What Are the Effects of a Bilateral Hip Exoskeleton During Daily Use by 65+ Adults?
Condition: Pre-frail Senior Adults
Study type: Interventional

Summary: 
      Despite the huge popularity exoskeletons have gained in the past years and the benefits that
      they have shown to provide to users, there are still many aspects of wearing an exoskeleton
      that have yet to be determined. Therefore, the main objective of this study is to evaluate
      the feasibility using the acceptability of incorporating a passive assistive bilateral
      exoskeleton into the daily routine of pre-frail adults for a duration of 12-weeks. The second
      aim of the study is to determine whether this effect can be sustained even after a period of
      6-weeks following the cessation of usage.
    

Detailed description: 
      Despite the high benefits of performing physical activity in terms of physical and cognitive
      function, between 27-38% of Danish older adults do not meet the required physical activity
      recommendations. Due to the longer life expectancy, the increasingly older population will
      face gait disorders. These gait disorders will affect their motor and cognitive functions,
      and impair the performance of daily physical activity and overall quality of life. Frailty is
      one of the most frequent aging-related deficits observed in older adults, often characterized
      by three of the following criteria: unintentional weight loss >4.5 kg within the last year,
      exhaustion, loss or slower mobility, loss of grip strength, and low physical activity.
      However, pre-frail adults may present some of the aforementioned criteria and a score of ≤5
      on the Tilburg Frailty Indicator. Therefore, there is an increasing need to provide the aging
      population with devices capable of promoting physical activity and independent living.
      Exoskeletons have been shown to facilitate physical activity in the older adult population by
      improving metabolic costs, increasing walking speed, and preventing falls. However, whether
      these benefits are only temporary, or can be maintained over a longer period, remains to be
      determined. Therefore, it is of pivotal importance to assess the long-term effects of
      exoskeletons, in terms of mobility, within the older adult population.

      The use of external mechanical walking devices started in the late 1890s. However, only in
      the past two decades have gait-assisting exoskeletons, with increased human performance
      capability, gained popularity. Exoskeletons have been shown to reduce metabolic cost, and
      fatigue onset and increase walking velocity. Currently on the market, there are several
      lower-limb exoskeletons that target older populations and people with gait and neurological
      disabilities which are designed to enhance walking performance and reduce the muscle
      activation required during walking activities. Wearing gait-assisting exoskeletons can
      provide instant ease, delay fatigue onset, increase social engagement, and support
      rehabilitation to recover normal walking capabilities. The effects of hip exoskeletons have
      been previously investigated in terms of quality of life and improvement of gait performance.
      However, the effect of long-term use has yet to be assessed. Hence, this study aims to
      evaluate the impact of extended usage of a non-invasive passive hip exoskeleton on the
      quality of life of older adults. This will be achieved by analyzing the spatiotemporal gait
      characteristics in a feasibility study conducted over a 12-week period of consistent device
      usage. Additionally, the study aims to ascertain the persistence of these effects for a
      duration of 6 weeks post-usage.
    

Intervention name(s): Exoskeleton
Intervention type(s): Device
Intervention description(s): Use a passive assistive hip exoskeleton (alQ, Imasen Electrical Industrial Co., Ltd.) for 30 minutes daily during moderate to intensive activities over a period of 12-weeks. The exoskeleton is designed to aid hip flexion and as such its primary role is to improve gait by increasing step length and improving speed. The amount of time the exoskeleton has been used will be weekly monitored through phone calls and two gait sessions will be conducted to measure the development.
Intervention model: Single Group Assignment
Intervention model description: All participants will complete three test sessions:
An initial assessment (baseline)
A 4-week assessment and
A 12-week assessment.
Around 8-10 participants will be invited for a follow-up assessment 6-weeks post after the trial has ended.
All participants will be instructed to wear the device 30 minutes daily during moderate to intensive physical activities. They will be required to provide a weekly overview of their usage and experience with the device.
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: exoskeleton; aging; walking