A novel in-bed body posture monitoring for decubitus ulcer prevention using body pressure distribution mapping.

BACKGROUND: Decubitus ulcers are prevalent among the aging population due to a gradual decline in their overall health, such as nutrition, mental health, and mobility, resulting in injury to the skin and tissue. The most common technique to prevent these ulcers is through frequent repositioning to redistribute body pressures. Therefore, the main goal of this study is to facilitate the timely repositioning of patients through the use of a pressure mat to identify in-bed postures in various sleep environments. Pressure data were collected from 10 healthy participants lying down on a pressure mat in 19 various in-bed postures, correlating to the supine, prone, right-side, and left-side classes. In addition, pressure data were collected from participants sitting at the edge of the bed as well as an empty bed. Each participant was asked to lie in these 19 postures in three distinct testing environments: a hospital bed, a home bed, and a home bed with a foam mattress topper. To categorize each posture into its respective class, the pre-trained 2D ResNet-18 CNN and the pre-trained Inflated 3D CNN algorithms were trained and validated using image and video pressure mapped data, respectively. RESULTS: The ResNet-18 and Inflated 3D CNN algorithms were validated using leave-one-subject-out (LOSO) and leave-one-environment-out (LOEO) cross-validation techniques. LOSO provided an average accuracy of 92.07% ± 5.72% and 82.22% ± 8.50%, for the ResNet-18 and Inflated 3D CNN algorithms, respectively. Contrastingly, LOEO provided a reduced average accuracy of 85.37% ± 14.38% and 77.79% ± 9.76%, for the ResNet-18 and Inflated 3D CNN algorithms, respectively. CONCLUSION: These pilot results indicate that the proposed algorithms can accurately distinguish between in-bed postures, on unseen participant data as well as unseen mattress environment data. The proposed algorithms can establish the basis of a decubitus ulcer prevention platform that can be applied to various sleeping environments. To the best of our knowledge, the impact of mattress stiffness has not been considered in previous studies regarding in-bed posture monitoring.

A novel wearable biofeedback system to prevent trip-related falls.

Real-time gait monitoring of older adults and gait-impaired individuals while providing real-time biofeedback has the potential to help reduce trip-related falls. A low or unsuccessful Minimum Toe Clearance (MTC) is considered a predictor of tripping risk. Thus, increasing the MTC can be a key component in minimizing the likelihood of tripping. This paper discusses a proof-of-concept wearable system that estimates the MTC in real-time using two Time-of-Flight (ToF) sensors and provides auditory biofeedback to alert users if they have a low MTC during everyday walking activities. Ten healthy female adults were asked to perform two experiments: 1) walk at a predetermined speed to evaluate the proposed real-time MTC detection algorithm, and 2) walk in four conditions: baseline, biofeedback with no distraction, biofeedback with distraction 1 (talking on the phone), and biofeedback with distraction 2 (playing a simple mobile game). The average MTC values were significantly greater during all feedback conditions than the baseline, indicating that the proposed system could successfully warn users to increase their MTC in real-time.

Machine learning prediction of footwear slip resistance on glycerol-contaminated surfaces: A pilot study.

Slippery surfaces due to oil spills pose a significant risk in various environments, including industrial workplaces, kitchens, garages, and outdoor areas. These situations can lead to accidents and falls, resulting in injuries that range from minor bruises to severe fractures or head trauma. To mitigate such risks, the use of slip resistant footwear plays a crucial role. In this study, we aimed to develop an Artificial Intelligence model capable of classifying footwear as having either high or low slip resistance based on the geometric characteristics and material parameters of their outsoles. Our model was trained on a unique dataset comprising images of 37 indoor work footwear outsoles made of rubber. To evaluate the slip resistant property of the footwear, all samples were tested using a cart-type friction measurement device, and the static and dynamic Coefficient of Frictions (COFs) of each outsole was determined on a glycerol-contaminated surface. Machine learning techniques were implemented, and a classification model was developed to determine high and low slip resistant footwear. Among the various models evaluated, the Support Vector Classifier (SVC) obtained the best results. This model achieved an accuracy of 0.68 ± 0.15 and an F1-score of 0.68 ± 0.20. Our results indicate that the proposed model effectively yet modestly identified outsoles with high and low slip resistance. This model is the first step in developing a model that footwear manufacturers can utilize to enhance product quality and reduce slip and fall incidents.

Joint angle estimation during shoulder abduction exercise using contactless technology.

BACKGROUND: Tele-rehabilitation, also known as tele-rehab, uses communication technologies to provide rehabilitation services from a distance. The COVID-19 pandemic has highlighted the importance of tele-rehab, where the in-person visits declined and the demand for remote healthcare rises. Tele-rehab offers enhanced accessibility, convenience, cost-effectiveness, flexibility, care quality, continuity, and communication. However, the current systems are often not able to perform a comprehensive movement analysis. To address this, we propose and validate a novel approach using depth technology and skeleton tracking algorithms. METHODS: Our data involved 14 participants (8 females, 6 males) performing shoulder abduction exercises. We collected depth videos from an LiDAR camera and motion data from a Motion Capture (Mocap) system as our ground truth. The data were collected at distances of 2 m, 2.5 m, and 3.5 m from the LiDAR sensor for both arms. Our innovative approach integrates LiDAR with the Cubemos and Mediapipe skeleton tracking frameworks, enabling the assessment of 3D joint angles. We validated the system by comparing the estimated joint angles versus Mocap outputs. Personalized calibration was applied using various regression models to enhance the accuracy of the joint angle calculations. RESULTS: The Cubemos skeleton tracking system outperformed Mediapipe in joint angle estimation with higher accuracy and fewer errors. The proposed system showed a strong correlation with Mocap results, although some deviations were present due to noise. Precision decreased as the distance from the camera increased. Calibration significantly improved performance. Linear regression models consistently outperformed nonlinear models, especially at shorter distances. CONCLUSION: This study showcases the potential of a marker-less system, to proficiently track body joints and upper-limb angles. Signals from the proposed system and the Mocap system exhibited robust correlation, with Mean Absolute Errors (MAEs) consistently below [Formula: see text]. LiDAR's depth feature enabled accurate computation of in-depth angles beyond the reach of traditional RGB cameras. Altogether, this emphasizes the depth-based system's potential for precise joint tracking and angle calculation in tele-rehab applications.

Design and Validation of Vision-Based Exercise Biofeedback for Tele-Rehabilitation.

Tele-rehabilitation has the potential to considerably change the way patients are monitored from their homes during the care process, by providing equitable access without the need to travel to rehab centers or shoulder the high cost of personal in-home services. Developing a tele-rehab platform with the capability of automating exercise guidance is likely to have a significant impact on rehabilitation outcomes. In this paper, a new vision-based biofeedback system is designed and validated to identify the quality of performed exercises. This new system will help patients to refine their movements to get the most out of their plan of care. An open dataset was used, which consisted of data from 30 participants performing nine different exercises. Each exercise was labeled as "Correctly" or "Incorrectly" executed by five clinicians. We used a pre-trained 3D Convolution Neural Network (3D-CNN) to design our biofeedback system. The proposed system achieved average accuracy values of 90.57% ± 9.17% and 83.78% ± 7.63% using 10-Fold and Leave-One-Subject-Out (LOSO) cross validation, respectively. In addition, we obtained average F1-scores of 71.78% ± 5.68% using 10-Fold and 60.64% ± 21.3% using LOSO validation. The proposed 3D-CNN was able to classify the rehabilitation videos and feedback on the quality of exercises to help users modify their movement patterns.

Development and Evaluation of BLE-Based Room-Level Localization to Improve Hand Hygiene Performance Estimation.

Hand hygiene is one of the most effective ways to prevent infection transmission. However, current electronic monitoring systems are not able to identify adherence to all hand hygiene (HH) guidelines. Location information can play a major role in enhancing HH monitoring resolution. This paper proposes a BLE-based solution to localize healthcare workers inside the patient room. Localization accuracy was evaluated using one to four beacons in a binary (entrance/proximal patient zone) or multiclass (entrance/sink/right side of the bed/left side of the bed) proximity-based positioning problem. Dynamic fingerprints were collected from nine different subjects performing 30 common nursing activities. Extremely randomized trees algorithm achieved the best accuracies of 81% and 71% in the binary and multiclass classifications, respectively. The proposed method can be further used as a proxy for caregiving activity recognition to improve the risk of infection transmission in healthcare settings.

Automated Fluid Intake Detection Using RGB Videos.

Dehydration is a common, serious issue among older adults. It is important to drink fluid to prevent dehydration and the complications that come with it. As many older adults forget to drink regularly, there is a need for an automated approach, tracking intake throughout the day with limited user interaction. The current literature has used vision-based approaches with deep learning models to detect drink events; however, most use static frames (2D networks) in a lab-based setting, only performing eating and drinking. This study proposes a 3D convolutional neural network using video segments to detect drinking events. In this preliminary study, we collected data from 9 participants in a home simulated environment performing daily activities as well as eating and drinking from various containers to create a robust environment and dataset. Using state-of-the-art deep learning models, we trained our CNN using both static images and video segments to compare the results. The 3D model attained higher performance (compared to 2D CNN) with F1 scores of 93.7% and 84.2% using 10-fold and leave-one-subject-out cross-validations, respectively.

Monitoring fluid intake by commercially available smart water bottles.

Fluid intake is important to prevent dehydration and reduce recurrent kidney stones. There has been a trend in recent years to develop tools to monitor fluid intake using "smart" products such as smart bottles. Several commercial smart bottles are available, mainly targeting health-conscious adults. To the best of our knowledge, these bottles have not been validated in the literature. This study compares four commercially available smart bottles in terms of both performance and functionality. These bottles are the H2OPal, HidrateSpark Steel, HidrateSpark 3, and Thermos Smart Lid. One hundred intake events for each bottle were recorded and analyzed versus ground truth obtained from a high-resolution weight scale. The H2OPal had the lowest Mean Percent Error (MPE) and was able to balance out errors throughout multiple sips. The HidrateSpark 3 provided the most consistent and reliable results, with the lowest per sip error. The MPE values for HidrateSpark bottles were further improved using linear regression, as they had more consistent individual error values. The Thermos Smart Lid provides the lowest accuracy, as the sensors do not extend through the entire bottle, leading to many missed recordings.

A New Performance Metric to Estimate the Risk of Exposure to Infection in a Health Care Setting: Descriptive Study.

BACKGROUND: Despite several measures to monitor and improve hand hygiene (HH) in health care settings, health care-acquired infections (HAIs) remain prevalent. The measures used to calculate HH performance are not able to fully benefit from the high-resolution data collected using electronic monitoring systems. OBJECTIVE: This study proposes a novel parameter for quantifying the HAI exposure risk of individual patients by considering temporal and spatial features of health care workers' HH adherence. METHODS: Patient exposure risk is calculated as a function of the number of consecutive missed HH opportunities, the number of unique rooms visited by the health care professional, and the time duration that the health care professional spends inside and outside the patient's room without performing HH. The patient exposure risk is compared to the entrance compliance rate (ECR) defined as the ratio of the number of HH actions performed at a room entrance to the total number of entrances into the room. The compliance rate is conventionally used to measure HH performance. The ECR and the patient exposure risk are analyzed using the data collected from an inpatient nursing unit for 12 weeks. RESULTS: The analysis of data collected from 59 nurses and more than 25,600 records at a musculoskeletal rehabilitation unit at the Toronto Rehabilitation Institute, KITE, showed that there is no strong linear relation between the ECR and patient exposure risk (r=0.7, P<.001). Since the ECR is calculated based on the number of missed HH actions upon room entrance, this parameter is already included in the patient exposure risk. Therefore, there might be scenarios that these 2 parameters are correlated; however, in several cases, the ECR contrasted with the reported patient exposure risk. Generally, the patients in rooms with a significantly high ECR can be potentially exposed to a considerable risk of infection. By contrast, small ECRs do not necessarily result in a high patient exposure risk. The results clearly explained the important role of the factors incorporated in patient exposure risk for quantifying the risk of infection for the patients. CONCLUSIONS: Patient exposure risk might provide a more reliable estimation of the risk of developing HAIs compared to ECR by considering both the temporal and spatial aspects of HH records.

Design of a Novel Wearable System for Foot Clearance Estimation.

Trip-related falls are one of the major causes of injury among seniors in Canada and can be attributable to an inadequate Minimum Toe Clearance (MTC). Currently, motion capture systems are the gold standard for measuring MTC; however, they are expensive and have a restricted operating area. In this paper, a novel wearable system is proposed that can estimate different foot clearance parameters accurately using only two Time-of-Flight (ToF) sensors located at the toe and heel of the shoe. A small-scale preliminary study was conducted to investigate the feasibility of foot clearance estimation using the proposed wearable system. We recruited ten young, healthy females to walk at three self-selected speeds (normal, slow, and fast) while wearing the system. Our data analysis showed an average correlation coefficient of 0.94, 0.94, 0.92 for the normal, slow, and fast speed, respectively, when comparing the ToF signals with motion capture. The ANOVA analysis confirmed these results further by revealing no statistically significant differences between the ToF signals and motion capture data for most of the gait parameters after applying the newly proposed foot angle and offset compensation. In addition, the proposed system can measure the MTC with an average Mean Error (ME) of -0.08 ± 3.69 mm, -0.12 ± 4.25 mm, and -0.10 ± 6.57 mm for normal, slow, and fast walking speeds, respectively. The proposed affordable wearable system has the potential to perform real-time MTC estimation and contribute to future work focused on minimizing tripping risks.

Fluid Intake Monitoring Systems for the Elderly: A Review of the Literature.

Fluid intake monitoring is an essential component in preventing dehydration and overhydration, especially for the senior population. Numerous critical health problems are associated with poor or excessive drinking such as swelling of the brain and heart failure. Real-time systems for monitoring fluid intake will not only measure the exact amount consumed by the users, but could also motivate people to maintain a healthy lifestyle by providing feedback to encourage them to hydrate regularly throughout the day. This paper reviews the most recent solutions to automatic fluid intake monitoring both commercially and in the literature. The available technologies are divided into four categories: wearables, surfaces with embedded sensors, vision- and environmental-based solutions, and smart containers. A detailed performance evaluation was carried out considering detection accuracy, usability and availability. It was observed that the most promising results came from studies that used data fusion from multiple technologies, compared to using an individual technology. The areas that need further research and the challenges for each category are discussed in detail.

Quantifying Mobility Scooter Performance in Winter Environments.

OBJECTIVES: To quantify mobility scooter performance when traversing snow, ice, and concrete in cold temperatures and to explore possible performance improvements with scooter winter tires. DESIGN: Cross-sectional. SETTING: Hospital-based research institute. PARTICIPANTS: Two drivers (50 and 100 kg) tested 8 scooter models (N=8). Two mobility scooters were used for winter tire testing. INTERVENTIONS: Scooters were tested on 3 different conditions in a random sequence (concrete, 2.5-cm depth snow, bare ice). Ramp ascent and descent, as well as right-angle cornering up to a maximum of 10° slopes on winter conditions, were observed. Winter tire testing used the same slopes with 2 scooters on bare and melting ice surfaces. MAIN OUTCOME MEASURES: Maximum achievable angle (MAA) and tire traction loss for ramp ascent and descent performance. The ability to steer around a corner on the ramp. RESULTS: All scooters underperformed in winter conditions, specifically when traversing snow- and ice-covered slopes (χ2 [2, N=8]=13.87-15.55, P<.001) and corners (χ2 [2, N=8]=12.25, P<.01). Half of the scooters we tested were unable to climb a 1:12 grade (4.8°) snow-covered slope without losing traction. All but 1 failed to ascend an ice-covered 1:12 grade (4.8°) slope. Performance was even more unsatisfactory for the forward downslopes on both snow and ice. Winter tires enhanced the MAA, permitting 1:12 (4.8°) slope ascent on ice. CONCLUSIONS: Mobility scooters need to be designed with winter months in mind. Our findings showed that Americans with Disabilities Act-compliant built environments, such as curb ramps that conform to a 1:12 (4.8°) slope, become treacherous or impassible to mobility scooter users when covered in ice or snow. Scooter manufacturers should consider providing winter tires as optional accessories in regions that experience ice and snow accumulation. Additional testing/standards need to be established to evaluate winter mobility scooter performance further.

Influential Factors in Remote Monitoring of Heart Failure Patients: A Review of the Literature and Direction for Future Research.

With new advances in technology, remote monitoring of heart failure (HF) patients has become increasingly prevalent and has the potential to greatly enhance the outcome of care. Many studies have focused on implementing systems for the management of HF by analyzing physiological signals for the early detection of HF decompensation. This paper reviews recent literature exploring significant physiological variables, compares their reliability in predicting HF-related events, and examines the findings according to the monitored variables used such as body weight, bio-impedance, blood pressure, heart rate, and respiration rate. The reviewed studies identified correlations between the monitored variables and the number of alarms, HF-related events, and/or readmission rates. It was observed that the most promising results came from studies that used a combination of multiple parameters, compared to using an individual variable. The main challenges discussed include inaccurate data collection leading to contradictory outcomes from different studies, compliance with daily monitoring, and consideration of additional factors such as physical activity and diet. The findings demonstrate the need for a shared remote monitoring platform which can lead to a significant reduction of false alarms and help in collecting reliable data from the patients for clinical use especially for the prevention of cardiac events.

Evaluation of Winter Footwear: Comparison of Test Methods to Determine Footwear Slip Resistance on Ice Surfaces.

The use of slip-resistant winter footwear is crucial for the prevention of slips and falls on ice and snow. The main objective of this paper is to evaluate a mechanical testing method to determine footwear slip resistance on wet and dry ice surfaces and to compare it with the human-centred test method introduced by researchers at KITE (Knowledge, Innovation, Talent, Everywhere)-Toronto Rehabilitation Institute-University Health Network. Phase 1 of this study assessed the repeatability and reproducibility of the mechanical method by evaluating ten different occupational winter boots using two SATRA Slip resistance testers (STM 603, SATRA Technology Centre, Kettering, UK). One tester is located in Toronto and one in Montreal. These boots were chosen based on the needs of the IRSST (Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail, Montréal, Quebec, Canada), who were primarily interested in providing safe winter footwear for police, firefighters and municipal workers. In Phase 2, the results of the human-centred test approach were compared with the mechanical results. In Phase 3, two of these boots with conflicting results from the previous phases were tested using a second human-centred method. In Phase 1, the mechanical testing results obtained in the two labs showed a high linear correlation (>0.94) and good agreement on both ice surfaces; however, they revealed a bias (~0.06) between the two labs on the dry ice condition. The mechanical and human-centred tests (phase 2) were found to be better correlated in the wet ice condition (R = 0.95) compared to the dry ice condition (R = 0.34). Finally, the rating of the footwear slip resistance based on the number of slips counted in phase 3 was consistent with the rating by the human-centred test method (phase 2), but not the mechanical method (phase 1). The findings of this study provide a better understanding of the limitations of the SATRA ice tray for measuring footwear slip resistance and demonstrate that the mechanical method must be further refined to make it more comparable to the human-centred methods to achieve better agreement with real-world performance.

Deep Neural Network for Slip Detection on Ice Surface.

Slip-induced falls are among the most common causes of major occupational injuries and economic loss in Canada. Identifying the risk factors associated with slip events is key to developing preventive solutions to reduce falls. One factor is the slip-resistance quality of footwear, which is fundamental to reducing the number of falls. Measuring footwear slip resistance with the recently developed Maximum Achievable Angle (MAA) test requires a trained researcher to identify slip events in a simulated winter environment. The human capacity for information processing is limited and human error is natural, especially in a cold environment. Therefore, to remove conflicts associated with human errors, in this paper a deep three-dimensional convolutional neural network is proposed to detect the slips in real-time. The model has been trained by a new dataset that includes data from 18 different participants with various clothing, footwear, walking directions, inclined angles, and surface types. The model was evaluated on three types of slips: Maxi-slip, midi-slip, and mini-slip. This classification is based on the slip perception and recovery of the participants. The model was evaluated based on both 5-fold and Leave-One-Subject-Out (LOSO) cross validation. The best accuracy of 97% was achieved when identifying the maxi-slips. The minimum accuracy of 77% was achieved when classifying the no-slip and mini-slip trials. The overall slip detection accuracy was 86% with sensitivity and specificity of 81% and 91%, respectively. The overall accuracy dropped by about 2% in LOSO cross validation. The proposed slip detection algorithm is not only beneficial for footwear manufactures to improve their footwear slip resistance quality, but it also has other potential applications, such as improving the slip resistance properties of flooring in healthcare facilities, commercial kitchens, and oil drilling platforms.

A Vision-Based Approach for Sidewalk and Walkway Trip Hazards Assessment.

Tripping hazards on the sidewalk cause many falls annually, and the inspection and repair of these hazards cost cities millions of dollars. Currently, there is not an efficient and cost-effective method to monitor the sidewalk to identify any possible tripping hazards. In this paper, a new portable device is proposed using an Intel RealSense D415 RGB-D camera to monitor the sidewalks, detect the hazards, and extract relevant features of the hazards. This paper first analyzes the effects of environmental factors contributing to the device's error and compares different regression techniques to calibrate the camera. The Gaussian Process Regression models yielded the most accurate predictions with less than 0.09 mm Mean Absolute Errors (MAEs). In the second phase, a novel segmentation algorithm is proposed that combines the edge detection and region-growing techniques to detect the true tripping hazards. Different examples are provided to visualize the output results of the proposed method.

Bathing frail seniors at home: Home care providers' approaches.

BACKGROUND: Home care providers assisting with seniors' personal care often experience high rates of musculoskeletal disorders, particularly affecting the lower back. Assisting with bathing is consistently identified as one of their most physically demanding activities. OBJECTIVE: To identify and describe care providers' procedures for assisting a frail senior to bathe that are likely to contribute most to the development of back injuries. METHODS: Eight community-based personal support workers (home care aides) assisted a frail senior (actor) to bathe in a simulated home bathroom. Video recordings of the activity were coded according to providers' postures and to characterize techniques for providing care. RESULTS: Exposure to severe trunk flexion and high posture-induced back loads was greatest during transfers in and out of the bathtub. In particular, lifting the legs over the rim of the tub, assisting the client to shift across the bath transfer bench, and providing care to the legs and feet involved the care provider spending substantial time in highly flexed postures. No observed techniques for these activities showed substantially lower exposures. CONCLUSIONS: Further tools and/or techniques must be identified or developed to improve caregiver safety during these strenuous activities.

Toward mitigating pressure injuries: Detecting patient orientation from vertical bed reaction forces.

INTRODUCTION: Prolonged bed rest without repositioning can lead to pressure injuries. However, it can be challenging for caregivers and patients to adhere to repositioning schedules. A device that alerts caregivers when a patient has remained in the same orientation for too long may reduce the incidence and/or severity of pressure injuries. This paper proposes a method to detect a person's orientation in bed using data from load cells placed under the legs of a hospital grade bed. METHODS: Twenty able-bodied individuals were positioned into one of three orientations (supine, left side-lying, or right side-lying) either with no support, a pillow, or a wedge, and the head of the bed either raised or lowered. Breathing pattern characteristics extracted from force data were used to train two machine learning classification systems (Logistic Regression and Feed Forward Neural Network) and then evaluate for their ability to identify each participant's orientation using a leave-one-participant-out cross-validation. RESULTS: The Feed Forward Neural Network yielded the highest orientation prediction accuracy at 94.2%. CONCLUSIONS: The high accuracy of this non-invasive system's ability to a participant's position in bed shows potential for this algorithm to be useful in developing a pressure injury prevention tool.

Challenges to Human Drivers in Increasingly Automated Vehicles.

OBJECTIVE: We examine the relationships between contemporary progress in on-road vehicle automation and its coherence with an envisioned "autopia" (automobile utopia) whereby the vehicle operation task is removed from all direct human control. BACKGROUND: The progressive automation of on-road vehicles toward a completely driverless state is determined by the integration of technological advances into the private automobile market; improvements in transportation infrastructure and systems efficiencies; and the vision of future driving as a crash-free enterprise. While there are many challenges to address with respect to automated vehicles concerning the remaining driver role, a considerable amount of technology is already present in vehicles and is advancing rapidly. METHODS: A multidisciplinary team of experts met to discuss the most critical challenges in the changing role of the driver, and associated safety issues, during the transitional phase of vehicle automation where human drivers continue to have an important but truncated role in monitoring and supervising vehicle operations. RESULTS: The group endorsed that vehicle automation is an important application of information technology, not only because of its impact on transportation efficiency, but also because road transport is a life critical system in which failures result in deaths and injuries. Five critical challenges were identified: driver independence and mobility, driver acceptance and trust, failure management, third-party testing, and political support. CONCLUSION: Vehicle automation is not technical innovation alone, but is a social as much as a technological revolution consisting of both attendant costs and concomitant benefits.

Selecting slip resistant winter footwear for personal support workers.

BACKGROUND: Falls are among the leading causes of occupational injuries for workers exposed to outdoor winter conditions such as Personal Support Workers (PSWs). Slip resistant footwear is known to reduce the risk of falls, however, it is difficult to predict how well a particular boot will perform prior to purchasing them. Our recently developed Maximum Achievable Angle (MAA) test can be used to rate footwear objectively to address this gap. OBJECTIVE: To rate the slip resistance of a selection of winter footwear that meets the needs and preferences of PSWs. METHODS: We selected 40 representative types of footwear based on survey results from 677 PSWs and applied our MAA test to rate slip resistance. RESULTS: Comfort and slip resistance were rated the most important features for selecting winter footwear. Of the 40 types of footwear tested, six were found to have a good slip resistance on ice. CONCLUSION: The vast majority of winter footwear that meet the needs and preferences of PSWs, perform poorly on ice. Therefore, PSWs should consult our website (ratemytreads.com) for selecting appropriate footwear that will keep them safe in the winter.