Effect of Exercise Using an Exoskeletal Hip-Assist Robot on Physical Function and Walking Efficiency in Older Adults

Abstract

Robotic technology has developed rapidly in recent years, and several robotic devices have been applied to improve physical, sensory, intellectual, psychological, and social functioning in the elderly and people with disabilities. In this study, we investigated the effects of EX1-assisted exercise in various environments on physical function, muscle strength, and walking efficiency in older adults. We designated four experimental conditions and randomly assigned participants to one of four groups: A (overground walking without an EX1), B (overground walking using the resistance mode of EX1), C (stair ascent using the assistance mode of EX1), and Group D (inclined treadmill walking using the assistance mode of EX1). A total of 60 community-dwelling elderly persons participated in 10 exercise intervention sessions for 4 weeks, and all participants were assessed before and after the exercise intervention. Physical function was measured by the 10-meter walk test for self-selected velocity (10MWT-SSV), short physical performance battery (SPPB), Berg balance scale (BBS), timed up and go (TUG), functional reach test (FRT), geriatric depression scale—short form (GDS-SF), and muscle strength of trunk and lower extremity. Cardiopulmonary metabolic energy efficiency was measured using a portable telemetric gas analyzer system. A significant increase in the 10MWT-SSV and TUG test was observed in groups B, C, and D. A statistically significant improvement in the SPPB and FRT was seen only in group D, and GDS-SF scores decreased significantly after exercise with an EX1 in groups B and D. Trunk and lower limb muscle strength increased more in the groups that exercised with EX1 assistance than those without an EX1, particularly in group B. The net metabolic energy costs and energy expenditure measurement during walking significantly improved in exercise groups C and D. The findings in this study support the application of the EX1 to physical activity and exercise to improve age-related changes in physical function, muscle strength, and walking efficiency among older adults. In addition, personalized exercise programs using different modes and training environments with an EX1 can enhance physical performance and walking efficiency in the elderly.

A State-of-the-Art of Exoskeletons in Line with the WHO’s Vision on Healthy Aging: From Rehabilitation of Intrinsic Capacities to Augmentation of Functional Abilities

“…A total of 22.2% of the included studies had a poor quality [32][33][34][35][36][37][38][39], 55.5% had a fair quality [24,[40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58] and 22.2% had a good quality [59][60][61][62][63][64][65][66] [Appendix B].…”

“…The included studies consisted of retrospective, prospective interventional, or observational research conducted in single or multi-center settings [Supplementary Materials (Tables S1-S3)]. A total of 17 studies investigated functional abilities [33,34,36,42,46,47,49,51,53,54,56,57,[59][60][61]63,65] [Table S1 in Supplementary Material], 23 investigated IC [32][33][34][35][36][37]42,45,47,49,50,52,53,[55][56][57][58][59][60][61][62][63]65] [Table S2 in Supplementary Material], and 26 investigated performance indicators [24,33,[35][36][37][38]…”

“…These studies covered a range of conditions, with ten investigating LLE use in patients with stroke [24,45,46,51,54,56,59,[63][64][65], four focusing on patients with Parkinson's Disease (PD) [38,58,60,61], two examining patient cohorts with various other neurological conditions [50,52], three centered on patients with osteoarthritis [42,53,57], and one each for hip fracture [34], sarcopenia [49], and depression [55]. Additionally, there were 14 studies involving healthy older adults [32,33,[35][36][37][39][40][41]43,44,47,48,62,66] [Supplementary Materials (Tables S1-S3)].…”

The Effects of Exercising on Psychological Well-Being in Older Adults

“…Exercises could be land-based or waterbased [12]. Some may even use exoskeletal robots in disabled individuals [13], virtual reality-based systems [14] or isokinetic systems [15]. Researchers have studied various types of exercises in older adults [16][17][18][19][20].…”

Morphological Changes in Quadriceps Muscles through 3-Week Combined Exercise using a Wearable Robot (EX1) in Young Adult

“…Samsung Electronics Co., Ltd. (Suwon, Republic of Korea) has developed a lightweight, personalizable robot named EX1that can be worn on the hip joint. A previous study employed EX1 to examine the impact of EX1-assisted exercise in different environments on the physical function, muscle strength, and walking efficiency of older adults [36]. According to the study's findings, utilizing EX1 during exercise in diverse settings provides multiple benefits in terms of physical function, muscle strength, and cardiopulmonary metabolic energy efficiency for older adults.…”