Gait training using a robotic hip exoskeleton improves metabolic gait efficiency in the elderly

Abstract

Robotic exoskeletons are regarded as promising technologies for neurological gait rehabilitation but have been investigated comparatively little as training aides to facilitate active aging in the elderly. This study investigated the feasibility of an exoskeletal Active Pelvis Orthosis (APO) for cardiopulmonary gait training in the elderly. Ten healthy elderly volunteers exhibited a decreased (−26.6 ± 16.1%) Metabolic Cost of Transport (MCoT) during treadmill walking following a 4-week APO-assisted training program, while no significant changes were observed for a randomly assigned control group (n = 10) performing traditional self-paced overground walking. Moreover, robot-assisted locomotion was found to require 4.24 ± 2.57% less oxygen consumption than free treadmill walking at the same speed. These findings support the adoption of exoskeletal devices for the training of frail individuals, thus opening new possibilities for sustainable strategies for healthy aging.

Benchmarking Wearable Robots: Challenges and Recommendations From Functional, User Experience, and Methodological Perspectives

“…Energy expenditure is currently one of the most adopted metrics to assess the effectiveness of a WR. Reduced metabolic cost has been widely considered as valuable evidence of effective human-robot interaction, with several recent studies proving that such results can be achieved in several contexts, ranging from walking and running (Kim et al, 2019), elderly gait training (Martini et al, 2019), and to repetitive upper-limb assistance of workers (Maurice et al, 2019;Baltrusch et al, 2020;Koopman et al, 2020). Currently, to the author's knowledge, no studies have provided evidence that metabolic cost reductions could be reliably assessed in out-the-lab conditions, but worldwide many research teams are investigating this issue.…”

Activity-based training with the Myosuit: a safety and feasibility study across diverse gait disorders

“…To assist this more capable section of the population, more lightweight wearable robots (also known as "exosuits", "exomuscles" or "dermoskeletons") have been proposed [20][21][22][23][24]. Unlike exoskeletons that act on all leg joints, these devices allow for-and require-the active participation of the user, and can (partially) assist walking over a larger range of speeds [20,25].…”

“…More recently, we showed that this functional improvement also translates to an increase in exercise intensity and a momentary reduction of the energetic cost of transport [26]. In larger longitudinal studies, training with wearable robots acting on the hip joint was shown to result in an intrinsic reduction of the cost of transport for elderly individuals [23] and individuals following stroke [24].…”

Wireless Epidermal Electromyogram Sensing System

“…These diseases cause chronic discomfort in daily behavior and walking, and they pose a potential risk of causing unexpected situations such as falling while in motion or other accidents in daily life. As a result, there is a growing need to develop walking-assisting technologies for the disabled [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. To implement these platforms, the development of skin-attachable and stretchable sensors for detecting and monitoring muscle signals involved in ambulation is essential ( Figure 1).…”