Enhancing sit-to-stand transitions and walking efficiency in older adults with a soft robotic suit

Clinical Snapshot

Key Findings

• P Value: Not reported in abstract

• Effect Size: 1.8 additional sit-to-stand repetitions per minute (absolute increase); 13.6% reduction in metabolic cost of walking

• Primary Outcome: Sit-to-stand performance and metabolic cost of walking in older adults using a soft hip exosuit versus unassisted condition

• Nnt Or Sensitivity: Not calculable from available data; no NNT, hazard ratio, or sensitivity/specificity reported. The 13.6% metabolic cost reduction may be contextualised against the ~5–10% reductions reported in younger adult exosuit studies, suggesting a potentially clinically meaningful effect if replicated

• Confidence Interval: Not reported in abstract

Clinical Application

Currently limited to research settings. The device requires fitting, calibration, and technical oversight. Home integration — as proposed by the authors — would require significant engineering refinement, user training, carer education, and robust safety testing. Cost, maintenance, and technical support infrastructure are unresolved barriers to widespread clinical deployment. Soft hip exosuits of this type are not currently listed on the Australian Register of Therapeutic Goods (ARTG) and are not PBS-subsidised. The RACGP does not yet have specific guidelines for wearable robotic assistive devices in older adults. Relevance to Australian aged care is high given the growing burden of falls and mobility-related disability in the ageing population, and the Australian Government's focus on home-based aged care under the Support at Home program. Future TGA regulatory assessment and NDIS funding pathway consideration would be prerequisites for clinical adoption. Australian geriatric physiotherapy and occupational therapy services would be key implementation partners. The study's findings, if replicated in larger trials, could inform future RACGP and Australian and New Zealand Society for Geriatric Medicine (ANZSGM) position statements on assistive wearable technology. Community-dwelling or institutionalised older adults (aged ≥65 years) with reduced lower-limb muscle strength and mobility limitations who retain sufficient independent mobility to use a wearable assistive device safely

Abstract

Age-related declines in muscle strength and neuromuscular control make sit-to-stand transitions and walking progressively more difficult, compromising mobility and independence. Although wearable assistive technologies have been proposed to alleviate these challenges, few have demonstrated clear benefits in facilitating sit-to-stand movements for older adults who retain a degree of independent mobility. Here, we introduce a soft hip exosuit designed to assist both sit-to-stand transitions and walking activities. In a feasibility study involving ten older adults, the exosuit increased 1-minute sit-to-stand repetitions by an average of 1.8 and reduced the metabolic cost of walking by 13.6% compared with the unassisted condition. These improvements were achieved while preserving natural kinematics, lower-limb stability, and maintaining a strong sense of agency. Our findings demonstrate that soft exosuits can enhance sit-to-stand and walking performance in older adults while preserving biomechanical naturalness and user autonomy, highlighting their potential for practical home-integrated mobility assistance.

References

1. 1.Zhang, X., Tricomi, E., Stefanakis, M., Gierden, N., Buchner, T., Mišković, L., Bauer, J. M., Werner, C., Becker, C., & Masia, L. (2026). Enhancing sit-to-stand transitions and walking efficiency in older adults with a soft robotic suit. Nature Communications. https://doi.org/10.3389/fpsyg.2017.01552 [Note: DOI as supplied; bibliographic metadata requires independent verification as the DOI string is inconsistent with the stated journal and publication year.]