This study was a randomized controlled trial to examine the effects of the RAPAEL® Smart Glove digital training system on upper extremity function and cortical hemodynamic changes in subacute stroke patients. Of 48 patients, 20 experimental and 16 controls completed the study. In addition to conventional occupational therapy (OT), the experimental group received game-based digital hand motor training with the RAPAEL® Smart Glove digital system, while the control group received extra OT for 30 min. The Fugl-Meyer assessment (UFMA) and Jebsen-Tayler hand function test (JTT) were assessed before (T0), immediately after (T1), and four weeks after intervention (T2). Cortical hemodynamics (oxyhemoglobin [OxyHb] concentration) were measured by functional near-infrared spectroscopy. The experimental group had significantly better improvements in UFMA (T1-T0 mean [SD]; Experimental 13.50 [7.49]; Control 8.00 [4.44]; p = 0.014) and JTT (Experimental 21.10 [20.84]; Control 5.63 [5.06]; p = 0.012). The OxyHb concentration change over the ipsilesional primary sensorimotor cortex during the affected wrist movement was greater in the experimental group (T1, Experimental 0.7943 × 10−4 μmol/L; Control −0.3269 × 10−4 μmol/L; p = 0.025). This study demonstrated a beneficial effect of game-based virtual reality training with the RAPAEL® Smart Glove digital system with conventional OT on upper extremity motor function in subacute stroke patients.

Wearable assistive robotics has emerged as a promising technology to supplement or replace motor functions and to retrain people recovering from an injury or living with reduced mobility. We developed delayed output feedback control for a wearable hip-assistive robot, the EX1, to provide gait assistance. Our purpose in this study was to investigate the effects of long-term exercise with EX1 on gait, physical function, and cardiopulmonary metabolic energy efficiency in elderly people. This study used parallel experimental (exercise with EX1) and control groups (exercise without EX1). A total of 60 community-dwelling elderly persons participated in 18 exercise intervention sessions during 6 weeks, and all participants were assessed at 5 time points: before exercise, after 9 exercise sessions, after 18 sessions, and 1 month and 3 months after the last session. The spatiotemporal gait parameters, kinematics, kinetics, and muscle strength of the trunk and lower extremities improved more after exercise with EX1 than in that without EX1. Furthermore, the effort of muscles over the trunk and lower extremities throughout the total gait cycle (100%) significantly decreased after exercise with EX1. The net metabolic energy costs during walking significantly improved, and functional assessment scores improved more in the experimental group than in the control group. Our findings provide evidence supporting the application of EX1 in physical activity and gait exercise is effective to improve age-related declines in gait, physical function, and cardiopulmonary metabolic efficiency among older adults.

OBJECTIVES The purpose of this study was to investigate the effects of assist and resistance torque on the spatiotemporal gait characteristics, and the symmetry and asymmetry of gait using a Gait Enhancing and Motivating System (GEMS) in the elderly.METHODS A cross-sectional and repeated measure design was used. A total of 18 participants (9 males, 9 females; age: 63.5 ± 5.02 years; mass: 64.26 ± 6.87 kg; height: 164.06 ± 7.15 cm) were recruited from a local community, and spatiotemporal gait data were collected with OptoGait system and GEMS. Spatiotemporal gait variables and differences between the dominant and non-dominant legs of these variables were assessed (step length, step time, stance phase, swing phase, single support, load response, pre swing phase, stride time, stride length, double support, cadence, and gait speed). The effects of three modes including normal, assist, and resist modes using GEMS were investigated twice for each participant on a 9-meter walkway. A one-way repeated measure analysis of variance followed by Bonferroni post-hoc tests was conducted.RESULTS The assist mode increased step time, swing phase, stride time and reduced stance phase, pre-swing phase, double support, cadence, and gait speed as compared to normal mode. The resist mode increased stance phase, load response, pre-swing phase, double support, cadence, and reduced step time, swing phase, and stride time. In dominant leg, assist mode showed increased step time and reduced pre-swing phase than normal mode, and greater step time than resist mode (<i>p</i> < 0.05). However, there was no effect of external torque on symmetry and asymmetry between both legs (<i>p</i> > 0.05).CONCLUSIONS The resistance and assist torque of GEMS alter spatiotemporal characteristics during the stance and swing phase of gait in the elderly. However, the resistance torque and assist torque of GEMS did not increase or decrease the gait asymmetry between the dominant and non-dominant legs.

Demand for wearable devices and supportive technology is growing as these devices have the potential to enhance physical function and quality of life in users. The purpose of this study was to investigate usability and satisfaction after performing functional and gait exercise with a wearable hip exoskeleton in community-living adults. A total of 225 adults residing in the local community participated in this study. All participants performed 40 min of exercise once with a wearable hip exoskeleton in various environments. The EX1, which functions as a wearable hip exoskeleton, was used. Physical function was assessed before and after exercise with the EX1. After completing exercise with the EX1, the usability and satisfaction questionnaires were evaluated. Gait speed, timed up and go test (TUG), and four square step test (FSST) showed statistically significant improvements after exercise with the EX1 in both groups (p < 0.05). In the 6 min walking test (6MWT), a significant increase was observed in the middle-aged group (p < 0.05). In the short physical performance battery (SPPB), there was a significant improvement in the old-aged group (p < 0.05). On the other hand, positive results in usability and satisfaction were noticed in both groups. These results demonstrate that a single session of exercise with the EX1 was effective in improving physical performance of both middle- and old-aged adults, with positive feedback from most of the participants.

Objective:This study was conducted to analyze the effect of wearable complex muscle support system on energy efficiency during walking in elderly. Design: Cross sectional study Methods: Twenty healthy elderly participated in this study. All subjects performed a 6 minuteswalk test(6MWT) and stair climbing test in dual, slack and no suit conditions. In each condition, oxygen consumption(VO2), metabolic equivalents(METs), energy expenditure measures(EEm), physiological cost index(PCI), walking velocity and heartrate were measured. Through repeated measured ANOVA, it was investigated whether there was a statistically significant difference in the measurement results between the three conditions. Results: In over-ground walking, VO2, METs and EEm showed significant differences between no suit and slack conditions(p ＜0.05). In stair climbing, VO2 showed significant difference between slack and dual conditions(p＜0.05). Also, METs and EEm showed significant differences between no suit and slack, and between slack and dual conditions(p＜0.05). Conclusions: Wearing the wearable complex muscle support system for elderly does not have much benefit in energy metabolism efficiency in over-ground, but there is a benefit in stair walking.