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

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/gerona/glac045

Keywords

Motor stimulation; Neurorehabilitation; Postural balance; Sensory augmentation; Sensory substitution

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This narrative review provides an overview of wearable technologies/devices that use noninvasive peripheral neuromodulation to improve mobility and gait function in adults over the age of 65. The study identifies three main categories of technologies: sensory substitution, sensory augmentation (open loop, closed loop), and motor stimulation. The results indicate that these technologies can address various aspects of mobility, such as gait function, fall risk, foot drop, navigating environment, and postural control. Overall, wearable peripheral neuromodulation technologies show promise in improving mobility for older adults.
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.

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