A wearable hip-assist robot reduces the cardiopulmonary metabolic energy expenditure during stair ascent in elderly adults: a pilot cross-sectional study

Dong-Seok Kim, Hwang-Jae Lee, Su-Hyun Lee, Won Hyuk Chang, Junwon Jang, Byung-Ok Choi, Gyu-Ha Ryu, Yun-Hee Kim, Dong-Seok Kim, Hwang-Jae Lee, Su-Hyun Lee, Won Hyuk Chang, Junwon Jang, Byung-Ok Choi, Gyu-Ha Ryu, Yun-Hee Kim

Abstract

Background: Stair ascent is one of the most important and challenging activities of daily living to maintain mobility and independence in elderly adults. Recently, various types of wearable walking assist robots have been developed to improve gait function and metabolic efficiency for elderly adults. Several studies have shown that walking assist robots can improve cardiopulmonary metabolic efficiency during level walking in elderly. However, there is limited evidence demonstrating the effect of walking assist robots on cardiopulmonary metabolic efficiency during stair walking in elderly adults. Therefore, the aim of this study was to investigate the assistance effect of a newly developed wearable hip assist robot on cardiopulmonary metabolic efficiency during stair ascent in elderly adults.

Methods: Fifteen healthy elderly adults participated. The Gait Enhancing Mechatronic System (GEMS), developed by Samsung Electronics Co., Ltd., Korea, was used in the present study. The metabolic energy expenditure was measured using a K4b2 while participants performed randomly assigned two conditions consecutively: free ascending stairs without the GEMS or robot-assisted ascending stair with the GEMS.

Results: There were significant differences in the oxygen consumption per unit mass (ml/min/kg), metabolic power per unit mass (W/kg) and metabolic equivalents (METs) values between the GEMS and NoGEMS conditions. A statistically significant difference was found between the two conditions in net oxygen consumption and net metabolic power, with a reduction of 8.59% and 10.16% respectively in GEMS condition (p < 0.05). The gross oxygen consumption while climbing stairs under the GEMS and NoGEMS conditions was equivalent to 6.38 METs and 6.85 METs, respectively.

Conclusion: This study demonstrated that the GEMS was helpful for reducing cardiopulmonary metabolic energy expenditure during stair climbing in elderly adults. The use of the GEMS allows elderly adults to climb stairs with less metabolic energy, therefore, they may experience more endurance in stair climbing while using the GEMS.

Trial registration: NCT03389165 , Registered 26 December 2017 - retrospectively registered.

Keywords: Elderly adult; Metabolic energy expenditure; Stair ascent; Wearable hip assist robot.

Conflict of interest statement

Ethics approval and consent to participate

All participants were briefed on the experimental procedure, and written consents were collected from all participants before the experiment. This study protocol was approved by the ethics committee of the Samsung Medical Center Institutional Review Board.

Consent for publication

Figure 1 contained in this manuscript have been agreed by the individual of the image.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

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Figures

Fig. 1
Fig. 1
Gait Enhancing Mechatronic System (GEMS)
Fig. 2
Fig. 2
Phases of the gait cycle divided into 4 as follows: foot contact to pull-up (FC-PU), pull-up to hip crossing (PU-HC), hip crossing to peak joint angle of a swing leg (HC-PJA), and peak joint angle of a swing leg to foot contact (PJA-FC), and 2 events (PU and PJA) used as initiation and termination criterion of assistance torque for the desired assistance duration, respectively. FC = Foot Contact, PU = Pull Up, HC = Hip Crossing, PJA = Peak Joint Angle
Fig. 3
Fig. 3
a) Comparison of average net oxygen consumption per unit mass (ml/min/kg) under the NoGEMS and GEMS conditions (* p < 0.05). b) Comparison of average net metabolic power per unit mass (W/kg) under the NoGEMS and GEMS conditions (* p < 0.05). c) Comparison of average metabolic equivalents (METs) values under the NoGEMS and GEMS conditions (* p < 0.05). d) Comparison of average stair climbing cadence (steps/min) under the NoGEMS and GEMS conditions (p = 0.388)

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