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How Adaptive Ankle Exoskeleton Assistance Affects Stability During Perturbed and Unperturbed Walking in the Elderly

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Abstract

Slowing the decline in walking mobility in the elderly is critical for maintaining the quality of life. Wearable assistive devices may 1 day facilitate mobility in older adults; however, we need to ensure that such devices do not impair stability in this population that is predisposed to fall-related injuries. This study sought to quantify the effects of untethered ankle exoskeleton assistance on measures of stability, whole-body dynamics, and strategies to maintain balance during normal and perturbed walking in older adults. Eight healthy participants (69–84 years) completed a treadmill-based walking protocol that included perturbations from unexpected belt accelerations while participants walked with and without ankle exoskeleton assistance. Exoskeleton assistance increased frontal plane range of angular momentum (8–14%, p ≤ 0.007), step width (18–34%, p ≤ 0.006), and ankle co-contraction (21–29%, p ≤ 0.039), and decreased biological ankle moment (16–27%, p ≤ 0.001) during unperturbed and perturbed walking; it did not affect the anteroposterior margin-of-stability, step length, trunk variability, or soleus activity during unperturbed and perturbed walking. Our finding that ankle exoskeleton assistance did not affect the anteroposterior margin-of-stability supports additional investigation of assistive exoskeletons for walking assistance in the elderly.

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Acknowledgements

This work was supported in part by Mary M. Winn-Radcliff and Gregory M. Winn through the Northern Arizona University Foundation. The authors thank Karl Harshe, Greg Orekhov, and Leah Liebelt for their assistance with this study.

Funding

Funding was provided by Northern Arizona University.

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Authors and Affiliations

  1. Department of Mechanical Engineering, Northern Arizona University, Flagstaff, AZ, 86011, USA

    Ying Fang & Zachary F. Lerner

  2. Department of Physical Therapy, Rosalind Franklin University of Medicine and Science, North Chicago, IL, 60064, USA

    Ying Fang

  3. Department of Orthopedics, The University of Arizona College of Medicine-Phoenix, Phoenix, AZ, 85004, USA

    Zachary F. Lerner

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  1. Ying Fang
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Correspondence to Zachary F. Lerner.

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Conflict of interest

ZFL is a named inventor on awarded patents and pending utility patent applications that cover the aspects of the robotic device utilized in the study. He is also a co-founder of a company seeking to commercialize the device.

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Associate Editor Stefan M. Duma oversaw the review of this article.

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Fang, Y., Lerner, Z.F. How Adaptive Ankle Exoskeleton Assistance Affects Stability During Perturbed and Unperturbed Walking in the Elderly. Ann Biomed Eng 51, 2606–2616 (2023). https://doi.org/10.1007/s10439-023-03310-1

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