Feasibility and Effects of a Gait Assistance and Gait Resistance Training Program Using a Walking-Assist Wearable Robot for Community-Dwelling Older Adults: Single-Group, Pre-, and Posttest Study

Abstract

Background: Two-thirds of people aged 65 years and older may require help with daily activities such as eating, bathing, and getting in and out of bed or a chair. Walking-assist wearable robots have shown significant improvements in physical function in controlled settings for patients.

Objective: In this study, we aimed to assess the feasibility and the effect of a gait assistance and gait resistance training program using a walking-assist wearable robot for community-dwelling older adults.

Methods: A total of 23 community-dwelling older adults aged 65 years and older (30 participants recruited, 7 dropped out) enrolled in a 12-session, 6-week gait assistance and gait resistance training program using a walking-assist wearable robot. A single-group, pre- and posttest design was employed to evaluate the feasibility based on program adherence and effectiveness. The primary and secondary outcomes for evaluating effectiveness were walking speed and functional performance, respectively.

Results: Regarding the feasibility, the average number of sessions attended was 11.7 out of 12, indicating a mean adherence rate of 97.8%. Linear mixed model analysis revealed significant improvements in walking speed and functional performance at the end of the program compared with baseline. Specifically, the walking speed measured using the 10-Meter Walk Test, which includes self-selected velocity and fastest safe velocity, improved by a mean of 0.15 (SD 0.13) m/s (P<.001) and 0.15 (SD 0.17) m/s (P<.001), respectively. Functional performance also improved, with faster performance in Timed Up-and-Go (mean -0.63, SD 0.92 s; P=.003) and Four Square Step Test (mean -1.71, SD 1.64 s; P≤.001). Leg muscle strength increased across all measured domains, including plantarflexion (mean +7.29, SD 4.92; P=.004), hip adduction (mean +3.03, SD 2.73; P≤.001), hip extension (mean +2.63, SD 2.50; P≤.001), knee extension (mean +2.33, SD 3.12; P≤.001), knee flexion (mean +2.19, SD 2.17; P≤.001), dorsiflexion (mean +2.10, SD 3.06; P≤.001), hip abduction (mean +1.59, SD 1.92; P=.002), and hip flexion (mean +0.90, SD 1.56; P≤.001).

Conclusions: This study stands out for applying gait assistance and resistance training across various terrains, unlike previous studies that only tested gait assistance in controlled environments. The results demonstrated significant improvements in walking speed and functional performance in older adults, suggesting the effectiveness of preventive health care services using a walking-assist wearable robot as an intervention that can contribute to improving independent functioning and frailty among community-dwelling older adults.