Wearable Technologies Using Peripheral Neuromodulation to Enhance Mobility and Gait Function in Older Adults-A Narrative Review

Melike Kahya; Dawn Hackman; Laura Jacobs; Daniel Nilsson; Yvonne Rumsey; Lars I E Oddsson

doi:10.1093/gerona/glac045

Wearable Technologies Using Peripheral Neuromodulation to Enhance Mobility and Gait Function in Older Adults-A Narrative Review

J Gerontol A Biol Sci Med Sci. 2023 May 11;78(5):831-841. doi: 10.1093/gerona/glac045.

Authors

Melike Kahya¹, Dawn Hackman², Laura Jacobs³, Daniel Nilsson³, Yvonne Rumsey³, Lars I E Oddsson^{3

4}

Affiliations

¹ Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, Massachusetts, USA.
² Health Sciences Library, University of Minnesota, Minneapolis, Minnesota, USA.
³ RxFunction Inc., Eden Prairie, Minnesota, USA.
⁴ Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, USA.

Abstract

Background: Mounting evidence suggests that wearable technologies using peripheral neuromodulation can provide novel ways of improving mobility and gait function in various patient populations including older adults. The purpose of this narrative review is to provide an overview of wearable technologies/devices to improve mobility and gait function through noninvasive peripheral neuromodulation in older adults over the age of 65 and to indicate the suggested mechanism of action behind these technologies.

Methods: We performed searches for articles and conference abstracts written in English, using the following databases: Embase Classic+Embase from 1947 to July 15, 2021; Ovid MEDLINE; Epub Ahead of Print, In-Process, In-Data-Review & Other Non-Indexed Citations, Daily and Versions from 1946 to July 15, 2021; PubMed; and Scopus.

Results: Forty-one technologies met the inclusion/exclusion criteria. We found that the primary implementation of the 41 technologies can be divided into 3 main categories: sensory substitution, sensory augmentation (open loop, closed loop), and motor stimulation. Using these technologies, various aspects of mobility are treated or addressed, including, gait function, fall risk, foot drop, navigating environment, and postural control.

Conclusions: This narrative review summarizes wearable technologies that are currently commercially available and in stages of research and development. Overall, studies suggest that wearable peripheral neuromodulation technologies can improve aspects of mobility for older adults. Existing literature suggests that these technologies may lead to physiological changes in the brain through sensory reweighting or other neuroplastic mechanisms to enhance the performance of mobility and gait function in older adults over the age of 65.

Keywords: Motor stimulation; Neurorehabilitation; Postural balance; Sensory augmentation; Sensory substitution.

Publication types

Review
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

MeSH terms

Aged
Gait* / physiology
Humans
Postural Balance / physiology
Wearable Electronic Devices*

Abstract

Publication types

MeSH terms

Grants and funding