    Letter/

50. fifty.

    Editorial/

51. 51.

    animal/

52. 52.

    human/

53. 53.

    51 not (51 and 52)

54. 54.

    48 or 49 or 50 or 53

55. 55.

    27 or 36 or 42 or 47

56. 56.

    55 not 54

57. 57.

    20 and 56

Appendix 2

Table iii PRISMA Checklist

Full size table

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Warrington, D.J., Shortis, East.J. & Whittaker, P.J. Are wearable devices effective for preventing and detecting falls: an umbrella review (a review of systematic reviews). BMC Public Health 21, 2091 (2021). https://doi.org/10.1186/s12889-021-12169-vii

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• Received: fifteen January 2021

• Accustomed: 26 October 2021

• Published: 14 November 2021

• DOI : https://doi.org/10.1186/s12889-021-12169-7

Keywords

• Wearable electronic devices
• Adventitious falls
• Aged
• Falls prevention
• Falls direction

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