Feasibility and Effects of a Soft-Wearable Robotic Suit Assisting Hip Extension in Older Adults: A Pilot Study

BACKGROUND: The global population of older adults is rapidly increasing, leading to a higher prevalence of gait impairment and fall risk. Soft-wearable robotic suits have emerged as alternatives to rigid exoskeletons; however, evidence of their effects in older adults remains limited. This pilot study evaluated the feasibility and effects of a cable-driven soft-wearable robotic suit (H-Medi) assisting hip extension during gait training in community-dwelling older adults. METHODS: This single-center, single-arm study recruited 22 community-dwelling older adults (age $\ge $ 65 years). Participants completed six exercise sessions over three weeks, each consisting of 20 minutes of robot-assisted gait training and 20 minutes of strength training. Feasibility was assessed through session adherence and safety monitoring. Functional outcomes were measured before and after the intervention without robotic assistance, including gait speed using the 4-meter walk test (4MWT), Timed Up and Go test (TUG), Short Physical Performance Battery (SPPB), Berg Balance Scale (BBS), and lower-limb joint range of motion (ROM). Pre-post comparisons were performed using paired t-tests or Wilcoxon signed-rank tests, and a linear mixed-effects model analyzed gait speed. RESULTS: Twenty-one of 22 participants completed all sessions with no adverse events. Gait speed increased from $1.00 [0.80-1.10]$ to $1.10 [1.00-1.20]$ m/s ( $\Delta $ $= 0.10 [0=0.20]$ m/s, p<0.001). TUG time decreased from $11.1\pm 1.8$ to $9.7\pm 1.4$ sec (p<0.001). Ankle sagittal-plane ROM increased significantly (p= 0.015). The mixed-effects model identified time and age as significant determinants of gait speed (ICC= 0.65). CONCLUSIONS: Short-term training using a soft-wearable robotic suit assisting hip extension was safe, feasible, and improved gait speed and mobility in older adults.