Do you ever think what will be the future of healthcare? What will be the health status of our grandfathers and grandmothers in their ageing process? How can we diagnose and cure the ageing disorders? There are so many such questions which came to our mind when we think about our health in old age. In ageing disorder there are so many different kinds of diseases under the domain of physiology and neurology, which can be extremely dangerous for our health and their timely diagnosis is very important. For instance, in order to diagnosis complex neurological diseases such as Parkinson, Dementia and many more, there is a need for a holistic approach to cover all the factors including the environmental ones. Which is very difficult for one doctor without having assistive devices and proper database. Only after appropriate diagnosis, we can give them proper treatment for rehabilitation. For addressing all the above concerns, “Keep Control” project is working on keeping the control on our ageing with aim of healthy ageing.
Keep Control is an EU-funded industrial academic initial training network (Grant Agreement No: 721577) towards specific diagnosis and treatment of age-related gait and balance deficits. It covers the entire range of expertise necessary and utilizes cutting-edge technology to educate 12 Ph.D. students in the area of gait and balance deficits in older adults.
Figure: Logo of Keep Control showing that a person is trying to maintain his/her balance (right) and funded by the European Union (left).
Balance and gait deficits are ubiquitous among the older population and lead to enormous personal, occupational and healthcare burden. For example, Falling is considered as the global burden of diseases according to the World Health Organization (WHO). Which not only reduce the quality of life of the elderly but also increase the healthcare cost. On other side, the European countries are hugely affected by the neurodegenerative diseases due to their living style and also due to their eating habits. Parkinson disease is considered the second most common neurodegenerative diseases. Loss of memory or in other words dementia is also common. In order to treat such diseases, emerging pharmacological and non-pharmacological interventions to date have only small to moderate effects on these deficits. This is likely due to remaining fundamental questions on underlying mechanisms and treatment. Through this project, such treatments will be investigated or such methods will be generated so that we can stop such chronic diseases at their initial stage.
Figure: Different types of ageing disorders
In order to stop such diseases, there is need of such markers which can be used for early diagnosis. Among many, Gait is considered as an early marker for diagnosis of such ageing disorders. There are different inertial sensing systems which can measure the human motion very accurately. Among them the wearable inertial sensor are the most suitable choice for gait assessment. The comparisons of different tools for gait analysis and balance assessment is given in below figure with their pros and cons. There are lot more tools, which will be used in this project and those are not discussed here. The ultimate goal for gait analysis is to develop such tools which can assess the diseases accurately or can be used for the rehabilitation purpose. Which should be portable, cheap and easy to use by the elderly.
Figure: Comparison of tools for assessing the human balance by measuring the human gait
In order to find the solution of such complex problems, Keep Control team consist of 12 different experts from clinical, biomechanics and neuroscience research, along with experts from the industry, who all aim at gaining a better understanding and treatment of balance and gait deficits in older adults. Their names with affiliation is provided in the below figure for detail you can take a look on the official website of the project (Link).
Figure: Principle investigators in the consortium handling all the 12 projects
With each expert, one fellow is attached for the training purpose and working on the project for achieving the overall goals of the project. Each fellow has the diverse background in research and most suitable candidates are selected for each project. From engineering to the medical science, everyone is involved for this novel cause. The researcher from different fields such as Industrial engineering, mechanical engineering, systems engineering, biomedical engineering, data analyzer, physiotherapist and coders are working together. This multidisciplinary team is highly motivated and enthusiastic to achieve the goals of their projects. Here Keep Control funded by the European Union is supporting them for their three years P.hd. program and nurturing them in their early research careers to become the leaders of the future in their research domains. The names of the fellows with their affiliation is shown in the below figure. For full detail please take a look on the official site of the project (link).
Figure: The early-stage research fellows working on different projects
The role of each fellow is unique in this project and there is flexibility to visit each other during the project. Arash from Gaitup Company is comparing the gait and balance parameters in the lab and free-living conditions. How sarcopenia is affecting the gait and balance is under investigation by the Fabiana from LMU. Elke from Kiel is interested in exploring the gait as an early marker for the Neurodegeneration. On the other hand, Rana from Newcastle is more focused on the developing the novel tools from wearable inertial sensors data for neurodegenerative diseases management using deep learning techniques (research framework of Ph.D. is given in below figure). In Leuven, Veerle is doing interesting work on finding the correlation of behavioral and neural system. An Italian girl Marta working in Porto is finding the effect of peripheral neuropathy on gait and balance in PD (people having Parkinson Diseases). What factors are important for maintaining the standing balance is under investigation by Leila in VU. In order to find the proper rehabilitation methods to prevent future falls, Markus is investigating the suitable gait training programs with Motek Company. For managing the falls proactively, Andreas from Hasomed Company is developing and validating interesting acoustic feedback-based system for preventing the falls. Does the medical drug in the older adults can affect their attention and motor skills is currently under assessment by Madli in Lille. In order to give a holistic shape to all the above assessments, Youhan is doing the Meta-analysis based on the ICF model in Groningen. The future of keeping the medical records through Patient Know Best System is simple and easy, in order to evaluate the feasibility of such system and user motivation, Hassan is working in this domain with PKB Company. From all these innovative research and combining the brilliant minds from all over the world for this project, you can imagine the importance of the Keep Control.
Figure: Layout of machine/deep learning for handing the sensor data for making the prediction and finding the progression of neurodegenerative diseases
In order to summarize all the above work, Keep Control is dealing with different aspects such as: (1) comparability of balance and gait assessment in the clinic and the home environment, (2) gait and balance deficits as prodromal markers of neurodegeneration, and as markers to differentiate between Parkinsonian syndromes, (3) association between freezing of gait and balance, and (4) gait and balance deficits in patients with sarcopenia. For these assessments different tools are under utilization such as sophisticated lab-based gait and balance assessment devices, perturbation treadmill, wearable devices, electrophysiology and blood and tissue investigations will be implemented. With their further aims to employ promising therapeutic strategies for specific gait and balance deficits in older adults, including both pharmacologic and non-pharmacologic strategies.
To put this in a nut-shell, Keep Control is the future of healthcare for healthy ageing. Through this project, we are doing this innovative research to save our children and grandchildren from such chronic diseases. We are motivated and determined today to achieve our goals for better tomorrow.
Written by: Rana Zia Ur Rehman
Comments by Walter Maetzler (Scientific Coordinator of Keep Control Project):
“For me, KEEP CONTROL is important because it offers 12 young enthusiastic researchers working on scientific projects that are highly relevant for our society, to be involved in an engaged network of academic and industry PIs, and eventually to build an entirely new own network that has the potential to make a real difference in this research area, even after the cessation of the project phase.”