Exercises utilizing the Hybrid Assistive Limb lumbar type to prevent frailty: a randomized controlled trial

Saito, Yoshinobu; Sho Nakamura; Takashi Kasukawa; Makoto Nagasawa; Yuko Oguma; Hiroto Narimatsu

doi:10.51094/jxiv.622

##article.authors##

Saito, Yoshinobu Faculty of Sport Management, Nippon Sport Science University
Sho Nakamura Graduate School of Health Innovation, Kanagawa University of Human Services
Takashi Kasukawa Shonan Robocare Center
Makoto Nagasawa Graduate School of Health Innovation, Kanagawa University of Human Services
Yuko Oguma Sports Medicine Research Center, Keio University
Hiroto Narimatsu Cancer Prevention and Control Division, Kanagawa Cancer Center Research Institute

DOI:

https://doi.org/10.51094/jxiv.622

キーワード:

biofeedback、 exercise、 frailty、 Hybrid Assistive Limb、 physical function、 sarcopenia

抄録

Background: Sarcopenia and frailty often worsen in older adults because of declines in activities of daily living and social connections that are associated with chronic diseases and traumatic injuries such as falls and fractures. Exercise intervention for sarcopenia can take more than three months to improve muscle mass, muscle strength, and walking speed. Thus, a specialized intervention system for shorter periods of time is needed. This study aimed to examine the short-term efficacy of an exercise program utilizing the wearable cyborg Hybrid Assistive Limb (HAL) lumbar type on physical function and frailty prevention.

Methods: This randomized, single-blind, parallel-group study involved 79 community-dwelling older adults with physical frailty or locomotive syndrome assigned to an intervention group (40) with the HAL lumbar type exercise program or a control group (39) without the exercise program. The intervention group underwent trunk training (including trunk and hip flexion, standing and sitting from a single sitting position, and squats) and gait training (treadmill and parallel bars) twice a week for 5 weeks while wearing the HAL lumbar type. The 10-m usual and maximum walking speeds, Timed Up and Go test, 5-times chair-standing test, 5-question Geriatric Locomotive Function Scale (GLFS-5), body-fat percentage, and muscle mass were measured before and after the intervention and analyzed using the intention-to-treat method.

Results: The intervention (23% male; mean age, 74.7±4.7 years) and control (21% male; mean age, 75.1±4.1 years) groups did not differ significantly in baseline characteristics. Seventy-seven participants completed the program; two withdrew for personal reasons. The mean difference (standard error) between the groups for the primary outcome (usual walking speed) was 0.35 (0.04) m/s; the time-by-group interaction was significant (p<0.001). Secondary outcomes (maximum walking speed, Timed Up and Go test, 5-times chair-standing test, and GLFS-5) were significantly improved in the intervention group. Body composition was unchanged in both groups.

Conclusions: In community residents with physical frailty and locomotive syndrome not requiring nursing care, a 5-week exercise program using the HAL lumbar type is a promising option for frailty prevention, improving physical function and resulting in clinically meaningful improvements in most physical functions over a short time period.

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The authors declare that they have no competing interests.

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