由于衰老和疾病导致的身体和功能损失降低了人类的流动性,独立性,和生活质量。这项研究旨在总结和量化这些损失,以激发解决方案来克服它们,并特别关注使用下肢外骨骼的可能性。
进行了叙述性文献综述,以确定广泛的与运动相关的身体和功能指标,这些指标受衰老和选定的心血管疾病的影响,呼吸,肌肉骨骼,和神经系统疾病。
研究发现,肢体最大肌肉力量和力量下降(33%和49%,分别,25-75年)和最大耗氧量(40%,20-80岁)与年轻人相比,老年人发生。反应时间超过两倍(18-90年)和视觉损失,前庭,报道了体感系统。此外,我们发现每天的步数减少(75%,60-85年),最大步行速度(24%25-75年),和最大六分钟和自选步行速度(38%和21%,分别,20-85年),虽然我们发现跌倒次数相对于每天的步数增加(800%),跌倒造成的伤害(472%,30-90岁)和跌倒造成的死亡(4000%,65-90年)。对于行动不便的个人,措施被确定为更糟。为他们确定的其他不利影响是失去直立和运动能力,在运动中冻结,接头应力,疼痛,和步态模式的变化。
这篇综述表明,衰老和慢性疾病会导致身体和感官能力的广泛丧失。虽然这些损失对水平行走的影响相对较小,它们在更苛刻的任务中变得受限,例如在倾斜的地面上行走,爬楼梯,或者长时间行走,尤其是当伴随着一种使人衰弱的疾病时。由于物理参数和功能参数密切相关,我们认为,通过训练身体能力可以间接改善失去的功能能力。然而,辅助设备可以直接通过补偿推进力的损失来补充失去的功能,重量支撑,平衡支持。
外骨骼是新一代的辅助设备,有可能提供这两种功能,培训能力和功能补偿,提高人类的流动性。
Physical and functional losses due to aging and diseases decrease human mobility, independence, and quality of life. This study is aimed at summarizing and quantifying these losses in order to motivate solutions to overcome them with a special focus on the possibilities by using lower limb exoskeletons.
A narrative literature review was performed to determine a broad range of mobility-related physical and functional measures that are affected by aging and selected cardiovascular, respiratory, musculoskeletal, and neurological diseases.
The study identified that decreases in limb maximum muscle force and power (33% and 49%, respectively, 25-75 yrs) and in maximum oxygen consumption (40%, 20-80 yrs) occur for older adults compared to young adults. Reaction times more than double (18-90 yrs) and losses in the visual, vestibular, and somatosensory systems were reported. Additionally, we found decreases in steps per day (75%, 60-85 yrs), maximum walking speed (24% 25-75 yrs), and maximum six-minute and self-selected walking speed (38% and 21%, respectively, 20-85 yrs), while we found increases in the number of falls relative to the number of steps per day (800%), injuries due to falls (472%, 30-90 yrs) and deaths caused by fall (4000%, 65-90 yrs). Measures were identified to be worse for individuals with
impaired mobility. Additional detrimental effects identified for them were the loss of upright standing and locomotion, freezing in movement, joint stress, pain, and changes in gait patterns.
This review shows that aging and chronic conditions result in wide-ranging losses in physical and sensory capabilities. While the impact of these losses are relatively modest for level walking, they become limiting during more demanding tasks such as walking on inclined ground, climbing stairs, or walking over longer periods, and especially when coupled with a debilitating disease. As the physical and functional parameters are closely related, we believe that lost functional capabilities can be indirectly improved by training of the physical capabilities. However, assistive devices can supplement the lost functional capabilities directly by compensating for losses with propulsion, weight support, and balance support.
Exoskeletons are a new generation of assistive devices that have the potential to provide both, training capabilities and functional compensation, to enhance human mobility.