ArticleJMIR rehabilitation and assistive technologies2026
Effects of Using a Lumbar-Type Hybrid Assistive Limb by Older Adults With Frailty on Exercise Self-Efficacy: Retrospective Analysis Based on the Kanagawa Prospective ME-BYO Cohort Study.
Article in JMIR rehabilitation and assistive technologies, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Improving exercise self-efficacy (ESE) is a key strategy for promoting sustained physical activity among older adults with frailty. The lumbar-type Hybrid Assistive Limb (HAL), a wearable device that supports voluntary movement through bioelectric signals, may facilitate mastery experiences in individuals with low baseline self-efficacy via adjustable assistance. However, its effects on ESE remain unclear. Objective: This study evaluated the effects of lumbar-type HAL exercise on ESE in older adults with frailty and examined whether responsiveness differed according to baseline readiness for exercise. Methods: A retrospective pooled analysis was conducted using data from 2 prospective studies of a lumbar-type HAL-based frailty prevention program: a feasibility study (n=20) and a randomized controlled trial (RCT; n=76; lumbar-type HAL group: n=38; waitlist control: n=38). Participants aged 50 to 84 years performed sit-to-stand and squat exercises using the lumbar-type HAL twice weekly. ESE was assessed using a validated 4-item questionnaire (range 4-20). The prespecified primary analysis examined within-person changes in ESE in the lumbar-type HAL group (2-tailed paired Results: The primary pooled paired analysis demonstrated a significant increase in ESE of 1.05 points (95% CI 0.41-1.69; Conclusions: The pooled analysis demonstrated significant within-person improvement in ESE among older adults with frailty following lumbar-type HAL training, with the greatest improvement in individuals without established exercise habits. The RCT indicated a favorable but inconclusive between-group effect, and adequately powered confirmatory RCTs remain necessary. The exploratory response among precontemplators-typically difficult to engage in interventions-suggests that HAL-supported mastery experiences may support disengaged older adults at high risk of frailty in starting physical exercise.
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