Optimizing Ankle Exoskeleton Assistance for Walking Across the Life Span

NCT ID: NCT04033146

Last Updated: 2024-06-21

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

View full results

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

16 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-02-04

Study Completion Date

2023-05-23

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The investigators seek to determine whether ankle exoskeletons can reduce metabolic energy expenditure during walking for users across the age-spectrum.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Older adults walk with greater metabolic rates than young adults. Growing evidence suggests that the greater older adult metabolic rates are related to the structural properties of their lower leg tissues. The tendons of the leg of older adults are more compliant than that of young adults. Accordingly, older adult leg tendons stretch more under a given load, such as during walking, causing their muscles to operate at shorter, less optimal lengths, and higher activity levels than the muscles of young adults - a less economical way to produces force.

Thus, the investigators seek to examine whether wearing wearable robotic boots (i.e., ankle exoskeletons) could enable muscles to produce force more economically. By adding an exoskeleton in-parallel to the ankle, the investigators hypothesize that older adults will walk with lower whole-body metabolic rate than without the exoskeleton assistance.

In this study, the investigators will have both young and older adult participants walk on a treadmill with a commercially available ankle exoskeleton set in multiple assistance modes. During these trials, the investigators will measure the metabolic cost of walking in young and older adults and also take many physiological and biomechanical measurements to help assess how exoskeletons work to reduce walking effort.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Aging

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

All participants will perform the same trials/sessions to complete the entire protocol. After each participant has performed all trials for this study, the investigators will analyze the data of this repeated-measures design.
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Young Adult Exoskeleton Users

Study participants who are 18-45 year old.

Group Type EXPERIMENTAL

Ankle Exoskeleton Assistance

Intervention Type DEVICE

The investigators will use ankle-exoskeletons to modulate the amount of mechanical power generated by the user's ankle joint. That is, participants will walk in a robotic device that either (a) adds a spring or (b) a motor in parallel with their calf muscles to help them generate a stronger propulsive push-off that could reduce the effort of walking.

Older Adult Exoskeleton Users

Study participants who are greater than 65 years of age.

Group Type EXPERIMENTAL

Ankle Exoskeleton Assistance

Intervention Type DEVICE

The investigators will use ankle-exoskeletons to modulate the amount of mechanical power generated by the user's ankle joint. That is, participants will walk in a robotic device that either (a) adds a spring or (b) a motor in parallel with their calf muscles to help them generate a stronger propulsive push-off that could reduce the effort of walking.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Ankle Exoskeleton Assistance

The investigators will use ankle-exoskeletons to modulate the amount of mechanical power generated by the user's ankle joint. That is, participants will walk in a robotic device that either (a) adds a spring or (b) a motor in parallel with their calf muscles to help them generate a stronger propulsive push-off that could reduce the effort of walking.

Intervention Type DEVICE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Subjects must be able to walk for 60 minutes in a 90-minute time frame.
* Subjects are apparently free of cardiovascular, metabolic, and renal disease, which includes no signs or symptoms suggestive of cardiovascular, metabolic or renal disease.
* Subjects have no current musculoskeletal injury.
* Subjects need to be either 18-45 or 65+ years old.

These criteria meet the American College of Sports Medicine's 2015 guidelines for participant health screening prior to joining a moderate or moderate-to-vigorous exercise protocol. (Riebe et al., 2015).

Exclusion Criteria

* Have dementia or an inability to give informed consent
* Have a musculoskeletal injury or feel pain while walking
* Have a history of dizziness and/or balance problems
* Have cardiovascular, heart, metabolic, or renal disease, or respiratory problems
* Smoke cigarettes
* Asthma
* Feel pain or discomfort in the chest, neck, jaw, arms during rest or exercise
* Have orthopnea or paroxysmal nocturnal dyspnea
* Have ankle edema
* Have palpitations or tachycardia
* Have a heart murmur
* Have had a heart attack
* Have diabetes
* Have a pace maker
* Have unusual shortness of breath with usual activities
* Are \<18 or 46-64 years of age
* Do not speak or understand English
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

National Institute on Aging (NIA)

NIH

Sponsor Role collaborator

Georgia Institute of Technology

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Gregory S Sawicki, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Georgia Institute of Technology

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Physiology of Wearable Robotics Laboratory (Georgia Tech)

Atlanta, Georgia, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Asbeck AT, De Rossi SM, Holt KG, and Walsh CJ. A biologically inspired soft exosuit for walking assistance. The international journal of robotics research 34: 744-762, 2015.

Reference Type BACKGROUND

Biewener AA, Farley CT, Roberts TJ, Temaner M. Muscle mechanical advantage of human walking and running: implications for energy cost. J Appl Physiol (1985). 2004 Dec;97(6):2266-74. doi: 10.1152/japplphysiol.00003.2004. Epub 2004 Jul 16.

Reference Type BACKGROUND
PMID: 15258124 (View on PubMed)

Browne MG, Franz JR. The independent effects of speed and propulsive force on joint power generation in walking. J Biomech. 2017 Apr 11;55:48-55. doi: 10.1016/j.jbiomech.2017.02.011. Epub 2017 Feb 21.

Reference Type BACKGROUND
PMID: 28262285 (View on PubMed)

Cavagna GA, Kaneko M. Mechanical work and efficiency in level walking and running. J Physiol. 1977 Jun;268(2):467--81. doi: 10.1113/jphysiol.1977.sp011866.

Reference Type BACKGROUND
PMID: 874922 (View on PubMed)

CAVAGNA GA, SAIBENE FP, MARGARIA R. MECHANICAL WORK IN RUNNING. J Appl Physiol. 1964 Mar;19:249-56. doi: 10.1152/jappl.1964.19.2.249. No abstract available.

Reference Type BACKGROUND
PMID: 14155290 (View on PubMed)

Collins SH, Wiggin MB, Sawicki GS. Reducing the energy cost of human walking using an unpowered exoskeleton. Nature. 2015 Jun 11;522(7555):212-5. doi: 10.1038/nature14288. Epub 2015 Apr 1.

Reference Type BACKGROUND
PMID: 25830889 (View on PubMed)

Csapo R, Malis V, Hodgson J, Sinha S. Age-related greater Achilles tendon compliance is not associated with larger plantar flexor muscle fascicle strains in senior women. J Appl Physiol (1985). 2014 Apr 15;116(8):961-9. doi: 10.1152/japplphysiol.01337.2013. Epub 2014 Feb 6.

Reference Type BACKGROUND
PMID: 24505104 (View on PubMed)

DeVita P, Helseth J, Hortobagyi T. Muscles do more positive than negative work in human locomotion. J Exp Biol. 2007 Oct;210(Pt 19):3361-73. doi: 10.1242/jeb.003970.

Reference Type BACKGROUND
PMID: 17872990 (View on PubMed)

DeVita P, Hortobagyi T. Age causes a redistribution of joint torques and powers during gait. J Appl Physiol (1985). 2000 May;88(5):1804-11. doi: 10.1152/jappl.2000.88.5.1804.

Reference Type BACKGROUND
PMID: 10797145 (View on PubMed)

Elliott G, Sawicki GS, Marecki A, Herr H. The biomechanics and energetics of human running using an elastic knee exoskeleton. IEEE Int Conf Rehabil Robot. 2013 Jun;2013:6650418. doi: 10.1109/ICORR.2013.6650418.

Reference Type BACKGROUND
PMID: 24187237 (View on PubMed)

Farris DJ, Sawicki GS. The mechanics and energetics of human walking and running: a joint level perspective. J R Soc Interface. 2012 Jan 7;9(66):110-8. doi: 10.1098/rsif.2011.0182. Epub 2011 May 25.

Reference Type BACKGROUND
PMID: 21613286 (View on PubMed)

Ferris DP, Sawicki GS, Domingo A. Powered lower limb orthoses for gait rehabilitation. Top Spinal Cord Inj Rehabil. 2005;11(2):34-49. doi: 10.1310/6gl4-um7x-519h-9jyd.

Reference Type BACKGROUND
PMID: 16568153 (View on PubMed)

Franz JR, Slane LC, Rasske K, Thelen DG. Non-uniform in vivo deformations of the human Achilles tendon during walking. Gait Posture. 2015 Jan;41(1):192-7. doi: 10.1016/j.gaitpost.2014.10.001. Epub 2014 Oct 12.

Reference Type BACKGROUND
PMID: 25457482 (View on PubMed)

Gottschall JS, Kram R. Energy cost and muscular activity required for propulsion during walking. J Appl Physiol (1985). 2003 May;94(5):1766-72. doi: 10.1152/japplphysiol.00670.2002. Epub 2002 Dec 27.

Reference Type BACKGROUND
PMID: 12506042 (View on PubMed)

Griffin TM, Tolani NA, Kram R. Walking in simulated reduced gravity: mechanical energy fluctuations and exchange. J Appl Physiol (1985). 1999 Jan;86(1):383-90. doi: 10.1152/jappl.1999.86.1.383.

Reference Type BACKGROUND
PMID: 9887153 (View on PubMed)

Holt NC, Roberts TJ, Askew GN. The energetic benefits of tendon springs in running: is the reduction of muscle work important? J Exp Biol. 2014 Dec 15;217(Pt 24):4365-71. doi: 10.1242/jeb.112813. Epub 2014 Nov 13.

Reference Type BACKGROUND
PMID: 25394624 (View on PubMed)

Huang HJ, Kram R, Ahmed AA. Reduction of metabolic cost during motor learning of arm reaching dynamics. J Neurosci. 2012 Feb 8;32(6):2182-90. doi: 10.1523/JNEUROSCI.4003-11.2012.

Reference Type BACKGROUND
PMID: 22323730 (View on PubMed)

Malcolm P, Derave W, Galle S, De Clercq D. A simple exoskeleton that assists plantarflexion can reduce the metabolic cost of human walking. PLoS One. 2013;8(2):e56137. doi: 10.1371/journal.pone.0056137. Epub 2013 Feb 13.

Reference Type BACKGROUND
PMID: 23418524 (View on PubMed)

Martin PE, Rothstein DE, Larish DD. Effects of age and physical activity status on the speed-aerobic demand relationship of walking. J Appl Physiol (1985). 1992 Jul;73(1):200-6. doi: 10.1152/jappl.1992.73.1.200.

Reference Type BACKGROUND
PMID: 1506370 (View on PubMed)

Mian OS, Thom JM, Ardigo LP, Minetti AE, Narici MV. Gastrocnemius muscle-tendon behaviour during walking in young and older adults. Acta Physiol (Oxf). 2007 Jan;189(1):57-65. doi: 10.1111/j.1748-1716.2006.01634.x.

Reference Type BACKGROUND
PMID: 17280557 (View on PubMed)

Mooney LM, Rouse EJ, Herr HM. Autonomous exoskeleton reduces metabolic cost of human walking during load carriage. J Neuroeng Rehabil. 2014 May 9;11:80. doi: 10.1186/1743-0003-11-80.

Reference Type BACKGROUND
PMID: 24885527 (View on PubMed)

Nelson ME, Rejeski WJ, Blair SN, Duncan PW, Judge JO, King AC, Macera CA, Castaneda-Sceppa C; American College of Sports Medicine; American Heart Association. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation. 2007 Aug 28;116(9):1094-105. doi: 10.1161/CIRCULATIONAHA.107.185650. Epub 2007 Aug 1.

Reference Type BACKGROUND
PMID: 17671236 (View on PubMed)

Nuckols Rich DT, Sawicki Greg. Ultrasound measurements link soleus muscle dynamics and metabolic cost during human walking with elastic ankle exoskeletons. In Prep.

Reference Type BACKGROUND

Onambele GL, Narici MV, Maganaris CN. Calf muscle-tendon properties and postural balance in old age. J Appl Physiol (1985). 2006 Jun;100(6):2048-56. doi: 10.1152/japplphysiol.01442.2005. Epub 2006 Feb 2.

Reference Type BACKGROUND
PMID: 16455811 (View on PubMed)

Ortega JD, Beck ON, Roby JM, Turney AL, Kram R. Running for exercise mitigates age-related deterioration of walking economy. PLoS One. 2014 Nov 20;9(11):e113471. doi: 10.1371/journal.pone.0113471. eCollection 2014.

Reference Type BACKGROUND
PMID: 25411850 (View on PubMed)

Ortega JD, Farley CT. Individual limb work does not explain the greater metabolic cost of walking in elderly adults. J Appl Physiol (1985). 2007 Jun;102(6):2266-73. doi: 10.1152/japplphysiol.00583.2006. Epub 2007 Mar 15.

Reference Type BACKGROUND
PMID: 17363623 (View on PubMed)

Ortega JO, Lindstedt SL, Nelson FE, Jubrias SA, Kushmerick MJ, Conley KE. Muscle force, work and cost: a novel technique to revisit the Fenn effect. J Exp Biol. 2015 Jul;218(Pt 13):2075-82. doi: 10.1242/jeb.114512. Epub 2015 May 11.

Reference Type BACKGROUND
PMID: 25964423 (View on PubMed)

Panizzolo FA, Green DJ, Lloyd DG, Maiorana AJ, Rubenson J. Soleus fascicle length changes are conserved between young and old adults at their preferred walking speed. Gait Posture. 2013 Sep;38(4):764-9. doi: 10.1016/j.gaitpost.2013.03.021. Epub 2013 May 1.

Reference Type BACKGROUND
PMID: 23642629 (View on PubMed)

Rall JA. Sense and nonsense about the Fenn effect. Am J Physiol. 1982 Jan;242(1):H1-6. doi: 10.1152/ajpheart.1982.242.1.H1.

Reference Type BACKGROUND
PMID: 7058903 (View on PubMed)

Rasske K, Thelen DG, Franz JR. Variation in the human Achilles tendon moment arm during walking. Comput Methods Biomech Biomed Engin. 2017 Feb;20(2):201-205. doi: 10.1080/10255842.2016.1213818. Epub 2016 Jul 27.

Reference Type BACKGROUND
PMID: 27460018 (View on PubMed)

Rubenson J, Pires NJ, Loi HO, Pinniger GJ, Shannon DG. On the ascent: the soleus operating length is conserved to the ascending limb of the force-length curve across gait mechanics in humans. J Exp Biol. 2012 Oct 15;215(Pt 20):3539-51. doi: 10.1242/jeb.070466. Epub 2012 Jul 5.

Reference Type BACKGROUND
PMID: 22771749 (View on PubMed)

Sawicki GS, Ferris DP. Mechanics and energetics of level walking with powered ankle exoskeletons. J Exp Biol. 2008 May;211(Pt 9):1402-13. doi: 10.1242/jeb.009241.

Reference Type BACKGROUND
PMID: 18424674 (View on PubMed)

Stanaway FF, Gnjidic D, Blyth FM, Le Couteur DG, Naganathan V, Waite L, Seibel MJ, Handelsman DJ, Sambrook PN, Cumming RG. How fast does the Grim Reaper walk? Receiver operating characteristics curve analysis in healthy men aged 70 and over. BMJ. 2011 Dec 15;343:d7679. doi: 10.1136/bmj.d7679.

Reference Type BACKGROUND
PMID: 22174324 (View on PubMed)

Stenroth L, Peltonen J, Cronin NJ, Sipila S, Finni T. Age-related differences in Achilles tendon properties and triceps surae muscle architecture in vivo. J Appl Physiol (1985). 2012 Nov;113(10):1537-44. doi: 10.1152/japplphysiol.00782.2012. Epub 2012 Oct 4.

Reference Type BACKGROUND
PMID: 23042907 (View on PubMed)

Studenski S, Perera S, Patel K, Rosano C, Faulkner K, Inzitari M, Brach J, Chandler J, Cawthon P, Connor EB, Nevitt M, Visser M, Kritchevsky S, Badinelli S, Harris T, Newman AB, Cauley J, Ferrucci L, Guralnik J. Gait speed and survival in older adults. JAMA. 2011 Jan 5;305(1):50-8. doi: 10.1001/jama.2010.1923.

Reference Type BACKGROUND
PMID: 21205966 (View on PubMed)

Takahashi KZ, Gross MT, van Werkhoven H, Piazza SJ, Sawicki GS. Adding Stiffness to the Foot Modulates Soleus Force-Velocity Behaviour during Human Walking. Sci Rep. 2016 Jul 15;6:29870. doi: 10.1038/srep29870.

Reference Type BACKGROUND
PMID: 27417976 (View on PubMed)

Takahashi KZ, Lewek MD, Sawicki GS. A neuromechanics-based powered ankle exoskeleton to assist walking post-stroke: a feasibility study. J Neuroeng Rehabil. 2015 Feb 25;12:23. doi: 10.1186/s12984-015-0015-7.

Reference Type BACKGROUND
PMID: 25889283 (View on PubMed)

Provided Documents

Download supplemental materials such as informed consent forms, study protocols, or participant manuals.

Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

F32AG063460

Identifier Type: NIH

Identifier Source: secondary_id

View Link

H18208

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Ankle Assistance and Resistance in Older Adults
NCT06284525 COMPLETED EARLY_PHASE1
Community Testing of Wearable Assistance
NCT06244901 RECRUITING EARLY_PHASE1
Walking Sensation Study
NCT06975423 RECRUITING NA