Faculty of Sport Management, Nippon Sport Science University, 1221-1 Kamoshida-cho, Aoba-ku, Yokohama, Kanagawa 227-0033, Japan; Graduate School of Physical Education, Health and Sport Studies, Nippon Sport Science University, 7-1-1 Fukasawa, Setagaya-ku, Tokyo 158-8508, Japan; Center for Innovation Policy, Kanagawa University of Human Services, Research Gate Building TONOMACHI 2-A, 3-25-10 Tonomachi, Kawasaki-ku, Kawasaki-shi, Kanagawa 210-0821, Japan.
Cancer Prevention and Control Division, Kanagawa Cancer Center Research Institute, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa 241-8515, Japan; Graduate School of Health Innovation, Kanagawa University of Human Services, Research Gate Building TONOMACHI 2-A, 3-25-10 Tonomachi, Kawasaki-ku, Kawasaki-shi, Kanagawa 210-0821, Japan.
Exp Gerontol. 2024 Oct 1;195:112536. doi: 10.1016/j.exger.2024.112536. Epub 2024 Aug 3.
Sarcopenia and frailty often worsen in older adults because of declines in activities of daily living and social connections that are associated with chronic diseases and traumatic injuries such as falls and fractures. Exercise intervention for sarcopenia can take >3 months to improve muscle mass, muscle strength, and walking speed. Thus, a specialized intervention system for shorter periods of time is needed. In this study, we aimed to evaluate the short-term efficacy of an exercise program using the wearable cyborg Hybrid Assistive Limb (HAL) lumbar type in physical function in mobility-limited older adults who do not require transition to long-term care.
This randomized, single-blind, parallel-group study involved 79 community-dwelling older adults with physical frailty or locomotive syndrome assigned to an intervention group (n = 40) with the HAL lumbar type exercise program or a control group (n = 39) without the exercise program. The intervention group underwent trunk training (including trunk and hip flexion, standing and sitting from a single sitting position, and squats) and gait training (treadmill and parallel bars) twice a week for 5 weeks while wearing the HAL lumbar type. The 10-m usual and maximum walking speeds, Timed Up and Go test results, 5-times chair-standing test results, 5-question Geriatric Locomotive Function Scale (GLFS-5) scores, body-fat percentage, and muscle mass were measured before and after the intervention and analyzed using the intention-to-treat method.
The intervention (23 % male; mean age, 74.7 ± 4.7 years) and control (21 % male; mean age, 75.1 ± 4.1 years) groups did not differ significantly in baseline characteristics. Seventy-seven participants completed the program; two withdrew for personal reasons. The mean difference (standard error) between the groups for the primary outcome (usual walking speed) was 0.35 (0.04) m/s; the time-by-group interaction was significant (p < 0.001). Secondary outcomes (maximum walking speed, Timed Up and Go test results, 5-times chair-standing test results, and GLFS-5 scores) significantly improved in the intervention group. Body composition was unchanged in both groups.
A 5-week exercise program using the HAL lumbar type is a promising option for community-dwelling older adults with limited mobility who do not require nursing care, resulting in clinically meaningful improvements in most physical functions within a short period.
由于与慢性病和创伤性损伤（如跌倒和骨折）相关的日常生活活动和社会联系的下降，老年人的肌肉减少症和虚弱往往会恶化。针对肌肉减少症的运动干预需要 >3 个月才能改善肌肉质量、肌肉力量和步行速度。因此，需要一种专门的干预系统来缩短时间。在这项研究中，我们旨在评估使用可穿戴混合辅助肢体（HAL）腰部类型在不需要过渡到长期护理的活动受限的老年人群中进行身体功能的运动计划的短期疗效。
这是一项随机、单盲、平行组研究，涉及 79 名患有身体虚弱或运动障碍综合征的社区居住的老年人，他们被分配到干预组（n=40），接受 HAL 腰部类型的运动计划，或对照组（n=39），不接受运动计划。干预组每周进行两次躯干训练（包括躯干和髋关节屈曲、从单坐位站立和坐下、深蹲）和步态训练（跑步机和平行杆），同时佩戴 HAL 腰部类型。在干预前后测量 10 米常用和最大步行速度、计时起立行走测试结果、5 次椅子站立测试结果、5 项老年运动功能量表（GLFS-5）评分、体脂肪百分比和肌肉质量，并使用意向治疗法进行分析。
干预组（23%为男性；平均年龄 74.7±4.7 岁）和对照组（21%为男性；平均年龄 75.1±4.1 岁）在基线特征上无显著差异。77 名参与者完成了该计划；2 名因个人原因退出。组间主要结局（常用步行速度）的平均差异（标准误差）为 0.35（0.04）m/s；时间-组交互作用有统计学意义（p<0.001）。干预组的次要结局（最大步行速度、计时起立行走测试结果、5 次椅子站立测试结果和 GLFS-5 评分）均显著改善。两组的身体成分均无变化。
HAL 腰部类型的 5 周运动计划是一种有前途的选择，适用于不需要护理的活动受限的社区居住老年人，可在短时间内显著改善大多数身体功能。
