Effects of ankle-to-knee external pressures on skin blood perfusion under and distal to compression

Evaluation of fabric-based pneumatic actuator enclosure and anchoring configurations in a pediatric soft robotic exosuit

Introduction

Soft robotics play an increasing role in the development of exosuits that assist, and in some cases enhance human motion. While most existing efforts have focused on the adult population, devices targeting infants are on the rise. This work investigated how different configurations pertaining to fabric-based pneumatic shoulder and elbow actuator embedding on the passive substrate of an exosuit for pediatric upper extremity motion assistance can affect key performance metrics.

Methods

The configurations varied based on actuator anchoring points onto the substrate and the type of fabric used to fabricate the enclosures housing the actuators. Shoulder adduction/abduction and elbow flexion/extension were treated separately. Two different variants (for each case) of similar but distinct actuators were considered. The employed metrics were grouped into two categories; reachable workspace, which includes joint range of motion and end-effector path length; and motion smoothness, which includes end-effector path straightness index and jerk. The former category aimed to capture first-order terms (i.e., rotations and displacements) that capture overall gross motion, while the latter category aimed to shed light on differential terms that correlate with the quality of the attained motion. Extensive experimentation was conducted for each individual considered configuration, and statistical analyses were used to establish distinctive strengths, weaknesses, and trade-offs among those configurations.

Results

The main findings from experiments confirm that the performance of the actuators can be significantly impacted by variations in the anchoring and fabric properties of the enclosures while establishing interesting trade-offs. Specifically, the most appropriate anchoring point was not necessarily the same for all actuator variants. In addition, highly stretchable fabrics not only maintained but even enhanced actuator capabilities, in comparison to the less stretchable materials which turned out to hinder actuator performance.

Conclusion

The established trade-offs can serve as guiding principles for other researchers and practitioners developing upper extremity exosuits.

Development of a comfort suit-type soft-wearable robot with flexible artificial muscles for walking assistance

Anchoring components are added to wearable robots to ensure a stable interaction between the suits and the human body and to minimize the displacement of the suits. However, these components can apply pressure to the body and can cause user dissatisfaction, which can decrease willingness to use the suits. Therefore, this study aims to develop a suit-type soft-wearable robot platform for walking assistance by providing comfortable garment pressure to ensure user satisfaction. The first prototype of a wearable robot suit was developed with anchoring components on the shoulders, waist, and thighs based on previous research results. Wear tests were conducted to measure garment pressure depending on posture using pressure sensors, and satisfaction surveys were conducted. The second prototype design was then developed, and performance tests with flexible artificial muscles and a satisfaction survey were conducted. Regarding the first prototype, the participants felt more than normal pressure in the shoulders and relatively less pressure in the thighs and calves. Thus, compared to the first design, the second design ensured a decreased garment pressure and resulted in an improvement of overall user satisfaction. These results can help provide guidance in the development of wearable robots by taking pressure comfort and user satisfaction into consideration.

Comparison of 4-Layer Bandages and an Adaptive Compression Therapy Device on Intended Pressure Delivery

PURPOSE

To characterize and compare interface pressure profiles of an adaptive compression therapy (ACT) device and a traditional 4-layer bandage (4LB) system.

DESIGN

A prospective, randomized, open-label, 1-arm, active controlled study.

SUBJECTS

The sample comprised 12 healthy volunteers.

METHODS

Subjects wore both devices for 8 hours on 3 consecutive days. Treatments were randomized to left and right legs. One clinician performed all applications and was experienced in the clinical use of both devices. Pressures were measured in seated and standing positions at the lower, mid, and upper calf immediately post application and after 1, 4, and 8 hours.

RESULTS

Pressures achieved with the ACT were closer to targeted 40/30/20 mmHg graduated pressure values and were significantly less than the 4LB for corresponding sites/postures (P < .001). In the seated position, initial interface pressures (mean ± SD) for the ACT were 36.9 ± 4.9, 30.5 ± 4.5, and 21.0 ± 3.6 mmHg. Corresponding interface pressures for the 4LB were 52.5 ± 8.4, 57.5 ± 10.3, and 53.5 ± 12.9 mmHg. In the standing position, initial interface pressures for the ACT were 40.7 ± 4.8, 35.6 ± 4.5, and 21.1 ± 4.6 compared to 54.6 ± 12.5, 64.4 ± 10.9, and 53.7 ± 14.3 for the 4LB. At 1, 4, and 8 hours after application, the 4LB showed a significant progressive decline in interface pressure in both seated and standing positions (P < .001). Conversely, the ACT did not decrease over time and there was a slight but significant increase for lower and mid-calf sites in the seated position (P < .001).

CONCLUSIONS

The ACT device provided more consistent interface pressures than the 4LB and the pressures achieved were consistent with contemporary venous ulcer therapy standards.

Bringing light into the dark: effects of compression clothing on performance and recovery

To assess original research addressing the effect of the application of compression clothing on sport performance and recovery after exercise, a computer-based literature research was performed in July 2011 using the electronic databases PubMed, MEDLINE, SPORTDiscus, and Web of Science. Studies examining the effect of compression clothing on endurance, strength and power, motor control, and physiological, psychological, and biomechanical parameters during or after exercise were included, and means and measures of variability of the outcome measures were recorded to estimate the effect size (Hedges g) and associated 95% confidence intervals for comparisons of experimental (compression) and control trials (noncompression). The characteristics of the compression clothing, participants, and study design were also extracted. The original research from peer-reviewed journals was examined using the Physiotherapy Evidence Database (PEDro) Scale. Results indicated small effect sizes for the application of compression clothing during exercise for short-duration sprints (10-60 m), vertical-jump height, extending time to exhaustion (such as running at VO2max or during incremental tests), and time-trial performance (3-60 min). When compression clothing was applied for recovery purposes after exercise, small to moderate effect sizes were observed in recovery of maximal strength and power, especially vertical-jump exercise; reductions in muscle swelling and perceived muscle pain; blood lactate removal; and increases in body temperature. These results suggest that the application of compression clothing may assist athletic performance and recovery in given situations with consideration of the effects magnitude and practical relevance.

Pressure and coverage effects of sporting compression garments on cardiovascular function, thermoregulatory function, and exercise performance

Sporting compression garments (CG) are used widely during exercise despite little evidence of benefits. The purpose of this study was to investigate coverage and pressure effects of full-body CG on cardiovascular and thermoregulatory function at rest and during prolonged exercise, and on exercise performance. Twelve recreationally trained male cyclists [mean (SD) age, 26 (7) years; VO(2 max), 53 (8) mL kg(-1) min(-1)] completed three sessions (counterbalanced order), wearing either correctly-sized CG (CSG; 11-15 mmHg), over-sized CG (OSG; 8-13 mmHg), or gym shorts (CONT). Test sessions were conducted in temperate conditions [24 (1)°C, 60 (4)% relative humidity; ~2 m s(-1) air velocity during exercise], consisting of resting on a chair then on a cycle ergometer, before 60-min fixed-load cycling at ~65% VO(2 max) and a 6-km time trial. Wearing CG (CSG or OSG) did not mitigate cardiovascular strain during mild orthostatic stress at rest (p = 0.20-0.93 for garment effects). During exercise, cardiac output was ~5% higher in the CG conditions (p < 0.05), which appears to be accounted for via non-significant higher end-exercise heart rate (~4-7%, p = 0.30; p = 0.06 for greater heart rate drift in CSG); other cardiovascular variables, including stroke volume, were similar among conditions (p = 0.23-0.91). Covered-skin temperature was higher in CG conditions (p < 0.001) but core (oesophageal) temperature was not (p = 0.79). Time-trial performance (mean power, time taken) was similar with or without CG (p = 0.24-0.44). In conclusion, any demonstrable physiological or psychophysical effects of full-body CG were mild and seemingly reflective more of surface coverage than pressure. No benefit was evident for exercise performance.