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Lu L, Xie Z, Wang H, Su B, Jung S, Xu X. Factors Affecting Workers' Mental Stress in Handover Activities During Human-Robot Collaboration. HUMAN FACTORS 2024:187208241226823. [PMID: 38215357 DOI: 10.1177/00187208241226823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2024]
Abstract
OBJECTIVE This study investigated the effects of different approach directions, movement speeds, and trajectories of a co-robot's end-effector on workers' mental stress during handover tasks. BACKGROUND Human-robot collaboration (HRC) is gaining attention in industry and academia. Understanding robot-related factors causing mental stress is crucial for designing collaborative tasks that minimize workers' stress. METHODS Mental stress in HRC tasks was measured subjectively through self-reports and objectively through galvanic skin response (GSR) and electromyography (EMG). Robot-related factors including approach direction, movement speed, and trajectory were analyzed. RESULTS Movement speed and approach direction had significant effects on subjective ratings, EMG, and GSR. High-speed and approaching from one side consistently resulted in higher fear, lower comfort, and predictability, as well as increased EMG and GSR signals, indicating higher mental stress. Movement trajectory affected GSR, with the sudden stop condition eliciting a stronger response compared to the constrained trajectory. Interaction effects between speed and approach direction were observed for "surprise" and "predictability" subjective ratings. At high speed, approach direction did not significantly differ, but at low speeds, approaching from the side was found to be more surprising and unpredictable compared to approaching from the front. CONCLUSION The mental stress of workers during HRC is lower when the robot's end effector (1) approaches a worker within the worker's field of view, (2) approaches at a lower speed, or (3) follows a constrained trajectory. APPLICATION The outcome of this study can serve as a guide to design HRC tasks with a low level of workers' mental stress.
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Affiliation(s)
- Lu Lu
- North Carolina State University, USA
| | | | | | - Bingyi Su
- North Carolina State University, USA
| | | | - Xu Xu
- North Carolina State University, USA
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Nasr A, Dickerson CR, McPhee J. Experimental Study of Fully Passive, Fully Active, and Active-Passive Upper-Limb Exoskeleton Efficiency: An Assessment of Lifting Tasks. SENSORS (BASEL, SWITZERLAND) 2023; 24:63. [PMID: 38202925 PMCID: PMC10780908 DOI: 10.3390/s24010063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024]
Abstract
Recently, robotic exoskeletons are gaining attention for assisting industrial workers. The exoskeleton power source ranges from fully passive (FP) to fully active (FA), or a mixture of both. The objective of this experimental study was to assess the efficiency of a new active-passive (AP) shoulder exoskeleton using statistical analyses of 11 quantitative measures from surface electromyography (sEMG) and kinematic data and a user survey for weight lifting tasks. Two groups of females and males lifted heavy kettlebells, while a shoulder exoskeleton helped them in modes of fully passive (FP), fully active (FA), and active-passive (AP). The AP exoskeleton outperformed the FP and FA exoskeletons because the participants could hold the weighted object for nearly twice as long before fatigue occurred. Future developments should concentrate on developing sex-specific controllers as well as on better-fitting wearable devices for women.
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Affiliation(s)
- Ali Nasr
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
| | - Clark R. Dickerson
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
| | - John McPhee
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
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Li YY, Gan J. Effect of wearable chair on gait, balance, and discomfort of new users during level walking with anterior loads. JOURNAL OF SAFETY RESEARCH 2023; 87:27-37. [PMID: 38081701 DOI: 10.1016/j.jsr.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 05/22/2023] [Accepted: 08/25/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION Walking with anterior loads is common in industrial scenarios, but as exoskeletons are increasingly used in work environments to alleviate musculoskeletal disorders (MSDs), this new "human-robot" system composed of the human body and exoskeleton may be associated with new risks and harm that warrant further investigation. Therefore, this study will discuss the effect of a wearable chair on the gait, balance, and discomfort of new users with different weights of anterior loads during level walking. METHOD Twenty-two healthy subjects (sex balanced) participated in the experiment. Each exposure comprised one of two exoskeleton states (with/without) and four load conditions: No carried load, carrying an empty box (0.3 kg), 5%Body Weight (BW), and 10%BW. The order of exoskeleton states and load conditions was randomly assigned. Using an eight-camera motion capture system to record the entire movement. And the subjective discomfort and perceived balance after each exposure were recorded on an 11-point numeric rating scale, respectively. Using SPSS 26.0 software (IBM Inc., Chicago) to conduct statistical analyses. RESULTS Level walking with a wearable chair in different load conditions significantly affected gait parameters (like cadence) and gait balance. The perceived balance decreased with the exoskeleton, consistent with objective results. For subjective discomfort, wearing the exoskeleton significantly impacted global discomfort. Also, it increased the local discomfort of the shoulders, waist, thighs, shanks, and feet/ankles. CONCLUSIONS For new users, the risk of losing balance or falling may be increased when wearing an exoskeleton for non-target task behaviors (level walking/anterior load), and caution is recommended when the anterior load exceeds 5% BW. PRACTICAL APPLICATION The proposed strategy for assessing human gait, balance, and discomfort in wearable chairs may be applied during the iterative design of the product. These controls will help develop training programs and implementation guidelines for this exoskeleton type.
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Affiliation(s)
- Ying-Yi Li
- School of Mechanical Engineering, Sichuan University, Chengdu, China.
| | - Jing Gan
- School of Mechanical Engineering, Sichuan University, Chengdu, China.
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Zhou J, Peng H, Su S, Song R. Spatiotemporal Compliance Control for a Wearable Lower Limb Rehabilitation Robot. IEEE Trans Biomed Eng 2023; 70:1858-1868. [PMID: 37015454 DOI: 10.1109/tbme.2022.3230784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Compliance control is crucial for physical human-robot interaction, which can enhance the safety and comfort of robot-assisted rehabilitation. In this study, we designed a spatiotemporal compliance control strategy for a new self-designed wearable lower limb rehabilitation robot (WLLRR), allowing the users to regulate the spatiotemporal characteristics of their motion. The high-level trajectory planner consists of a trajectory generator, an interaction torque estimator, and a gait speed adaptive regulator, which can provide spatial and temporal compliance for the WLLRR. A radial basis function neural network adaptive controller is adopted as the low-level position controller. Over-ground walking experiments with passive control, spatial compliance control, and spatiotemporal compliance control strategies were conducted on five healthy participants, respectively. The results demonstrated that the spatiotemporal compliance control strategy allows participants to adjust reference trajectory through physical human-robot interaction, and can adaptively modify gait speed according to participants' motor performance. It was found that the spatiotemporal compliance control strategy could provide greater enhancement of motor variability and reduction of interaction torque than other tested control strategies. Therefore, the spatiotemporal compliance control strategy has great potential in robot-assisted rehabilitation training and other fields involving physical human-robot interaction.
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Kuber PM, Alemi MM, Rashedi E. A Systematic Review on Lower-Limb Industrial Exoskeletons: Evaluation Methods, Evidence, and Future Directions. Ann Biomed Eng 2023:10.1007/s10439-023-03242-w. [PMID: 37248409 DOI: 10.1007/s10439-023-03242-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 05/14/2023] [Indexed: 05/31/2023]
Abstract
Industrial tasks that involve frequent sitting/standing transitions and squatting activities can benefit from lower-limb industrial exoskeletons; however, their use is not as widespread as their upper-body counterparts. In this review, we examined 23 articles that evaluated the effects of using Wearable Chair (WC) and Squat-assist (SA) exoskeletons. Evaluations mainly included assessment of muscular demands in the thigh, shank, and upper/lower back regions. Both types of devices were found to lessen muscular demands in the lower body by 30-90%. WCs also reduced low-back demands (~ 37%) and plantar pressure (54-80%) but caused discomfort/unsafe feeling in participants. To generalize outcomes, we suggest standardizing approaches used for evaluating the devices. Along with addressing low adoption through design upgrades (e.g., ground and body supports/attachments), we recommend that researchers thoroughly evaluate temporal effects on muscle fatigue, metabolic rate, and stability of wearers. Although lower-limb exoskeletons were found to be beneficial, discrepancies in experimental protocols (posture/task/measures) were discovered. We also suggest simulating more realistic conditions, such as walking/sitting interchangeability for WCs and lifting loads for SA devices. The presented outcomes could help improve the design/evaluation approaches, and implementation of lower limb wearable devices across industries.
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Affiliation(s)
- Pranav Madhav Kuber
- Biomechanics and Ergonomics Lab, Industrial and Systems Engineering Department, Rochester Institute of Technology, 1 Lomb Memorial Dr, Rochester, NY, 14623, USA
| | - Mohammad Mehdi Alemi
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA
- Training Services, MathWorks, Natick, MA, USA
| | - Ehsan Rashedi
- Biomechanics and Ergonomics Lab, Industrial and Systems Engineering Department, Rochester Institute of Technology, 1 Lomb Memorial Dr, Rochester, NY, 14623, USA.
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A Systematic Review on Evaluation Strategies for Field Assessment of Upper-Body Industrial Exoskeletons: Current Practices and Future Trends. Ann Biomed Eng 2022; 50:1203-1231. [PMID: 35916980 DOI: 10.1007/s10439-022-03003-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/30/2022] [Indexed: 01/02/2023]
Abstract
With rising manual work demands, physical assistance at the workplace is crucial, wherein the use of industrial exoskeletons (i-EXOs) could be advantageous. However, outcomes of numerous laboratory studies may not be directly translated to field environments. To explore this discrepancy, we conducted a systematic review including 31 studies to identify and compare the approaches, techniques, and outcomes within field assessments of shoulder and back support i-EXOs. Findings revealed that the subjective approaches [i.e., discomfort (23), usability (22), acceptance/perspectives (21), risk of injury (8), posture (3), perceived workload (2)] were reported more common (27) compared to objective (15) approaches [muscular demand (14), kinematics (8), metabolic costs (5)]. High variability was also observed in the experimental methodologies, including control over activity, task physics/duration, sample size, and reported metrics/measures. In the current study, the detailed approaches, their subject-related factors, and observed trends have been discussed. In sum, a new guideline, including tools/technologies has been proposed that could be utilized for field evaluation of i-EXOs. Lastly, we discussed some of the common technical challenges experimenters face in evaluating i-EXOs in field environments. Efforts presented in this study seek to improve the generalizability in testing and implementing i-EXOs.
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Ergonomic Assessment of a Lower-Limb Exoskeleton through Electromyography and Anybody Modeling System. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138088. [PMID: 35805747 PMCID: PMC9265844 DOI: 10.3390/ijerph19138088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/10/2022] [Accepted: 06/28/2022] [Indexed: 02/01/2023]
Abstract
The aim of this study was to determine the muscle load reduction of the upper extremities and lower extremities associated with wearing an exoskeleton, based on analyses of muscle activity (electromyography: EMG) and the AnyBody Modeling System (AMS). Twenty healthy males in their twenties participated in this study, performing bolting tasks at two working heights (60 and 85 cm). The muscle activities of the upper trapezius (UT), middle deltoid (MD), triceps brachii (TB), biceps brachii (BB), erector spinae (ES), biceps femoris (BF), rectus femoris (RF), and tibialis anterior (TA) were measured by EMG and estimated by AMS, respectively. When working at the 60 cm height with the exoskeleton, the lower extremity muscle (BF, RF, TA) activities of EMG and AMS decreased. When working at the 85 cm height, the lower extremity muscle activity of EMG decreased except for TA, and those of AMS decreased except for RF. The muscle activities analyzed by the two methods showed similar patterns, in that wearing the exoskeleton reduced loads of the lower extremity muscles. Therefore, wearing an exoskeleton can be recommended to prevent an injury. As the results of the two methods show a similar tendency, the AMS can be used.
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Steinhilber B, Seibt R, Rieger MA, Luger T. Postural Control When Using an Industrial Lower Limb Exoskeleton: Impact of Reaching for a Working Tool and External Perturbation. HUMAN FACTORS 2022; 64:635-648. [PMID: 32988243 PMCID: PMC9136386 DOI: 10.1177/0018720820957466] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 08/14/2020] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To investigate postural control related to a lower limb exoskeleton (Chairless Chair) when (a) reaching for a working tool, and (b) an external perturbation occurs. BACKGROUND Lower limb exoskeletons aiming to reduce physical load associated with prolonged standing may impair workers' postural control and increase the risk of falling. METHOD Forty-five males were reaching for an object (3-kg dumbbell) at the lateral end of their reaching area without the exoskeleton in upright standing (STAND) and with the exoskeleton at a high (EXOHIGH.SEAT) and low sitting position (EXOLOW.SEAT). The task was performed with the object placed in three different angles (120°, 150°, and 180°) in the transversal plane. The minimum absolute static postural stability (SSABS.MIN) as the shortest distance (mm) of the center of pressure to the base of support border was measured (zero indicates risk of falling). Additionally, eight subjects were standing without the exoskeleton or sitting on it (EXOHIGH.SEAT and EXOLOW.SEAT) while being pulled backward. The tilting moment when subjects lost their balance was assessed. RESULTS SSABS.MIN was lower when using the exoskeleton (p < .05) but still about 17 mm. The location of the object to be reached had no influence. Tilting moments of less than 30 nm were sufficient to let people fall backward when sitting on the exoskeleton (50 nm for STAND). CONCLUSION Impairments in postural control by the exoskeleton may not be relevant when reaching laterally for objects up to 3 kg. When an external perturbation occurs, the risk of falling may be much higher; irrespective of factors like uneven or slippery flooring. APPLICATION The risk of falling using the exoskeleton seems to be low when reaching laterally for an object of up to 3 kg. In situations where, for example, a collision with coworkers is likely, this exoskeleton is not recommended.
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Santoso G, Sugiharto S, Mughni A, Ammarullah MI, Bayuseno AP, Jamari J. Chairless Chairs for Orthopedic Surgery Purpose – A Literature Review. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Musculoskeletal disorders are often found in various types of work, including surgeons. Standing working position is immobile and rigid when performing surgical operations. The equipment used is less ergonomic which is the main parameter. The surgeon profession belongs to the category of the high-risk profession and has the potential to experience musculoskeletal disorders. Surgeons who suffer musculoskeletal disorders sense disease start from mild-to-severe due to the muscles receiving static loads frequently in the long-term. The emergence of musculoskeletal disorders can be caused by working environment conditions and standing position while working, causing injury to joints, vertebral discs, nerves, cartilage, tendons, and muscles. This paper describes in extensive the potential for reducing musculoskeletal problems with the use of a chairless chair for surgeons in carrying out operations. Musculoskeletal problems in surgery and the use of chairless chairs have been further explored to close the existing research gap.
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Hoffmann N, Prokop G, Weidner R. Methodologies for evaluating exoskeletons with industrial applications. ERGONOMICS 2022; 65:276-295. [PMID: 34415823 DOI: 10.1080/00140139.2021.1970823] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 08/12/2021] [Indexed: 06/13/2023]
Abstract
Industrial exoskeletons are globally developed, explored, and increasingly implemented in industrial workplaces. Multiple technical, physical, and psychological aspects should be assessed prior to their daily application in various occupational environments. The methodology for evaluating these aspects is not standardised and differs in terms of focussed research objectives, used types of analyses, applied testing procedures, and use cases. The aim of this paper is to provide a matrix comparing the prevalence of different types of analyses combined with their respective research objective(s). A systematic review in the database 'Web of Science' identified 74 studies, mainly in laboratory settings, with a focus on short-term effects as well as with male-dominated samples being low representative for industrial workforces. The conducted evaluation methodologies are further discussed and compared in terms of testing procedure, sample, and research objectives. Finally, relevant aspects for prospectively evaluating industrial exoskeletons in a more harmonised and comprehensive way are suggested. Practitioner summary: Industrial exoskeletons are still inconsistently and insufficiently evaluated in scientific studies, which might hamper the comparability of systems, threaten the human health, and block an iterative system optimisation. Thus, a comprehensive evaluation methodology is needed with harmonised and multicriteria types of analyses.
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Affiliation(s)
- Niclas Hoffmann
- Department of Production Technologies, Institute of Mechatronics, University of Innsbruck, Innsbruck, Austria
- Laboratory of Manufacturing Technology, Helmut-Schmidt-University/University of the Federal Armed Forces Hamburg, Hamburg, Germany
| | - Gilbert Prokop
- Department of Production Technologies, Institute of Mechatronics, University of Innsbruck, Innsbruck, Austria
| | - Robert Weidner
- Department of Production Technologies, Institute of Mechatronics, University of Innsbruck, Innsbruck, Austria
- Laboratory of Manufacturing Technology, Helmut-Schmidt-University/University of the Federal Armed Forces Hamburg, Hamburg, Germany
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Clites TR, Shepherd MK, Ingraham KA, Wontorcik L, Rouse EJ. Understanding patient preference in prosthetic ankle stiffness. J Neuroeng Rehabil 2021; 18:128. [PMID: 34433472 PMCID: PMC8390224 DOI: 10.1186/s12984-021-00916-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 07/21/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND User preference has the potential to facilitate the design, control, and prescription of prostheses, but we do not yet understand which physiological factors drive preference, or if preference is associated with clinical benefits. METHODS Subjects with unilateral below-knee amputation walked on a custom variable-stiffness prosthetic ankle and manipulated a dial to determine their preferred prosthetic ankle stiffness at three walking speeds. We evaluated anthropomorphic, metabolic, biomechanical, and performance-based descriptors at stiffness levels surrounding each subject's preferred stiffness. RESULTS Subjects preferred lower stiffness values at their self-selected treadmill walking speed, and elected to walk faster overground with ankle stiffness at or above their preferred stiffness. Preferred stiffness maximized the kinematic symmetry between prosthetic and unaffected joints, but was not significantly correlated with body mass or metabolic rate. CONCLUSION These results imply that some physiological factors are weighted more heavily when determining preferred stiffness, and that preference may be associated with clinically relevant improvements in gait.
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Affiliation(s)
- Tyler R Clites
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
- Robotics Institute, University of Michigan, Ann Arbor, MI, 48109, USA
- Neurobionics Lab, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Max K Shepherd
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA
- Shirley Ryan Ability Lab, Chicago, IL, 60611, USA
- Neurobionics Lab, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Kimberly A Ingraham
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
- Robotics Institute, University of Michigan, Ann Arbor, MI, 48109, USA
- Neurobionics Lab, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Leslie Wontorcik
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan Orthotics and Prosthetics Center, Ann Arbor, MI, 48104, USA
| | - Elliott J Rouse
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA.
- Robotics Institute, University of Michigan, Ann Arbor, MI, 48109, USA.
- Neurobionics Lab, University of Michigan, Ann Arbor, MI, 48109, USA.
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Bär M, Steinhilber B, Rieger MA, Luger T. The influence of using exoskeletons during occupational tasks on acute physical stress and strain compared to no exoskeleton - A systematic review and meta-analysis. APPLIED ERGONOMICS 2021; 94:103385. [PMID: 33676059 DOI: 10.1016/j.apergo.2021.103385] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/03/2021] [Accepted: 02/08/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES This systematic review and meta-analysis determined the effects of using an exoskeleton during occupational tasks on physical stress and strain compared to not using an exoskeleton. METHODS Systematic electronic database searches were performed and the review was prepared according to the PRISMA guidelines. Treatment effects on the predefined outcomes were calculated using standardized mean differences for continuous outcomes in several meta-analyses using Review Manager 5.3. Registration: PROSPERO (CRD42020168701). RESULTS 63 articles were included in qualitative syntheses and 52 in quantitative, but most of them did not extensively evaluate musculoskeletal stress and strain and the risk of bias was rated high for all included studies. Statistically significant effects of using back, upper-limb, or lower-limb exoskeletons have been observed in the supported body areas (e.g. reduced muscle activity, joint moments and perceived strain). Studies which did not exclusively focus on the supported body area also showed statistically significant effects in the non-supported areas (e.g. changed muscle activity and perceived strain) and in physiological outcomes (e.g. reduced energy expenditure). CONCLUSIONS Using an exoskeleton during occupational tasks seems to reduce user's acute physical stress and strain in the exoskeleton's target area. However, impact on workers' health is still unknown, primarily because of missing long-term evaluations under real working conditions. Furthermore, this systematic review highlights a lack of studies (1) following high quality methodological criteria, (2) evaluating various inter-related stress and strain parameters instead of only focusing on one specific, and (3) evaluating non-target body areas instead of only the directly supported body area.
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Affiliation(s)
- Mona Bär
- Institute of Occupational and Social Medicine and Health Services Research, University of Tübingen and University Hospital Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany.
| | - Benjamin Steinhilber
- Institute of Occupational and Social Medicine and Health Services Research, University of Tübingen and University Hospital Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany.
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University of Tübingen and University Hospital Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany.
| | - Tessy Luger
- Institute of Occupational and Social Medicine and Health Services Research, University of Tübingen and University Hospital Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany.
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Kozinc Ž, Babič J, Šarabon N. Human pressure tolerance and effects of different padding materials with implications for development of exoskeletons and similar devices. APPLIED ERGONOMICS 2021; 93:103379. [PMID: 33556885 DOI: 10.1016/j.apergo.2021.103379] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 01/22/2021] [Accepted: 01/28/2021] [Indexed: 06/12/2023]
Abstract
In this study, we assessed pressure tolerance in 16 healthy participants at the thigh, chest, and pelvic area, using different surfaces (1 cm2, 20 cm2 and different components, used in exoskeleton design), and the effects of different padding materials. Our results showed substantial variability in pressure tolerance among the participants, as well as lower pressure tolerance in females. Regarding the force applied with the exoskeleton components, male participants had higher discomfort threshold (230.3 ± 44.9 N compared to females (116.1 ± 24.6 N) in the chest area. For the applications with 20 cm2 surface, the males also showed higher pain threshold at the thigh (89.3 ± 41.8 N vs. 34.6 ± 27.2 N) and the pelvis (97.6 ± 37.0 N vs. 56.1 ± 29.5 N). All padding materials increased pressure tolerance for 10-38% (p < 0.001), but little differences between materials were observed.
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Affiliation(s)
- Žiga Kozinc
- Department of Health Studies, Andrej Marušič Institute, Universiry of Primorska, 6000, Koper, Slovenia; Faculty of Health Sciences Universiry of Primorska, 6310, Izola, Slovenia
| | - Jan Babič
- Laboratory of Neuromechanics and Biorobotics, Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia
| | - Nejc Šarabon
- Department of Health Studies, Andrej Marušič Institute, Universiry of Primorska, 6000, Koper, Slovenia; Innorenew CoE, Livade 2, 6310, Izola, Slovenia; S2P Ltd, Tehnološki Park 19, 1000, Ljubljana, Slovenia.
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Steinhilber B, Luger T, Schwenkreis P, Middeldorf S, Bork H, Mann B, von Glinski A, Schildhauer TA, Weiler S, Schmauder M, Heinrich K, Winter G, Schnalke G, Frener P, Schick R, Wischniewski S, Jäger M. The use of exoskeletons in the occupational context for primary, secondary, and tertiary prevention of work-related musculoskeletal complaints. IISE Trans Occup Ergon Hum Factors 2020; 8:132-144. [PMID: 33140996 DOI: 10.1080/24725838.2020.1844344] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OCCUPATIONAL APPLICATIONS This guideline includes 20 recommendations and four key statements that achieved consensus or strong consensus regarding the application of exoskeletons in the workplace for the prevention of musculoskeletal complaints and diseases, the general use and implementation of exoskeletons, and recommendations for risk assessment. The guideline is intended for company physicians, occupational physicians, ergonomists, occupational safety specialists, and employers, and serves as information for all other actors in practical occupational safety. Due to the lack of evidence from the scientific literature, the recommendations and key statements are the result of expert discussions that were conducted at a consensus conference in accordance with the Regulations of the Association of the Scientific Medical Societies in Germany, moderated by an external consultant.
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Affiliation(s)
- Benjamin Steinhilber
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Tübingen, Germany
| | - Tessy Luger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Tübingen, Germany
| | - Peter Schwenkreis
- Neurological University Hospital, BG University Hospital Bergmannsheil GmbH, Bochum, Germany
| | - Stefan Middeldorf
- Centre for Orthopaedics, Schön Clinic Bad Staffelstein, Bad Staffelstein, Germany
| | - Hartmut Bork
- St. Josef-Stift Sendenhorst Hospital for Orthopaedic Surgery and Rheumatology, Sendenhorst, Germany
| | - Bernhard Mann
- Institute for Sociology, University of Koblenz-Landau, Koblenz-Metternich, Germany
| | - Alexander von Glinski
- Surgical University Hospital and Polyclinic, BG University Hospital Bergmannsheil, Bochum, Germany
| | - Thomas A Schildhauer
- Surgical University Hospital and Polyclinic, BG University Hospital Bergmannsheil, Bochum, Germany
| | | | - Martin Schmauder
- Institute of Material Handling and Industrial Engineering, Technical University Dresden, Dresden, Germany
| | - Kai Heinrich
- Institute for Occupational Safety and Health of the German Social Accident Insurance, Sankt Augustin, Germany
| | - Gabriele Winter
- (BG) German Social Accident Insurance Institution for Commercial Transport, Postal Logistics and Telecommunication, Darmstadt, Germany
| | - Gerhard Schnalke
- Outpatient Rehabilitation Center Braunschweig, Braunschweig, Germany
| | - Peter Frener
- (BG) German Social Accident Insurance Institution for the Woodworking and Metalworking Industries, Düsseldorf, Germany
| | - Ralf Schick
- (BG) German Social Accident Insurance Institution for the Trade and Logistics Industry, Mannheim, Germany
| | | | - Matthias Jäger
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund University of Technology, Dortmund, Germany
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15
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Kim S, Madinei S, Alemi MM, Srinivasan D, Nussbaum MA. Assessing the potential for "undesired" effects of passive back-support exoskeleton use during a simulated manual assembly task: Muscle activity, posture, balance, discomfort, and usability. APPLIED ERGONOMICS 2020; 89:103194. [PMID: 32854824 DOI: 10.1016/j.apergo.2020.103194] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 06/10/2020] [Accepted: 06/14/2020] [Indexed: 06/11/2023]
Abstract
Back-support exoskeletons (BSEs) are wearable systems designed to reduce physical demands on the back, but which could have undesired effects beyond this design intention. Participants (n = 18) used two commercial BSEs to complete a brief (~15-20 s) simulated manual assembly task in varying conditions, with outcome measures that included: working posture, activity levels in "secondary" muscle groups (shoulders and thighs), perceived balance, discomfort, and usability. Using a BSE led to small and inconsistent changes in working postures (e.g., < ~14° change in lumbar flexion), muscular activity in the secondary muscle groups (<±2% of maximum voluntary isometric contractions), or perceived balance. Limitations in movement were reported for both BSEs, however, along with moderate levels of discomfort. Task-specific responses were evident for all outcome measures, though these depended on the specific BSE used and differed between genders in many cases. Future work should focus on interactions between a given user, BSE design, and task conditions.
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Affiliation(s)
- Sunwook Kim
- Department of Industrial and Systems Engineering, Virginia Tech Blacksburg, VA, 24061, USA
| | - Saman Madinei
- Department of Industrial and Systems Engineering, Virginia Tech Blacksburg, VA, 24061, USA
| | - Mohammad Mehdi Alemi
- Department of Orthopedic Surgery, Harvard Medical School, Boston, MA, 02115, USA
| | - Divya Srinivasan
- Department of Industrial and Systems Engineering, Virginia Tech Blacksburg, VA, 24061, USA
| | - Maury A Nussbaum
- Department of Industrial and Systems Engineering, Virginia Tech Blacksburg, VA, 24061, USA; School of Biomedical Engineering and Sciences, Virginia Tech Blacksburg, VA, 24061, USA.
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16
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Cha JS, Monfared S, Stefanidis D, Nussbaum MA, Yu D. Supporting Surgical Teams: Identifying Needs and Barriers for Exoskeleton Implementation in the Operating Room. HUMAN FACTORS 2020; 62:377-390. [PMID: 31593495 PMCID: PMC10027361 DOI: 10.1177/0018720819879271] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE The objective of this study was to identify potential needs and barriers related to using exoskeletons to decrease musculoskeletal (MS) symptoms for workers in the operating room (OR). BACKGROUND MS symptoms and injuries adversely impact worker health and performance in surgical environments. Half of the surgical team members (e.g., surgeons, nurses, trainees) report MS symptoms during and after surgery. Although the ergonomic risks in surgery are well recognized, little has been done to develop and sustain effective interventions. METHOD Surgical team members (n = 14) participated in focus groups, performed a 10-min simulated surgical task with a commercial upper-body exoskeleton, and then completed a usability questionnaire. Content analysis was conducted to determine relevant themes. RESULTS Four themes were identified: (1) characteristics of individuals, (2) perceived benefits, (3) environmental/societal factors, and (4) intervention characteristics. Participants noted that exoskeletons would benefit workers who stand in prolonged, static postures (e.g., holding instruments for visualization) and indicated that they could foresee a long-term decrease in MS symptoms with the intervention. Specifically, raising awareness of exoskeletons for early-career workers and obtaining buy-in from team members may increase future adoption of this technology. Mean participant responses from the System Usability Scale was 81.3 out of 100 (SD = 8.1), which was in the acceptable range of usability. CONCLUSION Adoption factors were identified to implement exoskeletons in the OR, such as the indicated need for exoskeletons and usability. Exoskeletons may be beneficial in the OR, but barriers such as maintenance and safety to adoption will need to be addressed. APPLICATION Findings from this work identify facilitators and barriers for sustained implementation of exoskeletons by surgical teams.
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Affiliation(s)
- Jackie S Cha
- 311308 Purdue University, West Lafayette, Indiana, USA
| | - Sara Monfared
- 12250 Indiana University School of Medicine, Indianapolis, USA
| | | | | | - Denny Yu
- 311308 Purdue University, West Lafayette, Indiana, USA
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17
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Pillai MV, Van Engelhoven L, Kazerooni H. Evaluation of a Lower Leg Support Exoskeleton on Floor and Below Hip Height Panel Work. HUMAN FACTORS 2020; 62:489-500. [PMID: 32150477 DOI: 10.1177/0018720820907752] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The aim of this study is to determine the effectiveness of using a leg support exoskeleton (legX) in different modes on simulated work tasks which emulate real-world job tasks. BACKGROUND Prolonged kneeling and squatting tasks increase the risk of work-related musculoskeletal disorders at the knee in industrial occupations. METHODS We evaluated legX capable of spring assistance throughout one's range of motion and/or locking support at a fixed angular position. Participants performed a dynamic panel task, alternating between hip and knee height, and a sustained floor level task with and without the exoskeleton. The exoskeleton was evaluated in spring mode, locking mode, and spring + locking mode for the panel task and only in locking mode for the floor task. The participants' (N = 15) muscle activity was recorded for the right lumbar erector spinae, thoracic erector spinae, tibialis anterior, rectus femoris, semitendinosus, and lateral gastrocnemius. RESULTS Significant reduction of the rectus femoris activity was observed with the exoskeleton (median reduction: 22%-56% and peak reduction: 12%-48% for the panel task and median reduction: 57% and peak reduction:34% during the floor task). CONCLUSION legX significantly reduces rectus femoris activity during squatted static (floor) and dynamic (panel) work and may reduce pain and discomfort associated with squatting and potentially reduce the risk of developing knee disorders. Dynamic tasks benefit from both locking modes and spring assistance, the greatest benefit occurring with a combination of the two. APPLICATION These results show that the legX can be beneficial to activities such as electrical panel work, grinding, sanding of larger surfaces, and concrete laying.
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18
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Howard J, Murashov VV, Lowe BD, Lu M. Industrial exoskeletons: Need for intervention effectiveness research. Am J Ind Med 2020; 63:201-208. [PMID: 31828844 DOI: 10.1002/ajim.23080] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/27/2019] [Accepted: 12/17/2019] [Indexed: 11/09/2022]
Abstract
Exoskeleton devices are being introduced across several industry sectors to augment, amplify, or reinforce the performance of a worker's existing body components-primarily the lower back and the upper extremity. Industrial exoskeletons may play a role in reducing work-related musculoskeletal disorders arising from lifting and handling heavy materials or from supporting heavy tools in overhead work. However, wearing an exoskeleton may pose a number of risks that are currently not well-studied. There are only a few studies about the safety and health implications of wearable exoskeletons and most of those studies involve only a small number of participants. Before the widespread implementation of industrial exoskeletons occurs, there is need for prospective interventional studies to evaluate the safety and health effectiveness of exoskeletons across various industry sectors. Developing a research strategy to fill current safety and health knowledge gaps, understanding the benefits, risks, and barriers to adoption of industrial exoskeletons, determining whether exoskeleton can be considered a type of personal protective equipment, and advancing consensus standards that address exoskeleton safety, should be major interests of both the occupational safety and health research and practice communities.
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Affiliation(s)
- John Howard
- Department of Health and Human Services, Centers for Disease Control and PreventionNational Institute for Occupational Safety and Health Washington District of Columbia
| | - Vladimir V. Murashov
- Department of Health and Human Services, Centers for Disease Control and PreventionNational Institute for Occupational Safety and Health Washington District of Columbia
| | - Brian D. Lowe
- Department of Health and Human Services, Centers for Disease Control and PreventionNational Institute for Occupational Safety and Health Washington District of Columbia
| | - Ming‐Lun Lu
- Department of Health and Human Services, Centers for Disease Control and PreventionNational Institute for Occupational Safety and Health Washington District of Columbia
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19
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Nussbaum MA, Lowe BD, de Looze M, Harris-Adamson C, Smets M. An Introduction to the Special Issue on Occupational Exoskeletons. IISE Trans Occup Ergon Hum Factors 2020. [DOI: 10.1080/24725838.2019.1709695] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Maury A. Nussbaum
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Brian D. Lowe
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | | | - Carisa Harris-Adamson
- Occupational and Environmental Medicine, University of California, San Francisco, CA, USA
| | - Marty Smets
- Advanced Manufacturing, Ford Motor Company, Glendale, MI, USA
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