Max Näder Lab for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA.
Departments of Physical Medicine and Rehabilitation, Medical Social Sciences and Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA.
J Neuroeng Rehabil. 2022 Dec 30;19(1):144. doi: 10.1186/s12984-022-01121-4.
Despite the benefits of physical activity for healthy physical and cognitive aging, 35% of adults over the age of 75 in the United States are inactive. Robotic exoskeleton-based exercise studies have shown benefits in improving walking function, but most are conducted in clinical settings with a neurologically impaired population. Emerging technology is starting to enable easy-to-use, lightweight, wearable robots, but their impact in the otherwise healthy older adult population remains mostly unknown. For the first time, this study investigates the feasibility and efficacy of using a lightweight, modular hip exoskeleton for in-community gait training in the older adult population to improve walking function.
Twelve adults over the age of 65 were enrolled in a gait training intervention involving twelve 30-min sessions using the Gait Enhancing and Motivating System for Hip in their own senior living community.
Performance-based outcome measures suggest clinically significant improvements in balance, gait speed, and endurance following the exoskeleton training, and the device was safe and well tolerated. Gait speed below 1.0 m/s is an indicator of fall risk, and two out of the four participants below this threshold increased their self-selected gait speed over 1.0 m/s after intervention. Time spent in sedentary behavior also decreased significantly.
This intervention resulted in greater improvements in speed and endurance than traditional exercise programs, in significantly less time. Together, our results demonstrated that exoskeleton-based gait training is an effective intervention and novel approach to encouraging older adults to exercise and reduce sedentary time, while improving walking function. Future work will focus on whether the device can be used independently long-term by older adults as an everyday exercise and community-use personal mobility device. Trial registration This study was retrospectively registered with ClinicalTrials.gov (ID: NCT05197127).
尽管身体活动有益于健康的身体和认知衰老,但美国 75 岁以上的成年人中有 35%不活跃。基于机器人外骨骼的运动研究表明,它在改善步行功能方面有好处,但大多数都是在有神经损伤的人群中在临床环境中进行的。新兴技术开始使易于使用、重量轻、可穿戴的机器人成为可能,但它们在其他健康的老年人群中的影响仍知之甚少。首次,本研究调查了在社区中使用轻量级、模块化的髋部外骨骼对老年人进行步态训练以改善步行功能的可行性和疗效。
12 名年龄在 65 岁以上的成年人参加了一项步态训练干预,在他们自己的高级生活社区中使用 Gait Enhancing and Motivating System for Hip 进行了 12 次 30 分钟的课程。
基于性能的结果测量表明,在接受外骨骼训练后,平衡、步态速度和耐力有临床意义的改善,而且该设备是安全且耐受良好的。步态速度低于 1.0m/s 是跌倒风险的指标,4 名参与者中有 2 名低于该阈值的参与者在干预后将他们的自主选择步态速度提高到 1.0m/s 以上。久坐行为所花费的时间也显著减少。
与传统的运动计划相比,这种干预在更短的时间内使速度和耐力有了更大的提高。总的来说,我们的结果表明,基于外骨骼的步态训练是一种有效的干预措施和新颖的方法,可以鼓励老年人进行锻炼并减少久坐时间,同时改善步行功能。未来的工作将集中在该设备是否可以被老年人长期独立用作日常锻炼和社区使用的个人移动设备。试验注册本研究在 ClinicalTrials.gov 上进行了回顾性注册(编号:NCT05197127)。