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

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          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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          Most cited references 49

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          Balance disorders in the elderly.

          Good balance is an imperative skill for daily life that requires the complex integration of sensory information regarding the position of the body relative to the surroundings and the ability to generate appropriate motor responses to control body movement. Balance calls upon contributions from vision, vestibular sense, proprioception, muscle strength and reaction time. With increased age, there is a progressive loss of functioning of these systems which can contribute to balance deficits. Balance disorders represent a growing public health concern due to the association with falls and fall-related injuries, particularly in regions of the world in which high proportions of the population are elderly. Falls present one of the most serious and costly problems associated with older adulthood. Falls can mark the beginning of a decline in function and independence and are the leading cause of injury-related hospitalisation in older people. One in three people over the age of 65 years who are living in the community experience at least one fall each year and 10-15% of these falls are associated with serious injury. In economic terms, the direct and indirect costs associated with falls are large and will grow as the proportion of older people increases. Consequently, understanding age-related changes in the physiological systems imperative to balance is of utmost importance to prevent falls in older people and reduce the injury-related burden on individuals and society.
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            Lower Extremity Exoskeletons and Active Orthoses: Challenges and State-of-the-Art

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              Adherence to exercise programs for older people is influenced by program characteristics and personal factors: a systematic review.

              How has adherence been measured in recent prospective studies focusing on adherence to exercise programs among older people? What is the range of adherence rates? Which factors are associated with better adherence?
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                Author and article information

                Contributors
                elena.martini@santannapisa.it
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                9 May 2019
                9 May 2019
                2019
                : 9
                Affiliations
                [1 ]ISNI 0000 0004 1762 600X, GRID grid.263145.7, The BioRobotics Institute, , Scuola Superiore Sant’Anna, ; Pisa, Italy
                [2 ]ISNI 0000 0001 1090 9021, GRID grid.418563.d, Fondazione Don Carlo Gnocchi, ; Milan, Italy
                [3 ]ISNI 0000 0001 1940 4177, GRID grid.5326.2, Institute of Clinical Physiology, , National Research Council, ; Pisa, Italy
                Article
                43628
                10.1038/s41598-019-43628-2
                6509339
                31073188
                © The Author(s) 2019

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                Funding
                Funded by: FundRef https://doi.org/10.13039/100007368, Fondazione Pisa (Pisa Foundation);
                Award ID: prog. 154/11
                Award ID: prog. 154/11
                Award ID: prog. 154/11
                Award ID: prog. 154/11
                Award ID: prog. 154/11
                Award ID: prog 154/11
                Award ID: prog. 154/11
                Award ID: prog. 154/11
                Award ID: prog. 154/11
                Award Recipient :
                Funded by: FundRef https://doi.org/10.13039/501100000780, European Commission (EC);
                Award ID: 287894
                Award ID: 731931
                Award ID: 287894
                Award ID: 731931
                Award ID: 287894
                Award ID: 731931
                Award ID: 287894
                Award ID: 731931
                Award ID: 287894
                Award ID: 731931
                Award ID: 287894
                Award ID: 731931
                Award ID: 287894
                Award ID: 731931
                Award ID: 287894
                Award ID: 731931
                Award ID: 287894
                Award ID: 731931
                Award Recipient :
                Categories
                Article
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                © The Author(s) 2019

                Uncategorized

                biomedical engineering, geriatrics

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