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Bessler-Etten J, Schaake L, Buurke JH, Prange-Lasonder GB. Investigating change of discomfort during repetitive force exertion though an exoskeleton cuff. APPLIED ERGONOMICS 2024; 115:104055. [PMID: 37984083 DOI: 10.1016/j.apergo.2023.104055] [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: 10/03/2022] [Revised: 05/17/2023] [Accepted: 05/26/2023] [Indexed: 11/22/2023]
Abstract
This article investigates discomfort development for forces exerted repetitively and for extended durations through a rigid cuff. Three force patterns, chosen to mimic exoskeleton use, were applied to the thigh of 15 healthy participants for 30 min. Changes in perceived comfort and skin effects were recorded. Discomfort was detected at normal forces ranging from 40 to >230 N. Repetitive force application triggered discomfort after a median of 4.1 min (normal force only) and 5.4 min (normal and shear force) respectively. Discomfort increased over time but the repetitive force applications did generally not result in pain and there were no significant differences between repetitive loading patterns. Exoskeleton design and use should be informed by comfort thresholds specific to prolonged repetitive loading. Large interindividual differences in perception of discomfort limit the possibilities for generally applicable comfort thresholds. Further research is needed to investigate how patient groups perceive such repetitive loading.
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Affiliation(s)
- Jule Bessler-Etten
- Roessingh Research and Development, Enschede, the Netherlands; Department of Biomedical Signals and Systems, University of Twente, Enschede, the Netherlands.
| | | | - Jaap H Buurke
- Roessingh Research and Development, Enschede, the Netherlands; Department of Biomedical Signals and Systems, University of Twente, Enschede, the Netherlands
| | - Gerdienke B Prange-Lasonder
- Roessingh Research and Development, Enschede, the Netherlands; Department of Biomechanical Engineering, University of Twente, Enschede, the Netherlands
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2
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Kim Y, Han I, Jung J, Yang S, Lee S, Koo B, Ahn S, Nam Y, Song SH. Measurements of Electrodermal Activity, Tissue Oxygen Saturation, and Visual Analog Scale for Different Cuff Pressures. SENSORS (BASEL, SWITZERLAND) 2024; 24:917. [PMID: 38339639 PMCID: PMC10857413 DOI: 10.3390/s24030917] [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: 01/08/2024] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024]
Abstract
The quantification of comfort in binding parts, essential human-machine interfaces (HMI) for the functioning of rehabilitation robots, is necessary to reduce physical strain on the user despite great achievements in their structure and control. This study aims to investigate the physiological impacts of binding parts by measuring electrodermal activity (EDA) and tissue oxygen saturation (StO2). In Experiment 1, EDA was measured from 13 healthy subjects under three different pressure conditions (10, 20, and 30 kPa) for 1 min using a pneumatic cuff on the right thigh. In Experiment 2, EDA and StO2 were measured from 10 healthy subjects for 5 min. To analyze the correlation between EDA parameters and the decrease in StO2, a survey using the visual analog scale (VAS) was conducted to assess the level of discomfort at each pressure. The EDA signal was decomposed into phasic and tonic components, and the EDA parameters were extracted from these two components. RM ANOVA and a post hoc paired t-test were used to determine significant differences in parameters as the pressure increased. The results showed that EDA parameters and the decrease in StO2 significantly increased with the pressure increase. Among the extracted parameters, the decrease in StO2 and the mean SCL proved to be effective indicators. Such analysis outcomes would be highly beneficial for studies focusing on the comfort assessment of the binding parts of rehabilitation robots.
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Affiliation(s)
- Youngho Kim
- Department of Biomedical Engineering, Yonsei University, Wonju 26493, Republic of Korea; (I.H.); (J.J.); (S.Y.); (S.L.); (B.K.)
| | - Incheol Han
- Department of Biomedical Engineering, Yonsei University, Wonju 26493, Republic of Korea; (I.H.); (J.J.); (S.Y.); (S.L.); (B.K.)
| | - Jeyong Jung
- Department of Biomedical Engineering, Yonsei University, Wonju 26493, Republic of Korea; (I.H.); (J.J.); (S.Y.); (S.L.); (B.K.)
| | - Sumin Yang
- Department of Biomedical Engineering, Yonsei University, Wonju 26493, Republic of Korea; (I.H.); (J.J.); (S.Y.); (S.L.); (B.K.)
| | - Seunghee Lee
- Department of Biomedical Engineering, Yonsei University, Wonju 26493, Republic of Korea; (I.H.); (J.J.); (S.Y.); (S.L.); (B.K.)
| | - Bummo Koo
- Department of Biomedical Engineering, Yonsei University, Wonju 26493, Republic of Korea; (I.H.); (J.J.); (S.Y.); (S.L.); (B.K.)
| | - Soonjae Ahn
- Institute of Smart Rehabilitation Engineering and Assistive Technology, Dong-Eui University, Busan 47340, Republic of Korea;
| | - Yejin Nam
- Department of Clinical Development, Angel Robotics, Seoul 04798, Republic of Korea;
| | - Sung-Hyuk Song
- Department of Robotics & Mechatronics, Korea Institute of Machinery & Materials, Daejeon 34103, Republic of Korea;
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Li-Baboud YS, Virts A, Bostelman R, Yoon S, Rahman A, Rhode L, Ahmed N, Shah M. Evaluation Methods and Measurement Challenges for Industrial Exoskeletons. SENSORS (BASEL, SWITZERLAND) 2023; 23:5604. [PMID: 37420770 DOI: 10.3390/s23125604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/15/2023] [Accepted: 05/22/2023] [Indexed: 07/09/2023]
Abstract
In recent years, exoskeleton test methods for industrial exoskeletons have evolved to include simulated laboratory and field environments. Physiological, kinematic, and kinetic metrics, as well as subjective surveys, are used to evaluate exoskeleton usability. In particular, exoskeleton fit and usability can also impact the safety of exoskeletons and their effectiveness at reducing musculoskeletal injuries. This paper surveys the state of the art in measurement methods applied to exoskeleton evaluation. A notional classification of the metrics based on exoskeleton fit, task efficiency, comfort, mobility, and balance is proposed. In addition, the paper describes the test and measurement methods used in supporting the development of exoskeleton and exosuit evaluation methods to assess their fit, usability, and effectiveness in industrial tasks such as peg in hole, load align, and applied force. Finally, the paper includes a discussion of how the metrics can be applied towards a systematic evaluation of industrial exoskeletons, current measurement challenges, and future research directions.
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Affiliation(s)
- Ya-Shian Li-Baboud
- National Institute of Standards and Technology, Gaithersburg, MD 20899, USA
| | - Ann Virts
- National Institute of Standards and Technology, Gaithersburg, MD 20899, USA
| | - Roger Bostelman
- National Institute of Standards and Technology, Gaithersburg, MD 20899, USA
- Smart HLPR LLC, Troutman, NC 28166, USA
| | - Soocheol Yoon
- National Institute of Standards and Technology, Gaithersburg, MD 20899, USA
- Institute for Soft Matter, Georgetown University, Washington, DC 20057, USA
| | - Amaan Rahman
- Department of Electrical Engineering, Albert Nerken School of Engineering, The Cooper Union for the Advancement of Science and Art, New York, NY 10003, USA
| | - Lucia Rhode
- Department of Electrical Engineering, Albert Nerken School of Engineering, The Cooper Union for the Advancement of Science and Art, New York, NY 10003, USA
| | - Nishat Ahmed
- Department of Electrical Engineering, Albert Nerken School of Engineering, The Cooper Union for the Advancement of Science and Art, New York, NY 10003, USA
| | - Mili Shah
- National Institute of Standards and Technology, Gaithersburg, MD 20899, USA
- Department of Mathematics, Albert Nerken School of Engineering, The Cooper Union for the Advancement of Science and Art, New York, NY 10003, USA
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Nam Y, Yang S, Kim J, Koo B, Song S, Kim Y. Quantification of Comfort for the Development of Binding Parts in a Standing Rehabilitation Robot. SENSORS (BASEL, SWITZERLAND) 2023; 23:2206. [PMID: 36850804 PMCID: PMC9967481 DOI: 10.3390/s23042206] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
Human-machine interfaces (HMI) refer to the physical interaction between a user and rehabilitation robots. A persisting excessive load leads to soft tissue damage, such as pressure ulcers. Therefore, it is necessary to define a comfortable binding part for a rehabilitation robot with the subject in a standing posture. The purpose of this study was to quantify the comfort at the binding parts of the standing rehabilitation robot. In Experiment 1, cuff pressures of 10-40 kPa were applied to the thigh, shank, and knee of standing subjects, and the interface pressure and pain scale were obtained. In Experiment 2, cuff pressures of 10-20 kPa were applied to the thigh, and the tissue oxygen saturation and the skin temperature were measured. Questionnaire responses regarding comfort during compression were obtained from the subjects using the visual analog scale and the Likert scale. The greatest pain was perceived in the thigh. The musculoskeletal configuration affected the pressure distribution. The interface pressure distribution by the binding part showed higher pressure at the intermuscular septum. Tissue oxygen saturation (StO2) increased to 111.9 ± 6.7% when a cuff pressure of 10 kPa was applied and decreased to 92.2 ± 16.9% for a cuff pressure of 20 kPa. A skin temperature variation greater than 0.2 °C occurred in the compressed leg. These findings would help evaluate and improve the comfort of rehabilitation robots.
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Affiliation(s)
- Yejin Nam
- Department of Biomedical Engineering, Yonsei University, Wonju 26493, Republic of Korea
| | - Sumin Yang
- Department of Biomedical Engineering, Yonsei University, Wonju 26493, Republic of Korea
| | - Jongman Kim
- Department of Biomedical Engineering, Yonsei University, Wonju 26493, Republic of Korea
| | - Bummo Koo
- Department of Biomedical Engineering, Yonsei University, Wonju 26493, Republic of Korea
| | - Sunghyuk Song
- Department of Robotics & Mechatronics, Korea Institute of Machinery & Materials, Daejeon 34103, Republic of Korea
| | - Youngho Kim
- Department of Biomedical Engineering, Yonsei University, Wonju 26493, Republic of Korea
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Bessler J, Prange-Lasonder GB, Schaake L, Saenz JF, Bidard C, Fassi I, Valori M, Lassen AB, Buurke JH. Safety Assessment of Rehabilitation Robots: A Review Identifying Safety Skills and Current Knowledge Gaps. Front Robot AI 2021; 8:602878. [PMID: 33937345 PMCID: PMC8080797 DOI: 10.3389/frobt.2021.602878] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 01/28/2021] [Indexed: 11/19/2022] Open
Abstract
The assessment of rehabilitation robot safety is a vital aspect of the development process, which is often experienced as difficult. There are gaps in best practices and knowledge to ensure safe usage of rehabilitation robots. Currently, safety is commonly assessed by monitoring adverse events occurrence. The aim of this article is to explore how safety of rehabilitation robots can be assessed early in the development phase, before they are used with patients. We are suggesting a uniform approach for safety validation of robots closely interacting with humans, based on safety skills and validation protocols. Safety skills are an abstract representation of the ability of a robot to reduce a specific risk or deal with a specific hazard. They can be implemented in various ways, depending on the application requirements, which enables the use of a single safety skill across a wide range of applications and domains. Safety validation protocols have been developed that correspond to these skills and consider domain-specific conditions. This gives robot users and developers concise testing procedures to prove the mechanical safety of their robotic system, even when the applications are in domains with a lack of standards and best practices such as the healthcare domain. Based on knowledge about adverse events occurring in rehabilitation robot use, we identified multi-directional excessive forces on the soft tissue level and musculoskeletal level as most relevant hazards for rehabilitation robots and related them to four safety skills, providing a concrete starting point for safety assessment of rehabilitation robots. We further identified a number of gaps which need to be addressed in the future to pave the way for more comprehensive guidelines for rehabilitation robot safety assessments. Predominantly, besides new developments of safety by design features, there is a strong need for reliable measurement methods as well as acceptable limit values for human-robot interaction forces both on skin and joint level.
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Affiliation(s)
- Jule Bessler
- Roessingh Research and Development, Enschede, Netherlands.,Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - Gerdienke B Prange-Lasonder
- Roessingh Research and Development, Enschede, Netherlands.,Department of Biomechanical Engineering, University of Twente, Enschede, Netherlands
| | | | - José F Saenz
- Fraunhofer Institute for Factory Operation and Automation, Magdeburg, Germany
| | | | - Irene Fassi
- National Research Council of Italy, Milan, Italy
| | | | - Aske Bach Lassen
- Department of Robot Technology, Danish Technological Institute, Odense, Denmark
| | - Jaap H Buurke
- Roessingh Research and Development, Enschede, Netherlands.,Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
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Kuber PM, Rashedi E. Product ergonomics in industrial exoskeletons: potential enhancements for workforce efficiency and safety. THEORETICAL ISSUES IN ERGONOMICS SCIENCE 2020. [DOI: 10.1080/1463922x.2020.1850905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Pranav Madhav Kuber
- Biomechanics and Ergonomics Lab, Industrial and Systems Engineering Department, Rochester Institute of Technology, Rochester, NY, USA
| | - Ehsan Rashedi
- Biomechanics and Ergonomics Lab, Industrial and Systems Engineering Department, Rochester Institute of Technology, Rochester, NY, USA
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Kermavnar T, O'Sullivan KJ, Casey V, de Eyto A, O'Sullivan LW. Circumferential tissue compression at the lower limb during walking, and its effect on discomfort, pain and tissue oxygenation: Application to soft exoskeleton design. APPLIED ERGONOMICS 2020; 86:103093. [PMID: 32342884 DOI: 10.1016/j.apergo.2020.103093] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 02/25/2020] [Accepted: 02/26/2020] [Indexed: 06/11/2023]
Abstract
Soft exoskeletons apply compressive forces at the limbs via connection cuffs to actuate movement or stabilise joints. To avoid excessive mechanical loading, the interface with the wearer's body needs to be carefully designed. The purpose of this study was to establish the magnitude of circumferential compression at the lower limb during walking that causes discomfort/pain. It was hypothesized that the thresholds differ from those during standing. A cohort of 21 healthy participants were tested using two sizes of pneumatic cuffs, inflated at the thigh and calf in a tonic or phasic manner. The results showed lower inflation pressures triggering discomfort/pain at the thigh, with tonic compression, and wider pneumatic cuffs. The thresholds were lower during walking than standing still. Deep tissue oxygenation increased during phasic compression and decreased during tonic compression. According to the findings, circumferential compression by soft exoskeletons is preferably applied at anatomical sites with smaller volumes of soft tissue, using narrow connection cuffs and inflation pressures below 14 kPa.
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Affiliation(s)
- Tjaša Kermavnar
- Design Factors, Health Research Institute & CONFIRM Smart Manufacturing Centre, School of Design, University of Limerick, Limerick, Ireland
| | - Kevin J O'Sullivan
- Design Factors, Health Research Institute & CONFIRM Smart Manufacturing Centre, School of Design, University of Limerick, Limerick, Ireland
| | - Vincent Casey
- Department of Physics, Faculty of Science & Engineering, University of Limerick, Limerick, Ireland
| | - Adam de Eyto
- Design Factors, Health Research Institute & CONFIRM Smart Manufacturing Centre, School of Design, University of Limerick, Limerick, Ireland
| | - Leonard W O'Sullivan
- Design Factors, Health Research Institute & CONFIRM Smart Manufacturing Centre, School of Design, University of Limerick, Limerick, Ireland.
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Kermavnar T, O'Sullivan KJ, de Eyto A, O'Sullivan LW. The effect of simulated circumferential soft exoskeleton compression at the knee on discomfort and pain. ERGONOMICS 2020; 63:618-628. [PMID: 32167025 DOI: 10.1080/00140139.2020.1743373] [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: 08/02/2019] [Accepted: 03/12/2020] [Indexed: 06/10/2023]
Abstract
There is a lack of data and guidance on soft exoskeleton pressure contact with the body. The purpose of this research was to study the relationship between circumferential loading at the knee and discomfort/pain, to inform the design of soft exoskeletons/exosuits. The development of discomfort and pain was studied during standing and walking with circumferential compression using a pneumatic cuff. Our results show higher tolerance for intermittent than continuous compression during standing. Discomfort was triggered at pressures ranging from 13.7 kPa (continuous compression) to 30.4 kPa (intermittent compression), and pain at 52.9 kPa (continuous compression) to 60.6 kPa (intermittent compression). During walking, cyclic compression caused an increase in discomfort with time. Higher cuff inflation pressures caused an earlier onset and higher end intensities of discomfort than lower pressures. Cyclic cuff inflation of 10 kPa and 20 kPa was reasonably well tolerated. Practitioner summary Soft exoskeleton compression of the knee was simulated during static and dynamic compression cycles. The results can be used to understand how users tolerate pressure at the knee, and also to understand the levels at which discomfort and pain are experienced. Abbreviations: BMI: body mass index; DDT: discomfort detection threshold; EndVAS: end of experiment rating on visual analog discomfort scale; PDT: pain detection threshold; SD: standard deviation; SE: standard error; TSP: temporal summation of pain; VAS: visual analogue scale.
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Affiliation(s)
| | | | - Adam de Eyto
- School of Design, University of Limerick, Limerick, Ireland
| | - Leonard W O'Sullivan
- School of Design, Health Research Institute and Confirm Smart Manufacturing Centre, University of Limerick, Limerick, Ireland
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