Measuring context-specific activity of diabetic persons using GPS, accelerometer, and GIS

Authors: Sungsoon Hwang*, DePaul University, Ryan Crews, Rosalind Franklin University of Medicine and Science, Sai Yalla, Rosalind Franklin University of Medicine and Science, Kristin Schneider, Rosalind Franklin University of Medicine and Science, Elizabeth Moxley, DePaul University
Topics: Geographic Information Science and Systems, Medical and Health Geography, Quantitative Methods
Keywords: daily mobility, activity space, GPS, environmental exposure, diabetic foot ulcer
Session Type: Paper
Day: 4/10/2018
Start / End Time: 12:40 PM / 2:20 PM
Room: Balcony N, Marriott, River Tower Elevators, 4th Floor
Presentation File: No File Uploaded


The prevalence of diabetes continues to rise. In the U.S., 12.2% of adults and 25.2% of older adults had diabetes in 2015. One of dire consequences of diabetes is the development of foot ulcers, often leading to lower extremity amputation. Given that sporadic weight bearing activity (WBA) appears to be associated with foot ulceration, identifying where WBA occurs can provide insights into diabetic foot ulceration. Although methodological advances using GPS, accelerometer, and GIS, have been made in assessing environmental exposures, methodological challenges with processing uncertain human GPS trajectory data remain. We developed the methodology for identifying the location of WBA using GPS, accelerometer and GIS. The methodology consists of (i) preprocessing GPS data, which includes gap imputation and segmentation into stop/move episodes; (ii) synchronizing GPS data with activity data; and (iii) overlaying location-specific activity data with remotely sensed imagery using GIS. Ten diabetic persons with risks for foot ulcers were asked to carry a GPS data logger (QStartz BT-Q1000XT) and accelerometer (PamSys) continuously for 7 days. The methodology we developed can be put into use in (i) generating activity spaces with potential environmental exposures (consisting of frequently visited places and routes taken by non-motorized mode of transportation); (ii) quantifying daily mobility (measured as the number of out-of-home stops visited); and (iii) identifying WBA events with risks for foot ulceration.

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