Optimizing exoskeleton assistance to improve walking speed and energy economy for older adults.
Ava Lakmazaheri, Seungmoon Song, Brian B Vuong and 3 others
PMID 38167151WHAT IT FOUND
Ten healthy older adults walked faster and used less energy with personalized ankle exoskeleton assistance.
The speed increase met clinical thresholds for meaningful change. However, participants required extensive training to adapt, and the device was tethered to a lab computer.
Key findings
01Personalized exoskeleton assistance increased self-selected walking speed by 7.8% and decreased metabolic cost by 19.2% compared to zero-torque assistance.
02The 0.10 m/s increase in walking speed meets the clinical threshold for meaningful change in older adults.
03Participants had not fully adapted to the exoskeleton after four hours of training, with step frequency variability remaining 42% above baseline.
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
The sample size was very small (n=10) and restricted to highly active, healthy older adults with fast baseline walking speeds, so results do not apply to frail or sedentary populations. The exoskeleton was tethered to an off-board computer; the weight and bulk of a portable, battery-powered version were not tested. Participants did not fully adapt to the device during the study, meaning the reported benefits might be underestimates of what is possible with longer training. Psychological factors, such as the desire to perform well, may have influenced walking speed in the validation trials.
Declared interests
The authors declared no competing interests. The work was supported by the National Institutes of Health and the National Science Foundation.
The easy way to misread this
Do not assume these benefits are immediately available with a commercial portable exoskeleton. The study used a tethered emulator, and when the device's weight was included in the comparison to normal shoes, the improvements were not statistically significant.