Skip to main content
SpringerLink
Log in

The Effect of a Physical Training with the Use of an Exoskeleton on Depression Levels in Institutionalized Elderly Patients: A Pilot Study

  • Published:
The journal of nutrition, health & aging

Abstract

Context

The Human Body Posturizer (HBP) is an exoskeleton used in the neurorehabilitation. The HBP may improve motor control by stimulating the pre-frontal cortex, a brain region involved also in the inhibitory modulation of the amygdala whose hyperactivity is involved in the mechanisms of depression.

Objective

The aim of the study was to investigate in institutionalized elderly patients the effects on depression of a physical training with the use of the HBP compared to a traditional training.

Design

Randomized controlled trial.

Participants

20 institutionalized patients (mean age = 88, ds = ± 5, 3 males) with moderate depression levels.

Intervention

The participants were randomly assigned to: a) HBP Group, which carried out physical training using the HBP; b) Excercise Group, which carried out a training without the use of the orthosis. The training was conducted for 6 months (3 sessions each week), with the same kind of exercises with or without the HBP according to the assignment group.

Measurements

Participants were evaluated at baseline using the Tinetti balance and Gait scale, the Mini Mental State Examination and the Geriatric Handicap Scale. The Geriatric Depression Scale was administered to the participants before and after the period of training. RESULTS: The two groups were homogeneous for age, baseline motor ability (risk falls), handicap score, cognitive functioning and depression levels. After 6 months of exercise training a significant reduction in depression levels was reported only in the HBP Group (p <.01).

Conclusions

A positive effect of the HBP in the modulation of mood in institutionalized elderly subjects was found. It is possible to hypothesis that a traditional training without the HBP may require more time to achieve significant results. Clinical implications will be discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Graphic 1
Table 1
Figure 1

Similar content being viewed by others

References

  1. Jerez-Roig J, de Oliveira NP, de Lima Filho BF et al. Depressive Symptoms and Associated Factors in Institutionalized Elderly. Exp Aging Res; 2016;42(5):479–491.

    Article  PubMed  Google Scholar 

  2. Kirsch I, Deacon BJ, Huedo-Medina TB, et al. Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Med; 2008;5(2):45.

    Article  Google Scholar 

  3. Fournier JC, DeRubeis RJ, Hollon SD et al. Antidepressant Drug Effects and Depression Severity. A Patient-Level Meta-analysis. JAMA, 2010;303, 1: 47–53.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Lauzé M, Martel DD, Agnoux A et al. Feasibility, Acceptability and Effects of a Home-Based Exercise Program Using a Gerontechnology on Physical Capacities after a Minor Injury in Community-Living Older Adults: A Pilot Study. J Nutr Health Aging. 2018;doi: 10.1007/s12603-017-0938-8.

    Google Scholar 

  5. Verrusio W, Andreozzi P, Renzi A et al. Efficacy and safety of spinning exercise in middle-aged and older adults with metabolic syndrome: randomized control trial. Ann Ist Super Sanità. 2016;doi:10.4415/ANN_16_02_24.

    Google Scholar 

  6. Carek PJ, Laibstain SE, Carek SM. Exercise for the treatment of depression and anxiety. Int J Psychiatry Med. 2011;41(1):15–28.

    Article  PubMed  Google Scholar 

  7. Verrusio W, Andreozzi P, Marigliano B, et al. Exercise Training And Music Therapy In Elderly With Depressive Syndrome: A Pilot Study. Complement Ther Med. 2014;doi:10.1016/J.Ctim.2014.05.012.

    Google Scholar 

  8. Mehrholz J, Elsner B, Werner C et al. Electromechanical-assisted training for walking after stroke. Cochrane Database Syst Rev, 2013. doi:10.1002/14651858.CD006185. pub3

    Google Scholar 

  9. Housley SN, Wu D, Richards K et al. Improving Upper Extremity Function and Quality of Life with a Tongue Driven Exoskeleton: A Pilot Study Quantifying Stroke Rehabilitation. Stroke Res Treat. 2017. doi: 10.1155/2017/3603860.

    Google Scholar 

  10. Pignolo L, Lucca LF, Basta G et al. A new treatment in the rehabilitation of the paretic upper limb after stroke: the ARAMIS prototype and treatment protocol. Ann Ist Super Sanita. 2016. doi: 10.4415/ANN_16_02_25

    Google Scholar 

  11. Galle S, Derave W, Bossuyt Fet al. Exoskeleton plantarflexion assistance for elderly. Gait Posture. 2016. doi: 10.1016/j.gaitpost.2016.11.040.

    Google Scholar 

  12. Verrusio W, Gianturco V, Cacciafesta M et al. Fall prevention in the young old using an exoskeleton human body posturizer: a randomized controlled trial. Aging Clin Exp Res. 2016. doi: 10.1007/s40520-016-0540-7.

    Google Scholar 

  13. Di Russo F, Berchicci M, Perri RL et al. A passive exoskeleton can push your life up: application on multiple sclerosis patients. PLoS One. 2013. doi:10.1371/journal.pone. 0077348

    Google Scholar 

  14. DeRubeis RJ, Siegle GJ, Hollon SD. Cognitive therapy vs. medications for depression: Treatment outcomes and neural mechanisms. Nat Rev Neurosci. 2008;Oct; 9(10): 788–796.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  15. Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc 1986;34:119–126.

    Article  PubMed  CAS  Google Scholar 

  16. Sheikh Ji, Yesavage Ja. Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. in: Clinical Gerontology: A Guide to Assessment and intervention. New York: the Haworth Press ltd 1986;165–173.

    Google Scholar 

  17. Verrusio W, Renzi A, Spallacci G et al. The development of a new tool for the evaluation of handicap in elderly: the Geriatric Handicap Scale (GHS). Aging Clin Exp Res. 2018. doi: 10.1007/s40520-018-0907-z.

    Google Scholar 

  18. Folstein, M., Folstein, S.E., McHugh, P.R. “Mini-Mental State” a Practical Method for Grading the Cognitive State of Patients for the Clinician. Journal of Psychiatric Research, 1975;12(3); 189–198.

    Article  PubMed  CAS  Google Scholar 

  19. Borg G. Borg’s perceived exertion and pain scales. Hum Kinet, 1998

    Google Scholar 

  20. Heinzel S, Lawrence JB, Kallies G et al. Using Exercise to Fight Depression in Older Adults: A Systematic Review and Meta-Analysis. The Journal of Gerontopsychology and Geriatric Psychiatry, 2015;http://dx.doi.org/10.1024/1662-9647/a000133

    Google Scholar 

  21. Murri MB, Ekkekakis P, Menchetti M et al. Physical exercise for late-life depression: Effects on symptom dimensions and time course Journal of Affective Disorders J Affect Disord. 2018. doi: 10.1016/j.jad.2018.01.004.

    Google Scholar 

  22. Treadway MT, Waskom ML, Dillon DG et al. Illness progression, recent stress, and morphometry of hippocampal subfields and medial prefrontal cortex in major depression. Biol Psychiatry 2015;1; 77(3):285–294

    Article  Google Scholar 

  23. Feyissa AM, Chandran A, Stockmeier CA et al. Reduced levels of NR2A and NR2B subunits of NMDA receptor and PSD-95 in the prefrontal cortex in major depression. Prog Neuropsychopharmacol Biol Psychiatry 2009;1; 33(1):70–5.

    Article  CAS  Google Scholar 

  24. Miller RM, Marriott D, Trotter J et al. Running exercise mitigates the negative consequences of chronic stress on dorsal hippocampal long-term potentiation in male mice. Neurobiol Learn Mem. 2018. doi: 10.1016/j.nlm.2018.01.008.

    Google Scholar 

  25. Pecci MT, Verrusio W, Radicioni AF et al. Music, spatial task performance and brain plasticity in elderly. J Am Geriatr Soc. 2016;doi: 10.1111/jgs.14361.

    Google Scholar 

  26. Hollon SD, Thase ME, Markowitz JC et al. Treatment and Prevention of Depression. Psychol Sci Public Interest; 2002;3(2):39–77.

    Article  PubMed  Google Scholar 

  27. Cho JW, Jung SY, Lee SW et al. Treadmill exercise ameliorates social isolationinduced depression through neuronal generation in rat pups. J Exerc Rehabil. 2017. doi: 10.12965/jer.1735180.590.

    Google Scholar 

  28. Siegle GJ, Thompson W, Carter CS et al. Increased amygdala and decreased dorsolateral prefrontal BOLD responses in unipolar depression: Related and independent features. Biol Psychiatry, 2007;15;61(2):198–209.

    Article  Google Scholar 

  29. Ströhle A. Physical activity, exercise, depression and anxiety disorders. J Neural Transm, 2009;116(6):777–84

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Sapienza University of Rome, Division of Gerontology, Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, Rome, Italy

    Walter Verrusio & M. Cacciafesta

  2. Sapienza University of Rome, Department of Dynamic and Clinical Psychology, Roma, Italy

    A. Renzi

  3. RSA Ebraica di Roma (CRER), Rome, Italy

    Walter Verrusio, A. Renzi, F. Cecchetti & M. Coi

  4. Sapienza University of Rome, Department of General Surgery, Surgical Specialties and Organ Transplantation «Paride Stefanini», Rome, Italy

    F. Gaj

  5. University of Rome “Foro Italico”, Department of Human Movement, Social and Health Sciences, Rome, Italy

    M. Ripani

  6. Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, “Sapienza” University of Rome, viale del Policlinico 155, 00161, Rome, Italy

    Walter Verrusio

Authors
  1. Walter Verrusio
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Renzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Cecchetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. F. Gaj
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Coi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. Ripani
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. Cacciafesta
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Walter Verrusio.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Verrusio, W., Renzi, A., Cecchetti, F. et al. The Effect of a Physical Training with the Use of an Exoskeleton on Depression Levels in Institutionalized Elderly Patients: A Pilot Study. J Nutr Health Aging 22, 934–937 (2018). https://doi.org/10.1007/s12603-018-1044-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-018-1044-2

Key words

Search

Navigation