Mobility related physical and functional losses due to aging and disease - a motivation for lower limb exoskeletons.
Martin Grimmer, Robert Riener, Conor James Walsh and 1 others
PMID 30606194WHAT IT FOUND
Aging and disease reduce lower limb strength, power, walking speed, endurance and daily steps, while falls rise.
Exoskeletons are proposed to assist or train mobility, not shown to work.
Key findings
01From age 25 to 75 years, lower limb muscle force decreases by 31% in males and 34% in females, and lower limb extensor power decreases by 50% in males and 47% in females.
02Between ages 60 and 85, mean steps per day decrease by 71% to 80% for males and females, and falls per number of steps taken per day are approximately 800% higher for older adults compared with young adults.
03The authors propose exoskeletons as possible assistive devices for daily mobility, training and rehabilitation, but state that how assistance levels affect users' physical capabilities is unknown and more development is needed.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a narrative review of selected articles, not a systematic review or original patient study, so the findings are not a tested treatment effect. The losses are from specific study samples and may not apply to patients with different income, education, ethnicity, sex or age. For impaired populations, many examples came from single studies, so one study may not represent all patients with that disease. Age comparisons use different ranges, and some trends were fitted with straight lines that may hide non-linear changes. Exoskeleton benefits are proposed; the paper says it is unknown how assistance levels affect users' physical capabilities.
Declared interests
Funded by H2020 European Research Council, Robert Bosch Stiftung, Deutsche Forschungsgemeinschaft, and Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung. The supplied text does not list author competing interests.
The easy way to misread this
Do not read this review as evidence that exoskeletons improve mobility. It summarizes age and disease losses and proposes exoskeletons, but it does not test them in patients.