Cho Eunhee, Hwang Sinwoo, Heo Seok-Jae, Lim Bokman, Lee Jewoo, Lee Younbaek
Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea.
College of Nursing, Graduate School, Yonsei University, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul, 03722, Republic of Korea, 82 10-3721-7432.
JMIR Mhealth Uhealth. 2025 May 26;13:e58142. doi: 10.2196/58142.
Two-thirds of people aged 65 years and older may require help with daily activities such as eating, bathing, and getting in and out of bed or a chair. Walking-assist wearable robots have shown significant improvements in physical function in controlled settings for patients.
In this study, we aimed to assess the feasibility and the effect of a gait assistance and gait resistance training program using a walking-assist wearable robot for community-dwelling older adults.
A total of 23 community-dwelling older adults aged 65 years and older (30 participants recruited, 7 dropped out) enrolled in a 12-session, 6-week gait assistance and gait resistance training program using a walking-assist wearable robot. A single-group, pre- and posttest design was employed to evaluate the feasibility based on program adherence and effectiveness. The primary and secondary outcomes for evaluating effectiveness were walking speed and functional performance, respectively.
Regarding the feasibility, the average number of sessions attended was 11.7 out of 12, indicating a mean adherence rate of 97.8%. Linear mixed model analysis revealed significant improvements in walking speed and functional performance at the end of the program compared with baseline. Specifically, the walking speed measured using the 10-Meter Walk Test, which includes self-selected velocity and fastest safe velocity, improved by a mean of 0.15 (SD 0.13) m/s (P<.001) and 0.15 (SD 0.17) m/s (P<.001), respectively. Functional performance also improved, with faster performance in Timed Up-and-Go (mean -0.63, SD 0.92 s; P=.003) and Four Square Step Test (mean -1.71, SD 1.64 s; P≤.001). Leg muscle strength increased across all measured domains, including plantarflexion (mean +7.29, SD 4.92; P=.004), hip adduction (mean +3.03, SD 2.73; P≤.001), hip extension (mean +2.63, SD 2.50; P≤.001), knee extension (mean +2.33, SD 3.12; P≤.001), knee flexion (mean +2.19, SD 2.17; P≤.001), dorsiflexion (mean +2.10, SD 3.06; P≤.001), hip abduction (mean +1.59, SD 1.92; P=.002), and hip flexion (mean +0.90, SD 1.56; P≤.001).
This study stands out for applying gait assistance and resistance training across various terrains, unlike previous studies that only tested gait assistance in controlled environments. The results demonstrated significant improvements in walking speed and functional performance in older adults, suggesting the effectiveness of preventive health care services using a walking-assist wearable robot as an intervention that can contribute to improving independent functioning and frailty among community-dwelling older adults.
三分之二的65岁及以上老年人在诸如进食、洗澡以及上下床或椅子等日常活动中可能需要帮助。步行辅助可穿戴机器人已在针对患者的受控环境中显示出身体功能的显著改善。
在本研究中，我们旨在评估使用步行辅助可穿戴机器人对社区居住的老年人进行步态辅助和步态阻力训练计划的可行性及效果。
共有23名65岁及以上的社区居住老年人（招募了30名参与者，7名退出）参加了一项为期12节、为期6周的使用步行辅助可穿戴机器人的步态辅助和步态阻力训练计划。采用单组前后测设计，基于计划依从性和有效性来评估可行性。评估有效性的主要和次要结果分别是步行速度和功能表现。
关于可行性，参加的平均节数为12节中的11.7节，表明平均依从率为97.8%。线性混合模型分析显示，与基线相比，计划结束时步行速度和功能表现有显著改善。具体而言，使用10米步行测试测量的步行速度，包括自选速度和最快安全速度，分别平均提高了0.15（标准差0.13）米/秒（P<0.001）和0.15（标准差0.17）米/秒（P<0.001）。功能表现也有所改善，定时起立行走测试（平均 -0.63，标准差0.92秒；P = 0.003）和四方步测试（平均 -1.71，标准差1.64秒；P≤0.001）的表现更快。在所有测量领域，腿部肌肉力量均有所增加，包括跖屈（平均 +7.29，标准差4.92；P = 0.004）、髋关节内收（平均 +3.03，标准差2.73；P≤0.001）、髋关节伸展（平均 +2.63，标准差2.50；P≤0.001）、膝关节伸展（平均 +2.33，标准差3.12；P≤0.001）、膝关节屈曲（平均 +2.19，标准差2.17；P≤0.001）、背屈（平均 +2.10，标准差3.06；P≤0.001）、髋关节外展（平均 +1.59，标准差1.92；P = 0.002）和髋关节屈曲（平均 +0.90，标准差1.56；P≤0.001）。
与以往仅在受控环境中测试步态辅助的研究不同，本研究在各种地形上应用步态辅助和阻力训练。结果表明老年人的步行速度和功能表现有显著改善，这表明使用步行辅助可穿戴机器人作为一种干预措施的预防性医疗服务的有效性，有助于改善社区居住老年人的独立功能和虚弱状况。
