Metabolic Power

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What it means is that the more we become personally empowered, the more The gait of the elderly is typically characterized by short step length, slow walking velocity, reduced range of joint motion, and reduced balance [ 7 ].

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These characteristics increase the risk of falls and unnecessary walking energy expenditure [ 22 ]. Furthermore, elderly adults were dependents on the higher metabolic energy expenditure during stair ascent than level walking [ 26 ]. Several studies have suggested that degradation in physical function in the elderly, such as decreased sense of balance and loss of muscle strength, might be related to increase in metabolic energy expenditure [ 24 , 27 ].

Waters et al. Also, several studies reported that decline in step length and gait speed contributed to increase in metabolic energy expenditure in elderly adults [ 24 , 29 ]. As reported several studies, the increase in metabolic energy expenditure in elderly adults is related to gait function. The result of our study found that the net metabolic energy expenditure reduction was about In the other hand, a recent study using hip-assist soft exoskeleton reported reduction of net metabolic energy expenditure by Therefore, further studies are needed to directly compare the effect of different robotic devices on metabolic energy expenditure for diverse ADL conditions in elderly adults.

Also, this study observed the metabolic power of climbing stairs to compare walking efficiency between assistive gait with the GEMS and free gait without the GEMS.

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  4. The calculated net metabolic power, which is based on the measured oxygen consumption VO 2 and carbon dioxide emission VCO 2 values, was The present results indicate that the assistance of the GEMS during stair ascent influences walking efficiency, with a reduction of Thus, the GEMS aids elderly adults in using metabolic energy more efficiently during stair ascent. From these results, we suggest that the reduction in metabolic energy expenditure caused by the aid of the GEMS on stair climbing might closely relate to the reduction of muscles activation or improvement of gait function in elderly adults.

    Recently, various kinds of wearable-type walking assist robots that provide assistance torque around the hip, knee, and ankle joints have been developed for energy-efficient walking and improvement in gait function in elderly adults and patients with gait impairment. Previous studies have reported the effects of other walking assist devices on gait function and metabolic efficiency during walking. Some energy expenditure effects of the wearable hip assist devices were reported even in young adults.

    Young et al. Additionally, Ding et al. There are many differences between these previous studies and the present study. Also, previous studies compared net metabolic power between power-on and power-off conditions both with the walking assist device attached in order to reduce the advantage of free gait without the device load. The METs are a physiological measure expressing the energy expenditure of physical activities and is defined as the ratio of metabolic rate during a specific physical activity to resting metabolic rate, which is an oxygen consumption at rest of approximately 3.

    As such, the physical activity at 3 METs demands three times a resting oxygen consumption of approximately 3. Therefore, the results from the present study indicate that use of the GEMS has a substantial benefit on reduction in metabolic energy expenditure during stair climbing in elderly adults. This study has a limitation. Participants of our study had relatively good functional status and elderly people with severe gait disorder were not involved. For this sub-population, who have limitations in muscle power or postural stability for independent walking or stair climbing, further study is needed to assess the clinical effects of the GEMS on efficiency of walking or stair climbing.

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    In this study, we found that the GEMS, which is a newly developed wearable hip assist robot designed to improve gait function and metabolic efficiency, is helpful for reducing cardiopulmonary metabolic energy expenditure during stair ascent in elderly adults.

    Therefore, elderly adults may experience more endurance in stair climbing while using the GEMS. Pain, fear of falling and stair climbing ability in patients with knee osteoarthritis before and after knee replacement: 6 month follow-up study. J Back Musculoskelet Rehabil. Physical and psychological factors associated with stair negotiation performance in older people. Journal of neuroengineering and rehabilitation. Energy cost of stair climbing and descending on the college alumnus questionnaire. Med Sci Sports Exerc.

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    Br J Sports Med. Effects of a robotic walking exercise on walking performance in community-dwelling elderly adults. Geriatr Gerontol Int. A wearable hip assist robot can improve gait function and cardiopulmonary metabolic efficiency in elderly adults. Experimental evaluation of energy efficiency for a soft wearable robotic suit. Exoskeleton plantarflexion assistance for elderly. Gait performance and foot pressure distribution during wearable robot-assisted gait in elderly adults. Foley M, Bowen B.

    Comparison of metabolic cost and cardiovascular response to stair ascending and descending with walkers and canes in older adults. Arch Phys Med Rehabil. Predictive value of the short physical performance battery following hospitalization in older patients.

    IEEE; — Reproducibility evaluation of gross and net walking efficiency in children with cerebral palsy. Zuntz N. Metabolic cost of generating muscular force in human walking: insights from load-carrying and speed experiments. J Appl Physiol. DeVita P, Hortobagyi T. Age causes a redistribution of joint torques and powers during gait. Gait biomechanics, spatial and temporal characteristics, and the energy cost of walking in older adults with impaired mobility. Phys Ther. Effects of age and physical activity status on the speed-aerobic demand relationship of walking. Waters R, Lunsford B.

    Energy expenditure of normal and pathological gait: application to orthotic prescription. Atlas of orthotics. Comparisons of energy cost and economical walking speed at various gradients in healthy, active younger and older adults. J Exerc Sci Fit. Energy cost of walking and gait instability in healthy and yr-olds. Comparable energy expenditure after arthrodesis of the hip and ankle. Donelan JM, Kram R.

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    Mechanical and metabolic determinants of the preferred step width in human walking. Human-in-the-loop optimization of exoskeleton assistance during walking.

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    Influence of power delivery timing on the energetics and biomechanics of humans wearing a hip exoskeleton. Frontiers in Bioengineering and Biotechnology. Biomechanical and physiological evaluation of multi-joint assistance with soft exosuits. Metabolic cost of daily activities and effect of mobility impairment in older adults. J Am Geriatr Soc. Energy expenditures for activities of daily living in Korean young adults: a preliminary study.

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    Ann Rehabil Med. Download references. DSK and HJL contributed to experimental design, experimental progress, data analysis and drafting the manuscript. SHL contributed to setting up the experiment and collecting data. WHC contributed to experimental design, data analysis and data interpretation.

    JWJ contributed to developing the device and the algorithm, and providing device maintenance and repairs.