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Japanese Deploying Powered Exoskeletons for Elderly
FoeNyx writes "The AFP is reporting that 30 Tokyo firms have planned to set up a joint-venture in next spring to market an 'exo-skeleton type power assist system' named HAL (Hybrid Assistive Leg) developed by Yoshiyuki Sankai, professor and engineer at the Sankai Lab, a Cybernetics specialized Laboratory of the Tsukuba University. When will the next generation be available?" The elderly with their exoskeletons and the bionic nurses will make quite a sight at Japanese nursing homes.
One major problem older people have is balance.
Balance is both a neurological and muscular issue. To balance you need:
- A set of clear inputs from your feet telling you about the surface you're trying to stand on, its angles, its texture, etc.
- Inputs from your inner ear, telling you what angle you are standing at.
- Other proprioception to accurately judge joint angles.
- The ability to integrate these inputs.
- Output to your muscles to maintain balance, especially while walking or when stepping onto something uneven.
This exoskeleton appears to amplify only a few muscle movements. Those connected with balance requiring strength in the ankle joints, the feet, etc. as well as angular motions of the knees don't appear to be covered in this device. Nor does it appear to help with balance.
For such a device to be really practical for disabled elderly, it needs to be able to balance on its own. I'm sure that's coming eventually but this device doesn't appear to be it.
But this exo-skeleton does nothing really to solve that problem. In fact, it can even make the falling problem even more severe, by allowing people that have lost their sense of balance to walk. Just like the fact that some old folks shouldn't be driving, some should not be walking, for their own safety.
Well this is exactly the problem. To slightly overstate the situation, there are no nursing homes in Japan. By which, I mean there are no transitional communities for the aged, no communities for the aged which retain a certain independence and dignity, nothing, nada, zilch. The traditional Japanese approach to the aged is that the oldest daughter in the family looks after the parents. Right now, the system is going titsup.com faster than you would believe because, firstly, all the daughters lived at home and delayed marrying as long as possible because their disposable income far exceeds what they can expect as a newlywed (there are entire cruise lines in Japan targeting women only), and secondly when they do marry, they move away from home and rarely return.
There's no sensible infrastructure for looking after the aged in Japan. There are an infinite number of token gestures, such as buttons at train stations so staff will rush to place a small ramp on the platform so a chairbound person can get on, all trains have a seat-free area for a wheelchair, but there is nothing that offers older people the ability to live at home for as long as possible and then transition to a managed facility.
To cope with this, industry is targeting older people partly because it is a growth market, and partly as a defensive survival tactic since the birthrate continues to decline. This can be seen in a range of products, such as hot water pots (ubiquitous in Japan) that phone home when the usage pattern changes, and small robotic pets that don't do a great deal but offer comfort and, again, have the ability to detect changes in usage patterns and transmit a warning.
I figure building exoskeletons for everyone that needs one in Japan is probably cheaper than building the infrastructure everyone thought they were paying for with their compulsory pension fees.
To witter on further and doom myself to be off-topic, consider this:
A lady in an aged facility has a problem with her stomach. The facility has a doctor on call, who has no skill in that area.
A family member decides a consultation is needed, so arranges for the lady to get scanned and have followup treatment, since stomach cancer is endemic in Japan.
The facility can't accept that, and insists the lady is removed from the facility 24 hours before any consultation not arranged by their own doctor and returned at least 24 hours after the consultation, to protect the dignity of the doctor.
Well, color me unimpressed, but if manufacturers in Japan make exoskeletons, emotion-surrogate robots, kitchen equipment that monitors daily patterns and anything else like that, it's fine by me, no matter how many westerners snigger.
Loss of balance and muscular weakness seem to be the major factors I've seen in elderly hip fractures... that and frank syncope (loss of consciousness). This might help with the latter, but balance might still be up the the individual's own vestibular and proprioceptive systems. If you experienced syncope, I doubt this contraption would hold you up.
You're quite correct regarding the complications. As far as hip fractures go, most orthopedists advocate agressive surgical repair of those injuries, with pinning/surgical fixation of some, and outright joint replacement for those that cannot be pinned (depends on the location and type of fracture). This is largely due to the risk of Thromboembolic disease (Deep Venous Thrombosis and Pulmonary Embolus) from prolonged immobilization and bed rest. Years ago, bed rest was the standard therapy for broken hips... God only knows how many people died as a result of that therapy (was thought at the time to be the best treatment... thank God for medical progress).
The other question with these devices is how much they would lead to deconditioning of elderly patients. Exercise really IS good for you, and keeps your muscles strong through stimulus and use... anything that isn't used enough WILL atrophy. That's one of the reasons for "rehab" centers that have grown up, primarily to act as a bridge between hospitalization and home. Some elderly patients are so deconditioned after a long hospital stay (eg. for pneumonia or urinary tract infection) that they require physical therapy and reconditioning before they are able to go home and function. This device might lead people to become totally dependent upon it.
To say nothing of the fact that it probably wouldn't help the extremely heavy patients. I regularly see 400 to 600 lb patients in my ER (takes half my staff, myself included, just to get them into a bed... often two ambulance crews get called to their homes just to get them to the hospital).
Even if a man chops off your hand with a sword, you still have two nice, sharp bones to stick in his eyes.