{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T08:42:16Z","timestamp":1768898536864,"version":"3.49.0"},"reference-count":51,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2020,1,16]],"date-time":"2020-01-16T00:00:00Z","timestamp":1579132800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["5T32HL139430\u201002"],"award-info":[{"award-number":["5T32HL139430\u201002"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["1R21CA190933\u201001A1"],"award-info":[{"award-number":["1R21CA190933\u201001A1"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Concern about falling is prevalent and increases the risk of falling in people with peripheral neuropathy (PN). However, the assessment of concern about falling relies on self-report surveys, and thus continuous monitoring has not been possible. We investigated the influence of concern about falling on sensor-based daily physical activity among people with PN. Forty-nine people with PN and various levels of concern about falling participated in this study. Physical activity outcomes were measured over a period of 48 hours using a validated chest-worn sensor. The level of concern about falling was assessed using the falls efficacy scale-international (FES-I). The low concern group spent approximately 80 min more in walking and approximately 100 min less in sitting\/lying compared to the high concern group. In addition, the low concern group had approximately 50% more walking bouts and step counts compared to the high concern group. Across all participants, the duration of walking bouts and total step counts was significantly correlated with FES-I scores. The duration of walking bouts and total step counts may serve as eHealth targets and strategies for fall risk assessment among people with PN.<\/jats:p>","DOI":"10.3390\/s20020505","type":"journal-article","created":{"date-parts":[[2020,1,17]],"date-time":"2020-01-17T04:14:41Z","timestamp":1579234481000},"page":"505","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Sensor-Based Daily Physical Activity: Towards Prediction of the Level of Concern about Falling in Peripheral Neuropathy"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4791-6839","authenticated-orcid":false,"given":"Gu Eon","family":"Kang","sequence":"first","affiliation":[{"name":"Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0320-8101","authenticated-orcid":false,"given":"Bijan","family":"Najafi","sequence":"additional","affiliation":[{"name":"Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA"}]}],"member":"1968","published-online":{"date-parts":[[2020,1,16]]},"reference":[{"key":"ref_1","unstructured":"(2019, November 30). The Foundation for Peripheral Neuropathy. Available online: https:\/\/www.foundationforpn.org\/what-is-peripheral-neuropathy\/types-risk-factors\/."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"M211","DOI":"10.1093\/gerona\/50A.4.M211","article-title":"Peripheral neuropathy: A true risk factor for falls","volume":"50","author":"Richardson","year":"1995","journal-title":"J. Gerontol. Ser. A Biol. Sci. Med. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1111\/j.1464-5491.1992.tb01819.x","article-title":"Problems with gait and posture in neuropathic patients with insulin-dependent diabetes mellitus","volume":"9","author":"Cavanagh","year":"1992","journal-title":"Diabet. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1001\/jamaneurol.2016.0383","article-title":"The association of chemotherapy-induced peripheral neuropathy symptoms and the risk of falling","volume":"73","author":"Kolb","year":"2016","journal-title":"JAMA Neurol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1093\/ageing\/26.3.189","article-title":"Fear of falling and restriction of mobility in elderly fallers","volume":"26","author":"Vellas","year":"1997","journal-title":"Age Ageing"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1093\/geront\/42.1.17","article-title":"A prospective study of the relationship between feared consequences of falling and avoidance of activity in community-living older people","volume":"42","author":"Yardley","year":"2002","journal-title":"Gerontologist"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1093\/ageing\/afh106","article-title":"Fear-related avoidance of activities, falls and physical frailty. A prospective community-based cohort study","volume":"33","author":"Delbaere","year":"2004","journal-title":"Age Ageing"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1046\/j.1532-5415.2002.50119.x","article-title":"Characteristics associated with fear of falling and activity restriction in community-living older persons","volume":"50","author":"Murphy","year":"2002","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1093\/ageing\/afi196","article-title":"Development and initial validation of the Falls Efficacy Scale-International (FES-I)","volume":"34","author":"Yardley","year":"2005","journal-title":"Age Ageing"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1093\/ageing\/afp225","article-title":"The falls efficacy scale international (FES-I). A comprehensive longitudinal validation study","volume":"39","author":"Delbaere","year":"2010","journal-title":"Age Ageing"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/1047-2797(90)90018-N","article-title":"Methodologic issues in the study of frequent and recurrent health problems falls in the elderly","volume":"1","author":"Cumming","year":"1990","journal-title":"Ann. Epidemiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2190","DOI":"10.1111\/j.1532-5415.2005.00509.x","article-title":"Monitoring falls in cohort studies of community-dwelling older people: Effect of the recall interval","volume":"53","author":"Ganz","year":"2005","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1136\/bjsports-2014-094413","article-title":"Measurement of physical activity in older adult interventions: A systematic review","volume":"50","author":"Falck","year":"2016","journal-title":"Br. J. Sports Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1046\/j.1532-5415.2002.50012.x","article-title":"Recreational physical activity levels in healthy older women: The importance of fear of falling","volume":"50","author":"Bruce","year":"2002","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.jdiacomp.2013.08.008","article-title":"Physical activity, glycemic control, and diabetic peripheral neuropathy: A national sample","volume":"28","author":"Loprinzi","year":"2014","journal-title":"J. Diabetes Complicat."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"923","DOI":"10.2522\/ptj.20100329","article-title":"Lower physical activity is associated with higher intermuscular adipose tissue in people with type 2 diabetes and peripheral neuropathy","volume":"91","author":"Tuttle","year":"2011","journal-title":"Phys. Ther."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2448","DOI":"10.2337\/dc10-1224","article-title":"Importance of time spent standing for those at risk of diabetic foot ulceration","volume":"33","author":"Najafi","year":"2010","journal-title":"Diabetes Care"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"126","DOI":"10.7547\/15-186","article-title":"Foot problems in older adults: Associations with incident falls, frailty syndrome, and sensor-derived gait, balance, and physical activity measures","volume":"108","author":"Muchna","year":"2018","journal-title":"J. Am. Podiatr. Med. Assoc."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1177\/1932296816662959","article-title":"Can\u2019t stand the pressure: The association between unprotected standing, walking, and wound healing in people with diabetes","volume":"11","author":"Najafi","year":"2017","journal-title":"J. Diabetes Sci. Technol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.maturitas.2017.05.015","article-title":"Levels of physical activity and sleep patterns among older people with dementia living in long-term care facilities: A 24-h snapshot","volume":"102","author":"Moyle","year":"2017","journal-title":"Maturitas"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.exger.2017.10.025","article-title":"Physical activity and physical fitness of nursing home residents with cognitive impairment: A pilot study","volume":"100","author":"Marmeleira","year":"2017","journal-title":"Exp. Gerontol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Mc Ardle, R., Del Din, S., Donaghy, P., Galna, B., Thomas, A., and Rochester, L. (2019). Factors that influence habitual activity in mild cognitive impairment and dementia. Gerontology, 1\u201312.","DOI":"10.1159\/000502288"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1159\/000352072","article-title":"A novel plantar stimulation technology for improving protective sensation and postural control in patients with diabetic peripheral neuropathy: A double-blinded, randomized study","volume":"59","author":"Najafi","year":"2013","journal-title":"Gerontology"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Kang, G.E., Zahiri, M., Lepow, B., Saleem, N., and Najafi, B. (2019). The Effect of Daily Use of Plantar Mechanical Stimulation Through Micro-Mobile Foot Compression Device Installed in Shoe Insoles on Vibration Perception, Gait, and Balance in People With Diabetic Peripheral Neuropathy. J. Diabetes Sci. Technol.","DOI":"10.1177\/1932296819839703"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1177\/1932296817695338","article-title":"Using plantar electrical stimulation to improve postural balance and plantar sensation among patients with diabetic peripheral neuropathy: A randomized double blinded study","volume":"11","author":"Najafi","year":"2017","journal-title":"J. Diabetes Sci. Technol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1159\/000494114","article-title":"Effectiveness of daily use of bilateral custom-made ankle-foot orthoses on balance, fear of falling, and physical activity in older adults: A randomized controlled trial","volume":"65","author":"Wang","year":"2019","journal-title":"Gerontology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1016\/j.jgo.2019.01.010","article-title":"Using wearables to screen motor performance deterioration because of cancer and chemotherapy-induced peripheral neuropathy (CIPN) in adults-Toward an early diagnosis of CIPN","volume":"10","author":"Zahiri","year":"2019","journal-title":"J. Geriatr. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1109\/79.91217","article-title":"Wavelets and signal processing","volume":"8","author":"Rioul","year":"1991","journal-title":"IEEE Signal Process. Mag."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1109\/TBME.2003.812189","article-title":"Ambulatory system for human motion analysis using a kinematic sensor: Monitoring of daily physical activity in the elderly","volume":"50","author":"Najafi","year":"2003","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1109\/TBME.2002.800763","article-title":"Measurement of stand-sit and sit-stand transitions using a miniature gyroscope and its application in fall risk evaluation in the elderly","volume":"49","author":"Najafi","year":"2002","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Najafi, B., Armstrong, D.G., and Mohler, J. (2013). Novel Wearable Technology for Assessing Spontaneous Daily Physical Activity and Risk of Falling in Older Adults with Diabetes, SAGE Publications.","DOI":"10.1177\/193229681300700507"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1159\/000460292","article-title":"Postural transitions during activities of daily living could identify frailty status: Application of wearable technology to identify frailty during unsupervised condition","volume":"63","author":"Parvaneh","year":"2017","journal-title":"Gerontology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1159\/000445889","article-title":"Motor performance and physical activity as predictors of prospective falls in community-dwelling older adults by frailty level: Application of wearable technology","volume":"62","author":"Mohler","year":"2016","journal-title":"Gerontology"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Razjouyan, J., Naik, A., Horstman, M., Kunik, M., Amirmazaheri, M., Zhou, H., Sharafkhaneh, A., and Najafi, B. (2018). Wearable sensors and the assessment of frailty among vulnerable older adults: An observational cohort study. Sensors, 18.","DOI":"10.3390\/s18051336"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Najafi, B., Reeves, N.D., and Armstrong, D.G. (2020). Leveraging smart technologies to improve the management of diabetic foot ulcers and extend ulcer-free days in remission. Diabetes Metab. Res. Rev., e3239.","DOI":"10.1002\/dmrr.3239"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.clinbiomech.2019.12.019","article-title":"Characteristics of the gait initiation phase in older adults with diabetic peripheral neuropathy compared to control older adults","volume":"72","author":"Kang","year":"2020","journal-title":"Clin. Biomech."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1080\/00325481.1996.11946142","article-title":"Peripheral neuropathy: An often-overlooked cause of falls in the elderly","volume":"99","author":"Richardson","year":"1996","journal-title":"Postgrad. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"ii7","DOI":"10.1093\/ageing\/afl077","article-title":"Postural orientation and equilibrium: What do we need to know about neural control of balance to prevent falls?","volume":"35","author":"Horak","year":"2006","journal-title":"Age Ageing"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1159\/000369095","article-title":"Wearable sensor-based in-home assessment of gait, balance, and physical activity for discrimination of frailty status: Baseline results of the Arizona frailty cohort study","volume":"61","author":"Schwenk","year":"2015","journal-title":"Gerontology"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.jamcollsurg.2016.03.030","article-title":"Assessing upper-extremity motion: An innovative, objective method to identify frailty in older bed-bound trauma patients","volume":"223","author":"Toosizadeh","year":"2016","journal-title":"J. Am. Coll. Surg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2529","DOI":"10.1016\/j.apmr.2013.06.013","article-title":"What is the relation between fear of falling and physical activity in older adults?","volume":"94","author":"Hornyak","year":"2013","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"M140","DOI":"10.1093\/geronj\/49.3.M140","article-title":"Fear of falling and fall-related efficacy in relationship to functioning among community-living elders","volume":"49","author":"Tinetti","year":"1994","journal-title":"J. Gerontol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1093\/ageing\/afi074","article-title":"Fear of falling limiting activity in young-old women is associated with reduced functional mobility rather than psychological factors","volume":"34","author":"Martin","year":"2005","journal-title":"Age Ageing"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1111\/j.1532-5415.2007.01639.x","article-title":"Activity restriction induced by fear of falling and objective and subjective measures of physical function: A prospective cohort study","volume":"56","author":"Deshpande","year":"2008","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1861","DOI":"10.1111\/pme.12570","article-title":"The avoidance of activities due to fear of falling contributes to sedentary behavior among community-dwelling older adults with chronic musculoskeletal pain: A multisite observational study","volume":"15","author":"Stubbs","year":"2014","journal-title":"Pain Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1093\/ageing\/afi215","article-title":"Reversal of diabetic peripheral neuropathy with phototherapy (MIRE\u2122) decreases falls and the fear of falling and improves activities of daily living in seniors","volume":"35","author":"Powell","year":"2005","journal-title":"Age Ageing"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1016\/j.gaitpost.2013.05.013","article-title":"Falls classification using tri-axial accelerometers during the five-times-sit-to-stand test","volume":"38","author":"Doheny","year":"2013","journal-title":"Gait Posture"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1093\/ageing\/aft157","article-title":"A Stroop Stepping Test (SST) using low-cost computer game technology discriminates between older fallers and nonfallers","volume":"43","author":"Schoene","year":"2013","journal-title":"Age Ageing"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1097\/MCO.0000000000000081","article-title":"New methods for fall risk prediction","volume":"17","author":"Ejupi","year":"2014","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1093\/gerona\/glw019","article-title":"Continuous monitoring of turning mobility and its association to falls and cognitive function: A pilot study","volume":"71","author":"Mancini","year":"2016","journal-title":"J. Gerontol. Ser. A Biomed. Sci. Med. Sci."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Stone, E.E., and Skubic, M. (2011, January 23\u201326). Evaluation of an inexpensive depth camera for passive in-home fall risk assessment. Proceedings of the 2011 5th International Conference on Pervasive Computing Technologies for Healthcare (PervasiveHealth) and Workshops, Dublin, Ireland.","DOI":"10.4108\/icst.pervasivehealth.2011.246034"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/20\/2\/505\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T14:26:33Z","timestamp":1760365593000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/20\/2\/505"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,16]]},"references-count":51,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,1]]}},"alternative-id":["s20020505"],"URL":"https:\/\/doi.org\/10.3390\/s20020505","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,16]]}}}