Application of human-centered design principles to wearable exoskeletons: a systematic review

Purpose of the article: As technologies continue to advance, designing wearable exoskeletons that are comfortable, safe, reliable, and engaging for users is an arduous task. The integration of HCD principles in exoskeleton development significantly contributes to ensuring that the product meets the needs and preferences of users. This study systematically reviews the application of human-centred design (HCD) principles in the development of wearable exoskeletons.

Methodology: It synthesizes existing literature, identifies key HCD concepts and assesses their impact on exoskeleton usability, comfort, and safety. The findings of the study revealed a moderate application of HCD in many of the studies; however, the concepts were found to play a crucial role in enhancing the usability, safety, and comfort of wearable exoskeleton technology implementation. Challenges revealed in the study include limited stakeholder involvement, a lack of standardized evaluation metrics, non-consideration of ethical, legal, and social issues, and a lack of studies on the potential adverse effects of exoskeleton use. Besides identifying the challenges faced in integrating HCD principles into exoskeleton development, the study also proposed pragmatic approaches to overcome them.

Results: The study underscores the significance of incorporating human-centred design principles in the design and development of wearable exoskeletons. This has implications for industry, rehabilitation, health, and agriculture to churn out positive outcomes. The research contributes to the expanding literature on wearable exoskeletons and HCD, offering valuable insights into the advancement of this technology in various domains and suggesting areas for future studies to address identified gaps.

Design and Control of a Soft Knee Exoskeleton for Pediatric Patients at Early Stages of the Walking Learning Process

Pediatric patients can suffer from different motor disorders that limit their neurological and motor development and hinder their independence. If treated at the very early stages of development, those limitations can be palliated or even removed. However, manual interventions are not completely effective due to the restrictions in terms of time, force, or tracking experienced by the physiotherapists. The knee flexo-extension is crucial for walking and often affected by disorders such as spasticity or lack of force in the posterior chain. This article focuses on the development of a knee exosuit to follow angular trajectories mimicking the maximum and minimum peaks present in the knee flexo-extension profiles of healthy individuals during walking. The proposed exosuit is based on shape memory alloy actuators along with four inertial sensors that close the control loop. The whole device is controlled through a two-level controller and has an hybrid rigid-flexible design to overcome the different issues present in the literature. The device was proven to be feasible for this type of application, with replicable and consistent behavior, reducing the price and weight of existing exosuits and enhancing patient comfort.

A robotic emulator for the systematic exploration of transtibial biarticular prosthesis designs

People with transtibial limb loss frequently experience suboptimal gait outcomes. This is partly attributable to the absence of the biarticular gastrocnemius muscle, which plays a unique role in walking. Although a recent surge of biarticular prostheses aims to restore gastrocnemius function, the broad design space and lack of consensus on optimal hardware and control strategies present scientific and engineering challenges. This study introduces a robotic biarticular prosthesis emulator, comprising a uniarticular ankle-foot prosthesis and knee flexion exoskeleton, each actuated by a custom off-board system. Benchtop experiments were conducted to characterize the emulator's mechatronic performance. Walking experiments with one transtibial amputee demonstrated the system's capability to provide knee and ankle assistance. The -3 dB bandwidths for the knee exoskeleton's torque and motor velocity controllers were measured at approximately 5 Hz and 100 Hz, respectively. A feedforward iterative learning controller reduced the root-mean-squared torque tracking error from 6.04 Nm to 0.99 Nm in hardware-in-the-loop experiments, an 84% improvement. User-preference-based tuning yielded a peak knee torque of approximately 20% of the estimated biological knee moment. This biarticular prosthesis emulator demonstrates significant potential as a versatile research platform that can offer valuable insights for the advancement of lower-limb assistive devices.

Human-Robot Joint Misalignment, Physical Interaction, and Gait Kinematic Assessment in Ankle-Foot Orthoses

Lower limb exoskeletons and orthoses have been increasingly used to assist the user during gait rehabilitation through torque transmission and motor stability. However, the physical human-robot interface (HRi) has not been properly addressed. Current orthoses lead to spurious forces at the HRi that cause adverse effects and high abandonment rates. This study aims to assess and compare, in a holistic approach, human-robot joint misalignment and gait kinematics in three fixation designs of ankle-foot orthoses (AFOs). These are AFOs with a frontal shin guard (F-AFO), lateral shin guard (L-AFO), and the ankle modulus of the H2 exoskeleton (H2-AFO). An experimental protocol was implemented to assess misalignment, fixation displacement, pressure interactions, user-perceived comfort, and gait kinematics during walking with the three AFOs. The F-AFO showed reduced vertical misalignment (peak of 1.37 ± 0.90 cm, p-value < 0.05), interactions (median pressures of 0.39-3.12 kPa), and higher user-perceived comfort (p-value < 0.05) when compared to H2-AFO (peak misalignment of 2.95 ± 0.64 and pressures ranging from 3.19 to 19.78 kPa). F-AFO also improves the L-AFO in pressure (median pressures ranging from 8.64 to 10.83 kPa) and comfort (p-value < 0.05). All AFOs significantly modified hip joint angle regarding control gait (p-value < 0.01), while the H2-AFO also affected knee joint angle (p-value < 0.01) and gait spatiotemporal parameters (p-value < 0.05). Overall, findings indicate that an AFO with a frontal shin guard and a sports shoe is effective at reducing misalignment and pressure at the HRI, increasing comfort with slight changes in gait kinematics.

Ergonomic dual four-bar linkage knee exoskeleton for stair ascent assistance

Introduction: Robotic exoskeletons are emerging technologies that have demonstrated their effectiveness in assisting with Activities of Daily Living. However, kinematic disparities between human and robotic joints can result in misalignment between humans and exoskeletons, leading to discomfort and potential user injuries. Methods: In this paper, we present an ergonomic knee exoskeleton based on a dual four-bar linkage mechanism powered by hydraulic artificial muscles for stair ascent assistance. The device comprises two asymmetric four-bar linkage mechanisms on the medial and lateral sides to accommodate the internal rotation of the knee and address the kinematic discrepancies between these sides. A genetic algorithm was employed to optimize the parameters of the four-bar linkage mechanism to minimize misalignment between human and exoskeleton knee joints. The proposed device was evaluated through two experiments. The first experiment measured the reduction in undesired load due to misalignment, while the second experiment evaluated the device's effectiveness in assisting stair ascent in a healthy subject. Results: The experimental results indicate that the proposed device has a significantly reduced undesired load compared to the traditional revolute joint, decreasing from 14.15 N and 18.32 N to 1.88 N and 1.07 N on the medial and lateral sides, respectively. Moreover, a substantial reduction in muscle activities during stair ascent was observed, with a 55.94% reduction in surface electromyography signal. Discussion: The reduced undesired load of the proposed dual four-bar linkage mechanism highlights the importance of the adopted asymmetrical design for reduced misalignment and increased comfort. Moreover, the proposed device was effective at reducing the effort required during stair ascent.

Control and evaluation of a humanoid robot with rolling contact joints on its lower body

In this paper, we introduce a new teen-sized humanoid platform dubbed DRACO 3, custom-built by Apptronik and altered for practical use by the Human Centered Robotics Laboratory at The University of Texas at Austin. The form factor of DRACO 3 is such that it can operate safely in human environments while reaching objects at human heights. To approximate the range of motion of humans, this robot features proximal actuation and mechanical artifacts to provide a high range of hip, knee, and ankle motions. In particular, rolling contact mechanisms on the lower body are incorporated using a proximal actuation principle to provide an extensive vertical pose workspace. To enable DRACO 3 to perform dexterous tasks while dealing with these complex transmissions, we introduce a novel whole-body controller (WBC) incorporating internal constraints to model the rolling motion behavior. In addition, details of our WBC for DRACO 3 are presented with an emphasis on practical points for hardware implementation. We perform a design analysis of DRACO 3, as well as empirical evaluations under the lens of the Centroidal Inertia Isotropy (CII) design metric. Lastly, we experimentally validate our design and controller by testing center of mass (CoM) balancing, one-leg balancing, and stepping-in-place behaviors.

Relevance of hazards in exoskeleton applications: a survey-based enquiry

Exoskeletons are becoming the reference technology for assistance and augmentation of human motor functions in a wide range of application domains. Unfortunately, the exponential growth of this sector has not been accompanied by a rigorous risk assessment (RA) process, which is necessary to identify the major aspects concerning the safety and impact of this new technology on humans. This situation may seriously hamper the market uptake of new products. This paper presents the results of a survey that was circulated to understand how hazards are considered by exoskeleton users, from research and industry perspectives. Our analysis aimed to identify the perceived occurrence and the impact of a sample of generic hazards, as well as to collect suggestions and general opinions from the respondents that can serve as a reference for more targeted RA. Our results identified a list of relevant hazards for exoskeletons. Among them, misalignments and unintended device motion were perceived as key aspects for exoskeletons' safety. This survey aims to represent a first attempt in recording overall feedback from the community and contribute to future RAs and the identification of better mitigation strategies in the field.

Estimation of Knee Assistive Moment in a Gait Cycle Using Knee Angle and Knee Angular Velocity through Machine Learning and Artificial Stiffness Control Strategy (MLASCS)

Nowadays, many people around the world cannot walk perfectly because of their knee problems. A knee-assistive device is one option to support walking for those with low or not enough knee muscle forces. Many research studies have created knee devices with control systems implementing different techniques and sensors. This study proposes an alternative version of the knee device control system without using too many actuators and sensors. It applies the machine learning and artificial stiffness control strategy (MLASCS) that uses one actuator combined with an encoder for estimating the amount of assistive support in a walking gait from the recorded gait data. The study recorded several gait data and analyzed knee moments, and then trained a k-nearest neighbor model using the knee angle and the angular velocity to classify a state in a gait cycle. This control strategy also implements instantaneous artificial stiffness (IAS), a control system that requires only knee angle in each state to determine the amount of supporting moment. After validating the model via simulation, the accuracy of the machine learning model is around 99.9% with the speed of 165 observers/s, and the walking effort is reduced by up to 60% in a single gait cycle.

Predicting Individualized Joint Kinematics Over Continuous Variations of Walking, Running, and Stair Climbing

Goal: Accounting for gait individuality is important to positive outcomes with wearable robots, but manually tuning multi-activity models is time-consuming and not viable in a clinic. Generalizations can possibly be made to predict gait individuality in unobserved conditions. Methods: Kinematic individuality-how one person's joint angles differ from the group-is quantified for every subject, joint, ambulation mode (walking, running, stair ascent, and stair descent), and intramodal task (speed, incline) in an open-access dataset with 10 able-bodied subjects. Four N-way ANOVAs test how prediction methods affect the fit to experimental data between and within ambulation modes. We test whether walking individuality (measured at a single speed on level ground) carries across modes, or whether a mode-specific prediction (based on a single task for each mode) is significantly more effective. Results: Kinematic individualization improves fit across joint and task if we consider each mode separately. Across all modes, tasks, and joints, modal individualization improved the fit in 81% of trials, improving the fit on average by 4.3[Formula: see text] across the gait cycle. This was statistically significant at all joints for walking and running, and half the joints for stair ascent/descent. Conclusions: For walking and running, kinematic individuality can be easily generalized within mode, but the trends are mixed on stairs depending on joint.

Bio-inspired design of a self-aligning, lightweight, and highly-compliant cable-driven knee exoskeleton

Powered knee exoskeletons have shown potential for mobility restoration and power augmentation. However, the benefits of exoskeletons are partially offset by some design challenges that still limit their positive effects on people. Among them, joint misalignment is a critical aspect mostly because the human knee joint movement is not a fixed-axis rotation. In addition, remarkable mass and stiffness are also limitations. Aiming to minimize joint misalignment, this paper proposes a bio-inspired knee exoskeleton with a joint design that mimics the human knee joint. Moreover, to accomplish a lightweight and high compliance design, a high stiffness cable-tension amplification mechanism is leveraged. Simulation results indicate our design can reduce 49.3 and 71.9% maximum total misalignment for walking and deep squatting activities, respectively. Experiments indicate that the exoskeleton has high compliance (0.4 and 0.1 Nm backdrive torque under unpowered and zero-torque modes, respectively), high control bandwidth (44 Hz), and high control accuracy (1.1 Nm root mean square tracking error, corresponding to 7.3% of the peak torque). This work demonstrates performance improvement compared with state-of-the-art exoskeletons.

A bioinspired robotic knee with controlled joint surfaces and adjustable ligaments

The knee joint plays a key role in kinematic and kinetic performances of pedestrain locomotion. The key role of meniscus with matched ligaments in joint stability and movability has not been fully explored in current robotic knee designs. We fabricate a bioinspired robotic knee based on a kinematic model of an anatomical knee in order to reveal the relationship between the meniscus, ligaments and their stability and movability, respectively. The kinematic model was built from magnetic resonance imaging of the human knee with generated contact profiles and customized ligament fibers. Then, the bioinspired knee was designed, and its dynamic stability was maintained by ligaments and specific contact profiles, which were acquired based on the kinematic model. Finally, a monopod robot with the bioinspired knee assembled was developed for dynamic testing. The results show that (1) a smooth rolling-sliding motion can be achieved with the addition of menisci and compatible ligaments; and (2) joint stiffness can be adjusted by changing the springs and activation lengths of ligament fibers. This study gives biomimetic insights into a new design of knee joint for a robotic/prosthetic leg.

Design and Backdrivability Modeling of a Portable High Torque Robotic Knee Prosthesis With Intrinsic Compliance For Agile Activities

High-performance prostheses are crucial to enable versatile activities like walking, squatting, and running for lower extremity amputees. State-of-the-art prostheses are either not powerful enough to support demanding activities or have low compliance (low backdrivability) due to the use of high speed ratio transmission. Besides speed ratio, gearbox design is also crucial to the compliance of wearable robots, but its role is typically ignored in the design process. This paper proposed an analytical backdrive torque model that accurately estimate the backdrive torque from both motor and transmission to inform the robot design. Following this model, this paper also proposed methods for gear transmission design to improve compliance by reducing inertia of the knee prosthesis. We developed a knee prosthesis using a high torque actuator (built-in 9:1 planetary gear) with a customized 4:1 low-inertia planetary gearbox. Benchtop experiments show the backdrive torque model is accurate and proposed prosthesis can produce 200 Nm high peak torque (shield temperature <60°C), high compliance (2.6 Nm backdrive torque), and high control accuracy (2.7/8.1/1.7 Nm RMS tracking errors for 1.25 m/s walking, 2 m/s running, and 0.25 Hz squatting, that are 5.4%/4.1%/1.4% of desired peak torques). Three able-bodied subject experiments showed our prosthesis could support agile and high-demanding activities.

Enhancing Voluntary Motion with Modular, Backdrivable, Powered Hip and Knee Orthoses

Mobility disabilities are prominent in society with wide-ranging deficits, motivating modular, partial-assist, lower-limb exoskeletons for this heterogeneous population. This paper introduces the Modular Backdrivable Lower-limb Unloading Exoskeleton (M-BLUE), which implements high torque, low mechanical impedance actuators on commercial orthoses with sheet metal modifications to produce a variety of hip- and/or knee-assisting configurations. Benchtop system identification verifies the desirable backdrive properties of the actuator, and allows for torque prediction within ±0.4 Nm. An able-bodied human subject experiment demonstrates that three unilateral configurations of M-BLUE (hip only, knee only, and hip-knee) with a simple gravity compensation controller can reduce muscle EMG readings in a lifting and lowering task relative to the bare condition. Reductions in mean muscular effort and peak muscle activation were seen across the primary squat musculature (excluding biceps femoris), demonstrating the potential to reduce fatigue leading to poor lifting posture. These promising results motivate applications of M-BLUE to additional populations, and the expansion of M-BLUE to bilateral and ankle configurations.

A Wearable Lower Limb Exoskeleton: Reducing the Energy Cost of Human Movement

Human body enhancement is an interesting branch of robotics. It focuses on wearable robots in order to improve the performance of human body, reduce energy consumption and delay fatigue, as well as increase body speed. Robot-assisted equipment, such as wearable exoskeletons, are wearable robot systems that integrate human intelligence and robot power. After careful design and adaptation, the human body has energy-saving sports, but it is an arduous task for the exoskeleton to achieve considerable reduction in metabolic rate. Therefore, it is necessary to understand the biomechanics of human sports, the body, and its weaknesses. In this study, a lower limb exoskeleton was classified according to the power source, and the working principle, design idea, wearing mode, material and performance of different types of lower limb exoskeletons were compared and analyzed. The study shows that the unpowered exoskeleton robot has inherent advantages in endurance, mass, volume, and cost, which is a new development direction of robot exoskeletons. This paper not only summarizes the existing research but also points out its shortcomings through the comparative analysis of different lower limb wearable exoskeletons. Furthermore, improvement measures suitable for practical application have been provided.

Modeling and Stiffness-based Continuous Torque Control of Lightweight Quasi-Direct-Drive Knee Exoskeletons for Versatile Walking Assistance

State-of-the-art exoskeletons are typically limited by low control bandwidth and small range stiffness of actuators which are based on high gear ratios and elastic components (e.g., series elastic actuators). Furthermore, most exoskeletons are based on discrete gait phase detection and/or discrete stiffness control resulting in discontinuous torque profiles. To fill these two gaps, we developed a portable lightweight knee exoskeleton using quasi-direct drive (QDD) actuation that provides 14 Nm torque (36.8% biological joint moment for overground walking). This paper presents 1) stiffness modeling of torque-controlled QDD exoskeletons and 2) stiffness-based continuous torque controller that estimates knee joint moment in real-time. Experimental tests found the exoskeleton had high bandwidth of stiffness control (16 Hz under 100 Nm/rad) and high torque tracking accuracy with 0.34 Nm Root Mean Square (RMS) error (6.22%) across 0-350 Nm/rad large range stiffness. The continuous controller was able to estimate knee moments accurately and smoothly for three walking speeds and their transitions. Experimental results with 8 able-bodied subjects demonstrated that our exoskeleton was able to reduce the muscle activities of all 8 measured knee and ankle muscles by 8.60%-15.22% relative to unpowered condition, and two knee flexors and one ankle plantar flexor by 1.92%-10.24% relative to baseline (no exoskeleton) condition.

The role of user preference in the customized control of robotic exoskeletons

User preference is a promising objective for the control of robotic exoskeletons because it may capture the multifactorial nature of exoskeleton use. However, to use it, we must first understand its characteristics in the context of exoskeleton control. Here, we systematically measured the control preferences of individuals wearing bilateral ankle exoskeletons during walking. We investigated users' repeatability identifying their preferences and how preference changes with walking speed, device exposure, and between individuals with different technical backgrounds. Twelve naive and 12 knowledgeable nondisabled participants identified their preferred assistance in repeated trials by simultaneously self-tuning the magnitude and timing of peak torque. They were blinded to the control parameters and relied solely on their perception of the assistance to guide their tuning. We found that participants' preferences ranged from 7.9 to 19.4 newton-meters and 54.1 to 59.2 percent of the gait cycle. Across trials, participants repeatably identified their preferences with a mean standard deviation of 1.7 newton-meters and 1.5 percent of the gait cycle. Within a trial, participants converged on their preference in 105 seconds. As the experiment progressed, naive users preferred higher torque magnitude. At faster walking speeds, these individuals were more precise at identifying the magnitude of their preferred assistance. Knowledgeable users preferred higher torque than naive users. These results highlight that although preference is a dynamic quantity, individuals can reliably identify their preferences. This work motivates strategies for the control of lower limb exoskeletons in which individuals customize assistance according to their unique preferences and provides meaningful insight into how users interact with exoskeletons.

Control of flexible knee joint exoskeleton robot based on dynamic model

The knee joint plays a significant role in ground clearness, which is a crucial subtask of normal walking and avoiding falls. While post-stroke survivors are often faced with muscle weakness during walking, which leads to inadequate knee flexion. The lack of ground clearance caused by inadequate knee flexion will severely impede walking, increase metabolic exertion, and increase the risk of falls. A compliant exoskeleton robot possesses more favorable edges than other rigid ones in lightweight, safety, sense of comfort, and so on. We developed a new type of soft exoskeleton robot to assist the knee joint to achieve desired movements with Bowden cable transmitting force and torque. With the agonist–antagonist driving method, like a group of muscles working, we have explored dual-motors structure to realize the knee flexion function. It has built a standard dynamic model to analyze stability and realize the control law. We have conducted simulation and prototype experiments to verify the feasibility and usefulness of our method. The results show that the device can compensate for the lack of the knee joint driving force and realize the reference movement. Finally, we concluded that our method is a desirable way, and the scheme could improve the knee flexion ability and clearing ground.

Design Principles for Compact, Backdrivable Actuation in Partial-Assist Powered Knee Orthoses

This paper presents the design and validation of a backdrivable powered knee orthosis for partial assistance of lower-limb musculature, which aims to facilitate daily activities in individuals with musculoskeletal disorders. The actuator design is guided by design principles that prioritize backdrivability, output torque, and compactness. First, we show that increasing the motor diameter while reducing the gear ratio for a fixed output torque ultimately reduces the reflected inertia (and thus backdrive torque). We also identify a tradeoff with actuator torque density that can be addressed by improving the motor's thermal environment, motivating our design of a custom Brushless DC motor with encapsulated windings. Finally, by designing a 7:1 planetary gearset directly into the stator, the actuator has a high package factor that reduces size and weight. Benchtop tests verify that the custom actuator can produce at least 23.9 Nm peak torque and 12.78 Nm continuous torque, yet has less than 2.68 Nm backdrive torque during walking conditions. Able-bodied human subjects experiments (N=3) demonstrate reduced quadriceps activation with bilateral orthosis assistance during lifting-lowering, sit-to-stand, and stair climbing. The minimal transmission also produces negligible acoustic noise.

Challenges and solutions for application and wider adoption of wearable robots

The science and technology of wearable robots are steadily advancing, and the use of such robots in our everyday life appears to be within reach. Nevertheless, widespread adoption of wearable robots should not be taken for granted, especially since many recent attempts to bring them to real-life applications resulted in mixed outcomes. The aim of this article is to address the current challenges that are limiting the application and wider adoption of wearable robots that are typically worn over the human body. We categorized the challenges into mechanical layout, actuation, sensing, body interface, control, human-robot interfacing and coadaptation, and benchmarking. For each category, we discuss specific challenges and the rationale for why solving them is important, followed by an overview of relevant recent works. We conclude with an opinion that summarizes possible solutions that could contribute to the wider adoption of wearable robots.

Lower-limb kinematics and kinetics during continuously varying human locomotion

Human locomotion involves continuously variable activities including walking, running, and stair climbing over a range of speeds and inclinations as well as sit-stand, walk-run, and walk-stairs transitions. Understanding the kinematics and kinetics of the lower limbs during continuously varying locomotion is fundamental to developing robotic prostheses and exoskeletons that assist in community ambulation. However, available datasets on human locomotion neglect transitions between activities and/or continuous variations in speed and inclination during these activities. This data paper reports a new dataset that includes the lower-limb kinematics and kinetics of ten able-bodied participants walking at multiple inclines (±0°; 5° and 10°) and speeds (0.8 m/s; 1 m/s; 1.2 m/s), running at multiple speeds (1.8 m/s; 2 m/s; 2.2 m/s and 2.4 m/s), walking and running with constant acceleration (±0.2; 0.5), and stair ascent/descent with multiple stair inclines (20°; 25°; 30° and 35°). This dataset also includes sit-stand transitions, walk-run transitions, and walk-stairs transitions. Data were recorded by a Vicon motion capture system and, for applicable tasks, a Bertec instrumented treadmill.

A Time Division Multiplexing Inspired Lightweight Soft Exoskeleton for Hip and Ankle Joint Assistance

Exoskeleton robots are frequently applied to augment or assist the user's natural motion. Generally, each assisted joint corresponds to at least one specific motor to ensure the independence of movement between joints. This means that as there are more joints to be assisted, more motors are required, resulting in increasing robot weight, decreasing motor utilization, and weakening exoskeleton robot assistance efficiency. To solve this problem, the design and control of a lightweight soft exoskeleton that assists hip-plantar flexion of both legs in different phases during a gait cycle with only one motor is presented in this paper. Inspired by time-division multiplexing and the symmetry of walking motion, an actuation scheme that uses different time-periods of the same motor to transfer different forces to different joints is formulated. An automatic winding device is designed to dynamically change the loading path of the assistive force at different phases of the gait cycle. The system is designed to assist hip flexion and plantar flexion of both legs with only one motor, since there is no overlap between the hip flexion movement and the toe-offs movement of the separate legs during walking. The weight of the whole system is only 2.24 kg. PD iterative control is accomplished by an algorithm that utilizes IMUs attached on the thigh recognizing the maximum hip extension angle to characterize toe-offs indirectly, and two load cells to monitor the cable tension. In the study of six subjects, muscle fatigue of the rectus femoris, vastus lateralis, gastrocnemius and soleus decreased by an average of 14.69%, 6.66%, 17.71%, and 8.15%, respectively, compared to scenarios without an exoskeleton.

Biomechanical Comparison of Assistance Strategies Using a Bilateral Robotic Knee Exoskeleton

Despite there being studies that have investigated the effects of human augmentation using a knee exoskeleton, comparing different assistance schemes on a single knee exoskeleton has not been studied. Using a light-weight, low-profile bilateral knee exoskeleton system, this study examined and compared the biomechanical effects of three common assistance strategies (biological torque, impedance, and proportional myoelectric controllers) exhibiting different levels of flexibility for the user to control the assistance. Nine subjects walked on a 15% gradient incline surface at 1.1 m/s in the three powered conditions and with the exoskeleton unpowered. All the assistance strategies significantly reduced the metabolic cost of the users compared to the unpowered condition by 3.0% on average across strategies (p < 0.05), led by the significant reduction in the biological knee kinetic effort and knee extensor muscle activation (p < 0.05). Between assistance strategies, the metabolic cost and biomechanics displayed no statistically significant differences. The metabolic and biomechanical results indicate that powered extension assistance during early stance can improve performance compared to the unpowered condition. However, the user's ability to control the assistance may not be significant for human augmentation when walking on an inclined surface with a knee exoskeleton.

Self-Aligning Mechanism Improves Comfort and Performance With a Powered Knee Exoskeleton

Misalignments between powered exoskeleton joints and the user's anatomical joints are inevitable due to difficulty locating the anatomical joint axis, non-constant location of the anatomical joint axis, and soft-tissue deformations. Self-aligning mechanisms have been proposed to prevent spurious forces and torques on the user's limb due to misalignments. Several exoskeletons have been developed with self-aligning mechanisms based on theoretical models. However, there is no experimental evidence demonstrating the efficacy of self-aligning mechanisms in lower-limb exoskeletons. Here we show that a lightweight and compact self-aligning mechanism improves the user's comfort and performance while using a powered knee exoskeleton. Experiments were conducted with 14 able-bodied subjects with the self-aligning mechanism locked and unlocked. Our results demonstrate up to 15.3% increased comfort and 38% improved performance when the self-aligning mechanism was unlocked. Not surprisingly, the spurious forces and torques were reduced by up to 97% when the self-aligning mechanism was unlocked. This study demonstrates the efficacy of self-aligning mechanisms in improving comfort and performance for sit-to-stand and position tracking tasks with a powered knee exoskeleton.

DESIGN, DYNAMIC MODELING AND CONTROL OF WEARABLE FINGER ORTHOSIS

Human hands and fingers are of significant importance in people’s capacity to perform daily tasks (touching, feeling, holding, gripping, writing). However, about 1.5 million people around the world are suffering from injuries, muscle and neurological disorders, a loss of hand function, or a few fingers due to stroke. This paper focuses on newly developed finger orthotics, which is thin, adaptable to the length of each finger and low energy costs. The aim of the study is to design and control a new robotic orthosis using for daily rehabilitation therapy. Kinematic and dynamic analysis of orthosis was calculated and the joint regulation of orthosis was obtained. The Lagrange method was used to obtain dynamics, and the Denavit–Hartenberg (D–H) method was used for kinematic analysis of hand. In order to understand its behavior, the robotic finger orthotics model was simulated in MatLab/Simulink. The simulation results show that the efficiency and robustness of proportional integral derivative (PID) controller are appropriate for the use of robotic finger orthotics.

Lower limb rehabilitation robotics: The current understanding and technology

BACKGROUND

With the increasing rate of ambulatory disabilities and rise in the elderly population, advance methods to deliver the rehabilitation and assistive services to patients have become important. Lower limb robotic therapeutic and assistive aids have been found to improve the rehabilitation outcome.

OBJECTIVE

The article aims to present the updated understanding in the field of lower limb rehabilitation robotics and identify future research avenues.

METHODS

Groups of keywords relating to assistive technology, rehabilitation robotics, and lower limb were combined and searched in EMBASE, IEEE Xplore Digital Library, Scopus, Web of Science and Google Scholar database.

RESULTS

Based on the literature collected from the databases we provide an overview of the understanding of robotics in rehabilitation and state of the art devices for lower limb rehabilitation. Technological advancements in rehabilitation robotic architecture (sensing, actuation and control) and biomechanical considerations in design have been discussed. Finally, a discussion on the major advances, research directions, and challenges is presented.

CONCLUSIONS

Although the use of robotics has shown a promising approach to rehabilitation and reducing the burden on caregivers, extensive and innovative research is still required in both cognitive and physical human-robot interaction to achieve treatment efficacy and efficiency.

Design and Validation of a Powered Knee-Ankle Prosthesis with High-Torque, Low-Impedance Actuators

We present the design of a powered knee-ankle prosthetic leg, which implements high-torque actuators with low-reduction transmissions. The transmission coupled with a high-torque and low-speed motor creates an actuator with low mechanical impedance and high backdrivability. This style of actuation presents several possible benefits over modern actuation styles in emerging robotic prosthetic legs, which include free-swinging knee motion, compliance with the ground, negligible unmodeled actuator dynamics, less acoustic noise, and power regeneration. Benchtop tests establish that both joints can be backdriven by small torques (~1-3 Nm) and confirm the small reflected inertia. Impedance control tests prove that the intrinsic impedance and unmodeled dynamics of the actuator are sufficiently small to control joint impedance without torque feedback or lengthy tuning trials. Walking experiments validate performance under the designed loading conditions with minimal tuning. Lastly, the regenerative abilities, low friction, and small reflected inertia of the presented actuators reduced power consumption and acoustic noise compared to state-of-art powered legs.

Quasi-Direct Drive Actuation for a Lightweight Hip Exoskeleton with High Backdrivability and High Bandwidth

High-performance actuators are crucial to enable mechanical versatility of wearable robots, which are required to be lightweight, highly backdrivable, and with high bandwidth. State-of-the-art actuators, e.g., series elastic actuators (SEAs), have to compromise bandwidth to improve compliance (i.e., backdrivability). We describe the design and human-robot interaction modeling of a portable hip exoskeleton based on our custom quasi-direct drive (QDD) actuation (i.e., a high torque density motor with low ratio gear). We also present a model-based performance benchmark comparison of representative actuators in terms of torque capability, control bandwidth, backdrivability, and force tracking accuracy. This paper aims to corroborate the underlying philosophy of "design for control", namely meticulous robot design can simplify control algorithms while ensuring high performance. Following this idea, we create a lightweight bilateral hip exoskeleton to reduce joint loadings during normal activities, including walking and squatting. Experiments indicate that the exoskeleton is able to produce high nominal torque (17.5 Nm), high backdrivability (0.4 Nm backdrive torque), high bandwidth (62.4 Hz), and high control accuracy (1.09 Nm root mean square tracking error, 5.4% of the desired peak torque). Its controller is versatile to assist walking at different speeds and squatting. This work demonstrates performance improvement compared with state-of-the-art exoskeletons.

Efficient Multiaxial Shoulder-Motion Tracking Based on Flexible Resistive Sensors Applied to Exosuits

This article describes the performance of a flexible resistive sensor network to track shoulder motion. This system monitors every gesture of the human shoulder in its range of motion except rotations around the longitudinal axis of the arm. In this regard, the design considers the movement of the glenohumeral, acromioclavicular, sternoclavicular, and scapulothoracic joints. The solution presented in this work considers several sensor configurations and compares its performance with a set of inertial measurement units (IMUs). These devices have been put together in a shoulder suit with Optitrack visual markers in order to be used as pose ground truth. Optimal configurations of flexible resistive sensors, in terms of accuracy requirements and number of sensors, have been obtained by applying principal component analysis techniques. The data provided by each configuration are then mapped onto the shoulder pose by using neural network algorithms. According to the results shown in this article, a set of flexible resistive sensors can be an adequate alternative to IMUs for multiaxial shoulder pose tracking in open spaces. Furthermore, the system presented can be easily embedded in fabric or wearable devices without obstructing the user's motion.

Overview: Types of Lower Limb Exoskeletons

Researchers have given attention to lower limb exoskeletons in recent years. Lower limb exoskeletons have been designed, prototype tested through experiments, and even produced. In general, lower limb exoskeletons have two different objectives: (1) rehabilitation and (2) assisting human work activities. Referring to these objectives, researchers have iteratively improved lower limb exoskeleton designs, especially in the location of actuators. Some of these devices use actuators, particularly on hips, ankles or knees of the users. Additionally, other devices employ a combination of actuators on multiple joints. In order to provide information about which actuator location is more suitable; a review study on the design of actuator locations is presented in this paper. The location of actuators is an important factor because it is related to the analysis of the design and the control system. This factor affects the entire lower limb exoskeleton’s performance and functionality. In addition, the disadvantages of several types of lower limb exoskeletons in terms of actuator locations and the challenges of the lower limb exoskeleton in the future are also presented in this paper.

Design and Validation of a Partial-Assist Knee Orthosis with Compact, Backdrivable Actuation

This paper presents the mechatronic design and initial validation of a partial-assist knee orthosis for individuals with musculoskeletal disorders, e.g., knee osteoarthritis and lower back pain. This orthosis utilizes a quasi-direct drive actuator with a low-ratio transmission (7:1) to greatly reduce the reflected inertia for high backdrivability. To provide meaningful assistance, a custom Brushless DC (BLDC) motor is designed with encapsulated windings to improve the motor's thermal environment and thus its continuous torque output. The 2.69 kg orthosis is constructed from all custom-made components with a high package factor for lighter weight and a more compact size. The combination of compactness, backdrivability, and torque output enables the orthosis to provide partial assistance without obstructing the natural movement of the user. Several benchtop tests verify the actuator's capabilities, and a human subject experiment demonstrates reduced quadriceps muscle activation when assisted during a repetitive lifting and lowering task.