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. 2019 May 9;9(1):7157.
doi: 10.1038/s41598-019-43628-2.

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

Elena Martini  1 , Simona Crea  2   3 , Andrea Parri  2 , Luca Bastiani  4 , Ugo Faraguna  4 , Zach McKinney  2 , Raffaello Molino-Lova  3 , Lorenza Pratali  4 , Nicola Vitiello  2   3
Affiliations

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

Elena Martini et al. Sci Rep. .

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.

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Conflict of interest statement

S.C., A.P. and N.V. have interests in a spin-off company (IUVO S.r.l.) which is the exclusive licensee of the APO technology. The other authors declare no competing interests.

Figures

Figure 1
Figure 1
Average MCoT at T0, TF and TU for the APO and the control groups. Stars mark statistically significant differences.
Figure 2
Figure 2
Individual Metabolic Cost of Transport results for the incremental tests repeated at T0, TF and TU. (IDs higher than 20 were assigned to the participants recruited after the exclusion of three subjects who did not meet the inclusion criteria).
Figure 3
Figure 3
(a) Average individual Oxygen uptake rates for the last two minutes of treadmill 6-minute Walk Test without the APO (CFW) and under the APO-active training condition (CRT). (IDs higher than 20 were assigned to the participants recruited after the exclusion of three subjects who did not meet the inclusion criteria). (b) Average Oxygen uptake rate (left) and Metabolic Power (right) for the APO group under treadmill walking without the APO (CFW) and under the training condition (CRT).
Figure 4
Figure 4
Right (dark grey) and left (light grey) angular, torque and power profiles of the APO under transparent mode (CTM) and training condition (CRT) for one sample subject.
Figure 5
Figure 5
Torque strategy of the APO. Based on literature data of hip muscular activation, flexor torque profiles were phased in order to assist the Rectus Femoris (hip flexor) contraction and resist the activation of the Gluteus Medius (hip extensor).
Figure 6
Figure 6
Schedule of the exercise and assessment sessions throughout the experimentation weeks.
See this image and copyright information in PMC

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