Although physical activity and exercise is known to benefit people with multiple sclerosis (MS), the ability of these individuals to participate in such interventions is difficult due to the mobility impairments caused by the disease. Keeogo is a lower-extremity powered exoskeleton that may be a potential solution for enabling people with MS to benefit from physical activity and exercise. An open-label, randomized, cross-over trial was used to examine the immediate performance effects when using the device, and the potential benefits of using the device in a home setting for 2 weeks. Clinical performance tests with and without the device included the 6 min walk test, timed up and go test and the 10-step stair test (up and down). An activity monitor was also used to measure physical activity at home, and a patient-reported questionnaire was used to determine the amount and extent of home use. Generalized linear models were used to test for trial effects, and correlation analysis used to examine relationships between trial effects and usage. Twenty-nine patients with MS participated. All measures showed small decrements in performance while wearing the device compared to not wearing the device. However, significant improvements in unassisted (Rehab effect) performance were found after using the device at home for 2 weeks, compared to 2 weeks at home without the device, and participants improved their ability to use the device over the trial period (Training effect). Rehab and Training effects were related to the self-reported extent that participants used Keeogo at home. Keeogo appears to deliver an exercise-mediated benefit to individuals with MS that improved their unassisted gait endurance and stair climbing ability. Keeogo might be a useful tool for delivering physical activity interventions to individuals with mobility impairment due to MS. ClinicalTrials.gov : NCT02904382 . Registered 19 September 2016 - Retrospectively registered.

Protective footwear is necessary for preventing injurious slips and falls in winter conditions. Valid methods for assessing footwear slip resistance on winter surfaces are needed in order to evaluate footwear and outsole designs. The purpose of this study was to utilise a method of testing winter footwear that was ecologically valid in terms of involving actual human testers walking on realistic winter surfaces to produce objective measures of slip resistance. During the experiment, eight participants tested six styles of footwear on wet ice, on dry ice, and on dry ice after walking over soft snow. Slip resistance was measured by determining the maximum incline angles participants were able to walk up and down in each footwear–surface combination. The results indicated that testing on a variety of surfaces is necessary for establishing winter footwear performance and that standard mechanical bench tests for footwear slip resistance do not adequately reflect actual performance. Practitioner Summary: Existing standardised methods for measuring footwear slip resistance lack validation on winter surfaces. By determining the maximum inclines participants could walk up and down slopes of wet ice, dry ice, and ice with snow, in a range of footwear, an ecologically valid test for measuring winter footwear performance was established.

Many older adults in long-term-care homes have complex physical and cognitive impairments and have difficulty propelling manual wheelchairs. Power wheelchair use is restricted owing to safety concerns. Power wheelchairs with collision-avoidance features are being developed to enable safe and independent mobility; however, a paucity of information exists on interface features to help users navigate away from obstacles. We developed a system combining an interface with auditory, visual, and haptic feedback and a simulated collision-avoidance power wheelchair. This device allowed the investigator to stop movement of the power wheelchair when users approached obstacles and to deliver feedback to help them navigate. Five long-term-care home residents with mild or moderate cognitive impairments evaluated device usability, which included effectiveness, efficiency, and user satisfaction. Each resident used the device for six 1 h sessions. Observations, feedback interviews, and outcome questionnaires were completed during and after the sessions. We found the device effective in enabling residents to achieve basic driving tasks and self-identified indoor mobility goals. Furthermore, residents perceived workload to be low and were satisfied with the device. Residents also felt that the feedback was useful to help them navigate away from obstacles.