{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T15:59:59Z","timestamp":1788278399093,"version":"build-2803163510"},"reference-count":42,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Mhealth Uhealth"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Two-thirds of people aged 65 years and older may require help with daily activities such as eating, bathing, and getting in and out of bed or a chair. Walking-assist wearable robots have shown significant improvements in physical function in controlled settings for patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In this study, we aimed to assess the feasibility and the effect of a gait assistance and gait resistance training program using a walking-assist wearable robot for community-dwelling older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 23 community-dwelling older adults aged 65 years and older (30 participants recruited, 7 dropped out) enrolled in a 12-session, 6-week gait assistance and gait resistance training program using a walking-assist wearable robot. A single-group, pre- and posttest design was employed to evaluate the feasibility based on program adherence and effectiveness. The primary and secondary outcomes for evaluating effectiveness were walking speed and functional performance, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Regarding the feasibility, the average number of sessions attended was 11.7 out of 12, indicating a mean adherence rate of 97.8%. Linear mixed model analysis revealed significant improvements in walking speed and functional performance at the end of the program compared with baseline. Specifically, the walking speed measured using the 10-Meter Walk Test, which includes self-selected velocity and fastest safe velocity, improved by a mean of 0.15\u202f\u202f(SD 0.13)\u202fm\/s (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001) and 0.15\u202f(SD\u202f0.17)\u202fm\/s (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001), respectively. Functional performance also improved, with faster performance in Timed Up-and-Go (mean \u22120.63, SD 0.92 s;\n                      <jats:italic>P<\/jats:italic>\n                      =.003) and Four Square Step Test (mean \u22121.71, SD 1.64 s;\n                      <jats:italic>P<\/jats:italic>\n                      \u2264.001). Leg muscle strength increased across all measured domains, including plantarflexion (mean +7.29, SD 4.92;\n                      <jats:italic>P<\/jats:italic>\n                      =.004), hip adduction (mean +3.03, SD 2.73;\n                      <jats:italic>P<\/jats:italic>\n                      \u2264.001), hip extension (mean +2.63, SD 2.50;\n                      <jats:italic>P<\/jats:italic>\n                      \u2264.001), knee extension (mean +2.33, SD 3.12;\n                      <jats:italic>P<\/jats:italic>\n                      \u2264.001), knee flexion (mean +2.19, SD 2.17;\n                      <jats:italic>P<\/jats:italic>\n                      \u2264.001), dorsiflexion (mean +2.10, SD 3.06;\n                      <jats:italic>P<\/jats:italic>\n                      \u2264.001), hip abduction (mean +1.59, SD 1.92;\n                      <jats:italic>P<\/jats:italic>\n                      =.002), and hip flexion (mean +0.90, SD 1.56;\n                      <jats:italic>P<\/jats:italic>\n                      \u2264.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study stands out for applying gait assistance and resistance training across various terrains, unlike previous studies that only tested gait assistance in controlled environments. The results demonstrated significant improvements in walking speed and functional performance in older adults, suggesting the effectiveness of preventive health care services using a walking-assist wearable robot as an intervention that can contribute to improving independent functioning and frailty among community-dwelling older adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/58142","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T10:10:06Z","timestamp":1744625406000},"page":"e58142-e58142","source":"Crossref","is-referenced-by-count":4,"title":["Feasibility and Effects of a Gait Assistance and Gait Resistance Training Program Using a Walking-Assist Wearable Robot for Community-Dwelling Older Adults: Single-Group, Pre-, and Posttest Study"],"prefix":"10.2196","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7871-6848","authenticated-orcid":false,"given":"Eunhee","family":"Cho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0380-8446","authenticated-orcid":false,"given":"Sinwoo","family":"Hwang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8764-7995","authenticated-orcid":false,"given":"Seok-Jae","family":"Heo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0867-2827","authenticated-orcid":false,"given":"Bokman","family":"Lim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2729-6660","authenticated-orcid":false,"given":"Jewoo","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6711-4174","authenticated-orcid":false,"given":"Younbaek","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"R1","unstructured":"Life expectancy and healthy life expectancy. World health organization (WHO). 2024. URL: https:\/\/apps.who.int\/gho\/data\/node.main.688?lang=en [Accessed 18-01-2024]"},{"issue":"4","key":"R2","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1093\/ageing\/afr054","article-title":"Limitations in physical functioning among older people as a predictor of subsequent disability in instrumental activities of daily living","volume":"40","author":"Seidel","journal-title":"Age Ageing"},{"key":"R3","unstructured":"Framework for countries to achieve an integrated continuum of long-term care 2021. World Health Organization (WHO). URL: https:\/\/www.who.int\/publications\/i\/item\/9789240038844 [Accessed 18-01-2024]"},{"key":"R4","unstructured":"Older adults. Healthy People 2030. URL: https:\/\/health.gov\/healthypeople\/objectives-and-data\/browse-objectives\/older-adults [Accessed 26-02-2024]"},{"issue":"1","key":"R5","doi-asserted-by":"publisher","DOI":"10.1186\/s40064-016-2739-7","article-title":"An exploratory investigation of changes in gait parameters with age in elderly Japanese women","volume":"5","author":"Afiah","journal-title":"Springerplus"},{"issue":"1","key":"R6","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-45113-2","article-title":"The spatial parameters of gait and their association with falls, functional decline and death in older adults: a prospective study","volume":"9","author":"Rodr\u00edguez-Molinero","journal-title":"Sci Rep"},{"issue":"1","key":"R7","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1093\/geronb\/56.1.p12","article-title":"The disablement process in very late life: a study of the oldest-old in Sweden","volume":"56","author":"Femia","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"issue":"3","key":"R8","doi-asserted-by":"publisher","first-page":"M146","DOI":"10.1093\/gerona\/56.3.m146","article-title":"Frailty in older adults: evidence for a phenotype","volume":"56","author":"Fried","journal-title":"J Gerontol A Biol Sci Med Sci"},{"issue":"11","key":"R9","doi-asserted-by":"publisher","first-page":"1774","DOI":"10.1046\/j.1532-5415.2002.50504.x","article-title":"Physical activity as a determinant of change in mobility performance: the longitudinal aging study Amsterdam","volume":"50","author":"Visser","journal-title":"J Am Geriatr Soc"},{"issue":"1","key":"R10","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1108\/IR-08-2014-0379","article-title":"Robotic exoskeletons: a review of recent progress","volume":"42","author":"Bogue","journal-title":"Ind Rob"},{"issue":"9","key":"R11","doi-asserted-by":"publisher","first-page":"1549","DOI":"10.1109\/TNSRE.2017.2664801","article-title":"A wearable hip assist robot can improve gait function and cardiopulmonary metabolic efficiency in elderly adults","volume":"25","author":"Lee","journal-title":"IEEE Trans Neural Syst Rehabil Eng"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.772660","article-title":"Comparison of efficacy of Lokomat and wearable exoskeleton-assisted gait training in people with spinal cord injury: a systematic review and network meta-analysis","volume":"13","author":"Zhang","journal-title":"Front Neurol"},{"issue":"4","key":"R13","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000032761","article-title":"Clinical efficacy of overground powered exoskeleton for gait training in patients with subacute stroke: a randomized controlled pilot trial","volume":"102","author":"Yoo","journal-title":"Medicine (Baltimore)"},{"issue":"4","key":"R14","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1097\/MRR.0000000000000132","article-title":"Feasibility and efficacy of high-speed gait training with a voluntary driven exoskeleton robot for gait and balance dysfunction in patients with chronic stroke: nonrandomized pilot study with concurrent control","volume":"38","author":"Yoshimoto","journal-title":"Int J Rehabil Res"},{"issue":"4","key":"R15","doi-asserted-by":"publisher","DOI":"10.3390\/jpm13040676","article-title":"Effects and safety of wearable exoskeleton for robot-assisted gait training: a retrospective preliminary study","volume":"13","author":"Park","journal-title":"J Pers Med"},{"issue":"4","key":"R16","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1016\/j.apmr.2019.10.192","article-title":"Exoskeleton-assisted gait training in persons with multiple sclerosis: a single-group pilot study","volume":"101","author":"Afzal","journal-title":"Arch Phys Med Rehabil"},{"issue":"2","key":"R17","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1016\/j.apmr.2020.10.122","article-title":"Effects of robotic exoskeleton-aided gait training in the strength, body balance, and walking speed in individuals with multiple sclerosis: a single-group preliminary study","volume":"102","author":"Dru\u017cbicki","journal-title":"Arch Phys Med Rehabil"},{"issue":"5","key":"R18","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11050643","article-title":"Functional improvement and satisfaction with a wearable hip exoskeleton in community-living adults","volume":"11","author":"Kim","journal-title":"Healthcare (Basel)"},{"issue":"8","key":"R19","doi-asserted-by":"publisher","first-page":"1939","DOI":"10.1007\/s40279-022-01675-2","article-title":"Progressive resistance training for concomitant increases in muscle strength and bone mineral density in older adults: a systematic review and meta-analysis","volume":"52","author":"O\u2019Bryan","journal-title":"Sports Med"},{"issue":"1","key":"R20","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1186\/s12984-022-01121-4","article-title":"Modular hip exoskeleton improves walking function and reduces sedentary time in community-dwelling older adults","volume":"19","author":"Jayaraman","journal-title":"J Neuroeng Rehabil"},{"issue":"23","key":"R21","doi-asserted-by":"publisher","first-page":"12609","DOI":"10.3390\/app132312609","article-title":"Verification of industrial worker walking efficiency with wearable hip exoskeleton","volume":"13","author":"Chang","journal-title":"Appl Sci (Basel)"},{"issue":"4","key":"R22","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1212\/01.wnl.0000198502.88147.dd","article-title":"Short-distance walking speed and timed walking distance: redundant measures for clinical trials?","volume":"66","author":"Dobkin","journal-title":"Neurology (ECronicon)"},{"issue":"2","key":"R23","doi-asserted-by":"publisher","first-page":"M85","DOI":"10.1093\/geronj\/49.2.m85","article-title":"A Short Physical Performance Battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission","volume":"49","author":"Guralnik","journal-title":"J Gerontol"},{"issue":"2","key":"R24","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1111\/j.1532-5415.1991.tb01616.x","article-title":"The timed \u201cUp & Go\u201d: a test of basic functional mobility for frail elderly persons","volume":"39","author":"Podsiadlo","journal-title":"J Am Geriatr Soc"},{"issue":"11","key":"R25","doi-asserted-by":"publisher","first-page":"1566","DOI":"10.1053\/apmr.2002.35469","article-title":"A clinical test of stepping and change of direction to identify multiple falling older adults","volume":"83","author":"Dite","journal-title":"Arch Phys Med Rehabil"},{"issue":"7","key":"R26","doi-asserted-by":"publisher","first-page":"1306","DOI":"10.1016\/j.apmr.2013.01.027","article-title":"Reliability and concurrent validity of Four Square Step Test scores in subjects with chronic stroke: a pilot study","volume":"94","author":"Goh","journal-title":"Arch Phys Med Rehabil"},{"issue":"6","key":"R27","doi-asserted-by":"publisher","first-page":"M192","DOI":"10.1093\/geronj\/45.6.m192","article-title":"Functional reach: a new clinical measure of balance","volume":"45","author":"Duncan","journal-title":"J Gerontol"},{"issue":"5","key":"R28","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1111\/j.1532-5415.2006.00701.x","article-title":"Meaningful change and responsiveness in common physical performance measures in older adults","volume":"54","author":"Perera","journal-title":"J Am Geriatr Soc"},{"issue":"1-2","key":"R29","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1007\/s00421-004-1286-z","article-title":"Effect of load and speed on the energetic cost of human walking","volume":"94","author":"Bastien","journal-title":"Eur J Appl Physiol"},{"issue":"6","key":"R30","doi-asserted-by":"publisher","first-page":"938","DOI":"10.1109\/TNSRE.2013.2248749","article-title":"Powered hip exoskeletons can reduce the user\u2019s hip and ankle muscle activations during walking","volume":"21","author":"Lenzi","journal-title":"IEEE Trans Neural Syst Rehabil Eng"},{"issue":"5","key":"R31","doi-asserted-by":"publisher","first-page":"1804","DOI":"10.1152\/jappl.2000.88.5.1804","article-title":"Age causes a redistribution of joint torques and powers during gait","volume":"88","author":"DeVita","journal-title":"J Appl Physiol (1985)"},{"issue":"1","key":"R32","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-45602-4","article-title":"The metabolic cost of walking in healthy young and older adults - a systematic review and meta analysis","volume":"9","author":"Das Gupta","journal-title":"Sci Rep"},{"key":"R33","doi-asserted-by":"publisher","DOI":"10.1590\/S1980-220X2017028703392","article-title":"Physical frailty and gait speed in community elderly: a systematic review","volume":"52","author":"Binotto","journal-title":"Rev Esc Enferm USP"},{"key":"R34","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2318-11-33","article-title":"Predicting ADL disability in community-dwelling elderly people using physical frailty indicators: a systematic review","volume":"11","author":"Vermeulen","journal-title":"BMC Geriatr"},{"issue":"5","key":"R35","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1111\/j.1532-5415.2011.03336.x","article-title":"Is timed up and go better than gait speed in predicting health, function, and falls in older adults?","volume":"59","author":"Viccaro","journal-title":"J Am Geriatr Soc"},{"issue":"3","key":"R36","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1093\/ageing\/32.3.315","article-title":"Identifying a cut-off point for normal mobility: a comparison of the timed \u201cup and go\u201d test in community-dwelling and institutionalised elderly women","volume":"32","author":"Bischoff","journal-title":"Age Ageing"},{"issue":"4","key":"R37","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1093\/ageing\/afn101","article-title":"Prognostic validity of the Timed Up-and-Go test, a modified Get-Up-and-Go test, staff\u2019s global judgement and fall history in evaluating fall risk in residential care facilities","volume":"37","author":"Nordin","journal-title":"Age Ageing"},{"issue":"1","key":"R38","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.apmr.2006.10.027","article-title":"The reliability and validity of the Four Square Step Test for people with balance deficits secondary to a vestibular disorder","volume":"88","author":"Whitney","journal-title":"Arch Phys Med Rehabil"},{"issue":"10","key":"R39","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1080\/09593985.2017.1354951","article-title":"Predicting falls in older adults using the four square step test","volume":"33","author":"Cleary","journal-title":"Physiother Theory Pract"},{"issue":"1","key":"R40","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1519\/JPT.0000000000000337","article-title":"The psychometric properties of the Short Physical Performance Battery to assess physical performance in older adults: a systematic review","volume":"47","author":"Kameniar","journal-title":"J Geriatr Phys Ther"},{"key":"R41","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2018.11.015","article-title":"Usefulness, assessment and normative data of the Functional Reach Test in older adults: a systematic review and meta-analysis","volume":"81","author":"Rosa","journal-title":"Arch Gerontol Geriatr"},{"key":"R42","unstructured":"WHO global strategy and action plan on ageing and health (2016\u20132020). World Health Organization (WHO). 2016. URL: http:\/\/apps.who.int\/gb\/ebwha\/pdf_files\/WHA69\/A69_17-en.pdf [Accessed 18-11-2024]"}],"container-title":["JMIR mHealth and uHealth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/mhealth.jmir.org\/2025\/1\/e58142","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:49:41Z","timestamp":1782841781000},"score":1,"resource":{"primary":{"URL":"https:\/\/mhealth.jmir.org\/2025\/1\/e58142"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,26]]},"references-count":42,"URL":"https:\/\/doi.org\/10.2196\/58142","relation":{},"ISSN":["2291-5222"],"issn-type":[{"value":"2291-5222","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,26]]},"article-number":"v13i4e58142"}}