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Hu X, Ma Z, Zhao F, Guo S. Recent Advances in Self-Powered Wearable Flexible Sensors for Human Gaits Analysis. NANOMATERIALS (BASEL, SWITZERLAND) 2024; 14:1173. [PMID: 39057851 PMCID: PMC11279839 DOI: 10.3390/nano14141173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 07/05/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024]
Abstract
The rapid progress of flexible electronics has met the growing need for detecting human movement information in exoskeleton auxiliary equipment. This study provides a review of recent advancements in the design and fabrication of flexible electronics used for human motion detection. Firstly, a comprehensive introduction is provided on various self-powered wearable flexible sensors employed in detecting human movement information. Subsequently, the algorithms utilized to provide feedback on human movement are presented, followed by a thorough discussion of their methods and effectiveness. Finally, the review concludes with perspectives on the current challenges and opportunities in implementing self-powered wearable flexible sensors in exoskeleton technology.
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Affiliation(s)
- Xiaohe Hu
- School of Mechanical, Electronic and Control Engineering, Beijing Jiaotong University, Beijing 100044, China; (X.H.); (F.Z.)
| | - Zhiqiang Ma
- Department of Biomedical Engineering, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong 999077, China
| | - Fuqun Zhao
- School of Mechanical, Electronic and Control Engineering, Beijing Jiaotong University, Beijing 100044, China; (X.H.); (F.Z.)
| | - Sheng Guo
- School of Mechanical, Electronic and Control Engineering, Beijing Jiaotong University, Beijing 100044, China; (X.H.); (F.Z.)
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Cha JS, Athanasiadis DI, Asadi H, Stefanidis D, Nussbaum MA, Yu D. Evaluation of a passive arm-support exoskeleton for surgical team members: Results from live surgeries. JOURNAL OF SAFETY RESEARCH 2024; 89:322-330. [PMID: 38858056 DOI: 10.1016/j.jsr.2024.02.003] [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: 11/17/2022] [Revised: 08/16/2023] [Accepted: 02/05/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND Musculoskeletal symptoms and injuries adversely impact the health of surgical team members and their performance in the operating room (OR). Though ergonomic risks in surgery are well-recognized, mitigating these risks is especially difficult. In this study, we aimed to assess the impacts of an exoskeleton when used by OR team members during live surgeries. METHODS A commercial passive arm-support exoskeleton was used. One surgical nurse, one attending surgeon, and five surgical trainees participated. Twenty-seven surgeries were completed, 12 with and 15 without the exoskeleton. Upper-body postures and muscle activation levels were measured during the surgeries using inertial measurement units and electromyography sensors, respectively. Postures, muscle activation levels, and self-report metrics were compared between the baseline and exoskeleton conditions using non-parametric tests. RESULTS Using the exoskeleton significantly decreased the percentage of time in demanding postures (>45° shoulder elevation) for the right shoulder by 7% and decreased peak muscle activation of the left trapezius, right deltoid, and right lumbar erector spinae muscles, by 7%, 8%, and 12%, respectively. No differences were found in perceived effort, and overall scores on usability ranged from "OK" to "excellent." CONCLUSIONS Arm-support exoskeletons have the potential to assist OR team members in reducing musculoskeletal pain and fatigue indicators. To further increase usability in the OR, however, better methods are needed to identify the surgical tasks for which an exoskeleton is effective.
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Affiliation(s)
| | | | - Hamed Asadi
- Purdue University, West Lafayette, IN, United States
| | | | | | - Denny Yu
- Purdue University, West Lafayette, IN, United States
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3
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Gonzales A, Barbieri DF, Carbonell AM, Joseph A, Srinivasan D, Cha J. The compatibility of exoskeletons in perioperative environments and workflows: an analysis of surgical team members' perspectives and workflow simulation. ERGONOMICS 2024; 67:674-694. [PMID: 37478005 DOI: 10.1080/00140139.2023.2240045] [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: 03/01/2023] [Accepted: 07/15/2023] [Indexed: 07/23/2023]
Abstract
Surgical team members in perioperative environments experience high physical demands. Interventions such as exoskeletons, external wearable devices that support users, have the potential to reduce these work-related physical demands. However, barriers such as workplace environment and task compatibility may limit exoskeleton implementation. This study gathered the perspectives of 33 surgical team members: 12 surgeons, four surgical residents, seven operating room (OR) nurses, seven surgical technicians (STs), two central processing technicians (CPTs), and one infection control nurse to understand their workplace compatibility. Team members were introduced to passive exoskeletons via demonstrations, after which surgical staff (OR nurses, STs, and CPTs) were led through a simulated workflow walkthrough where they completed tasks representative of their workday. Five themes emerged from the interviews (workflow, user needs, hindrances, motivation for intervention, and acceptance) with unique subthemes for each population. Overall, exoskeletons were largely compatible with the duties and workflow of surgical team members.
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Affiliation(s)
- Alec Gonzales
- Department of Industrial Engineering, Clemson University, Clemson, South Carolina, USA
| | | | - Alfredo M Carbonell
- Department of Surgery, Prisma Health - Upstate, Greenville, South Carolina, USA
- University of South Carolina School of Medicine-Greenville, Greenville, South Carolina, USA
| | - Anjali Joseph
- School of Architecture, Clemson University, Clemson, South Carolina, USA
| | - Divya Srinivasan
- Department of Industrial Engineering, Clemson University, Clemson, South Carolina, USA
| | - Jackie Cha
- Department of Industrial Engineering, Clemson University, Clemson, South Carolina, USA
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Vallée A. Exoskeleton technology in nursing practice: assessing effectiveness, usability, and impact on nurses' quality of work life, a narrative review. BMC Nurs 2024; 23:156. [PMID: 38443892 PMCID: PMC10913291 DOI: 10.1186/s12912-024-01821-3] [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: 08/23/2023] [Accepted: 02/22/2024] [Indexed: 03/07/2024] Open
Abstract
The use of exoskeletons in nursing practice has gained attention as a potential solution to address the physical demands and risks associated with the profession. This narrative review examines the effectiveness, usability, and impact of exoskeleton technology on nurses' quality of work life. The review focuses on the reduction of physical strain and fatigue, improved posture and body mechanics, enhanced patient care, usability and acceptance factors, and the broader impact on work life. The effectiveness of exoskeletons in reducing physical strain and fatigue among nurses is supported by evidence showing decreased muscle activation and reduced forces exerted on the body. The usability and acceptance of exoskeletons are critical considerations, including device comfort and fit, ease of use and integration into workflows, user experience and training, compatibility with the work environment, and user feedback for iterative design improvements. The implementation of exoskeletons has the potential to positively impact nurses' work life by reducing work-related injuries, improving physical well-being, enhancing job satisfaction, and promoting psychological and psychosocial benefits. Additionally, the use of exoskeletons can lead to improved patient care outcomes. Challenges and future directions in the field of exoskeleton technology for nurses include cost and accessibility, adaptability to nursing specialties and tasks, long-term durability and maintenance, integration with personal protective equipment, and ethical considerations. Addressing these challenges and considering future research and development efforts are crucial for the successful integration of exoskeleton technology in nursing practice, ultimately improving nurses' quality of work life and patient care delivery.
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Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology and Public Health, Foch Hospital, 92150, Suresnes, France.
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Accompagnement d’une blanchisserie dans l’acquisition d’exosquelettes professionnels. ARCH MAL PROF ENVIRO 2023. [DOI: 10.1016/j.admp.2023.101795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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Maurice P, Cuny-Enault F, Ivaldi S. Influence of a passive back support exoskeleton on simulated patient bed bathing: results of an exploratory study. ERGONOMICS 2023; 66:859-873. [PMID: 36154913 DOI: 10.1080/00140139.2022.2129097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 09/20/2022] [Indexed: 05/24/2023]
Abstract
Low-back pain is a major concern among healthcare workers. One cause is the frequent adoption of repetitive forward bent postures in their daily activities. Occupational exoskeletons have the potential to assist workers in such situations. However, their efficacy is largely task-dependent, and their biomechanical benefit in the healthcare sector has rarely been evaluated. The present study investigates the effects of a passive back support exoskeleton in a simulated patient bed bathing task. Nine participants performed the task on a medical manikin, with and without the exoskeleton. Results show that working with the exoskeleton induced a significantly larger trunk forward flexion, by 13 deg in average. Due to this postural change, using the exoskeleton did not affect substantially the muscular and cardiovascular demands nor the perceived effort. These results illustrate that postural changes induced by exoskeleton use, whether voluntary or not, should be considered carefully since they may cancel out biomechanical benefits expected from the assistance. Practitioner summary: Low-back pain is a major concern among nurses, associated with bent postures. We observed that using a passive back-support exoskeleton during the typical patient bed bathing activity results in a larger trunk flexion, without changing muscular, cardiovascular or perceived physical effort.
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Affiliation(s)
| | | | - Serena Ivaldi
- Université de Lorraine, CNRS, Inria, LORIA, Nancy, France
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Gordon DFN, Christou A, Stouraitis T, Gienger M, Vijayakumar S. Adaptive assistive robotics: a framework for triadic collaboration between humans and robots. ROYAL SOCIETY OPEN SCIENCE 2023; 10:221617. [PMID: 37388317 PMCID: PMC10300679 DOI: 10.1098/rsos.221617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 05/30/2023] [Indexed: 07/01/2023]
Abstract
Robots and other assistive technologies have a huge potential to help society in domains ranging from factory work to healthcare. However, safe and effective control of robotic agents in these environments is complex, especially when it involves close interactions and multiple actors. We propose an effective framework for optimizing the behaviour of robots and complementary assistive technologies in systems comprising a mix of human and technological agents with numerous high-level goals. The framework uses a combination of detailed biomechanical modelling and weighted multi-objective optimization to allow for the fine tuning of robot behaviours depending on the specification of the task at hand. We illustrate our framework via two case studies across assisted living and rehabilitation scenarios, and conduct simulations and experiments of triadic collaboration in practice. Our results indicate a marked benefit to the triadic approach, showing the potential to improve outcome measures for human agents in robot-assisted tasks.
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Affiliation(s)
- Daniel F. N. Gordon
- The University of Edinburgh, Edinburgh, UK
- The Alan Turing Institute, London, UK
| | | | | | | | - Sethu Vijayakumar
- The University of Edinburgh, Edinburgh, UK
- The Alan Turing Institute, London, UK
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Farah L, Roll D, Sorais A, Vallée A. Assessment of Exoskeletons on Nurses' Quality of Work Life: A Pilot Study at Foch Hospital. NURSING REPORTS 2023; 13:780-791. [PMID: 37218949 DOI: 10.3390/nursrep13020068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/05/2023] [Accepted: 05/09/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND The prevention of occupational risks is part of the quality of work life and it is a component that improves the physical work environment. The purpose of the present study was to investigate how to maintain posture and to reduce pain and fatigue for nurses, with an exoskeleton adapted to the work at hospital. METHODS The exoskeleton was used between 2022 to 2023 at Foch Hospital, France. Phase 1 consisted of the selection of the exoskeleton, and Phase 2 included the testing of the device by the nurses and a questionnaire to assess it. RESULTS The "active" ATLAS model from JAPET, ensuring lumbar protection, was selected because it corresponds to all the specification criteria to tackle the nurses' unmet need. Among the 14 healthcare professionals, 86% were women; the age of the nurses was between 23 years old and 58 years old. The global median satisfaction score of the nurses relative to the use of the exoskeleton was 6/10. The median impact of the exoskeleton on nurses' fatigue was 7/10. CONCLUSIONS The implementation of the exoskeleton received global positive qualitative feedback from the nurses concerning the improvement of posture and the reduction in fatigue and pain.
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Affiliation(s)
- Line Farah
- Innovation Center for Medical Devices, Foch Hospital, 92150 Suresnes, France
| | - Dorota Roll
- Quality of Work Life Department, Foch Hospital, 92150 Suresnes, France
| | - Amrei Sorais
- Quality of Work Life Department, Foch Hospital, 92150 Suresnes, France
| | - Alexandre Vallée
- Department of Epidemiology-Data-Biostatistics, Foch Hospital, 92150 Suresnes, France
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Garces E, Puyuelo G, Sánchez-Iglesias I, Francisco Del Rey JC, Cumplido C, Destarac M, Plaza A, Hernández M, Delgado E, Garcia E. Using a robotic exoskeleton at home: An activity tolerance case study of a child with spinal muscular atrophy. J Pediatr Nurs 2022; 67:e71-e78. [PMID: 36192285 DOI: 10.1016/j.pedn.2022.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 09/12/2022] [Accepted: 09/20/2022] [Indexed: 11/15/2022]
Abstract
PURPOSE Spinal Muscular Atrophy (SMA) Type II is a neurodegenerative disease that leads to progressive muscle weakness. It prevents children from walking and affects their respiratory function and their activity tolerance, among other health problems. We aimed to assess the activity tolerance showed by a child with SMA using a pediatric gait exoskeleton at home when walking and performing activities. DESIGN AND METHODS This study presents the case of a 6-year-old boy with SMA Type II and respiratory failure who used a pediatric gait exoskeleton at home for a period of two months. A nursing assessment was done before and during the use of the device to evaluate the child's activity tolerance during the sessions. Nursing interviews, performance, vital signs, fatigue, field notes, and functional scales were analyzed. RESULTS The nursing assessment showed a good activity tolerance of the child. Performance using the device improved over time; vital signs did not vary significantly during the sessions; fatigue perception decreased over time; and the child reached a higher score on some functional outcomes. CONCLUSIONS A first step has been taken to evaluate the impact of exoskeleton technology in children with SMA Type II from the nursing point of view, exposing the potential of this technology for the care of children with neuromuscular diseases, and the need for more research on the topic. PRACTICE IMPLICATIONS The information in this study will be useful to nurses to know the effects of gait exoskeletons in pediatric care of children with neuromuscular diseases like SMA.
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Affiliation(s)
- Elena Garces
- Marsi Bionics S.L., Calle Marie Curie 19, 28521 Rivas Vaciamadrid, Madrid, Spain; University of Alcalá, Pza. San Diego, s/n, 28801 Alcalá de Henares, Madrid, Spain.
| | - Gonzalo Puyuelo
- Marsi Bionics S.L., Calle Marie Curie 19, 28521 Rivas Vaciamadrid, Madrid, Spain; Rey Juan Carlos University, Camino del Molino, s/n, 28942 Fuenlabrada, Madrid, Spain
| | - Iván Sánchez-Iglesias
- Complutense University of Madrid, Psychobiology & Behavioural Sciences Methods Department, Avda. de Séneca. N 2, 28040 Madrid, Spain
| | | | - Carlos Cumplido
- Rey Juan Carlos University, Camino del Molino, s/n, 28942 Fuenlabrada, Madrid, Spain; Centre for Automation and Robotics, (CSIC-UPM), Km. 22,800. N-III. La Poveda, Rivas Vaciamadrid, Madrid, Spain
| | - Marie Destarac
- Marsi Bionics S.L., Calle Marie Curie 19, 28521 Rivas Vaciamadrid, Madrid, Spain
| | - Alberto Plaza
- Marsi Bionics S.L., Calle Marie Curie 19, 28521 Rivas Vaciamadrid, Madrid, Spain; Technical University of Madrid, Calle Ramiro de Maeztu. N 7, 28040 Madrid, Spain
| | - Mar Hernández
- Centre for Automation and Robotics, (CSIC-UPM), Km. 22,800. N-III. La Poveda, Rivas Vaciamadrid, Madrid, Spain
| | | | - Elena Garcia
- Centre for Automation and Robotics, (CSIC-UPM), Km. 22,800. N-III. La Poveda, Rivas Vaciamadrid, Madrid, Spain
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Rayssiguie E, Erden MS. A Review of Exoskeletons Considering Nurses. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22187035. [PMID: 36146385 PMCID: PMC9501849 DOI: 10.3390/s22187035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/17/2022] [Accepted: 08/29/2022] [Indexed: 05/31/2023]
Abstract
Daily tasks of nurses include manual handling to assist patients. Repetitive manual handling leads to high risk of injuries due to the loads on nurses' bodies. Nurses, in hospitals and care homes, can benefit from the advances in exoskeleton technology assisting their manual handling tasks. There are already exoskeletons both in the market and in the research area made to assist physical workers to handle heavy loads. However, those exoskeletons are mostly designed for men, as most physical workers are men, whereas most nurses are women. In the case of nurses, they handle patients, a more delicate task than handling objects, and any such device used by nurses should easily be disinfected. In this study, the needs of nurses are examined, and a review of the state-of-the-art exoskeletons is conducted from the perspective of to what extent the existing technologies address the needs of nurses. Possible solutions and technologies and particularly the needs that have not been addressed by the existing technologies are discussed.
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Koyanagi K, Takata Y, Kakinuma Y, Anzai H, Sakurai K, Oshima T. Large force actuator using an electro-adhesive gel super multi-disk. Adv Robot 2022. [DOI: 10.1080/01691864.2022.2117573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
| | - Yudai Takata
- Graduate School of Engineering, Toyama Prefectural University, Imizu, Japan
| | | | - Hidenobu Anzai
- ERG R&D Department, Fujikura Kasei Co., Ltd., Saitama, Japan
| | - Koji Sakurai
- ERG R&D Department, Fujikura Kasei Co., Ltd., Saitama, Japan
| | - Toru Oshima
- Faculty of Engineering, Toyama Prefectural University, Imizu, Japan
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Zheng L, Hawke AL, Evans K. Critical review on applications and roles of exoskeletons in patient handling. INTERNATIONAL JOURNAL OF INDUSTRIAL ERGONOMICS 2022; 89:10.1016/j.ergon.2022.103290. [PMID: 35924209 PMCID: PMC9345507 DOI: 10.1016/j.ergon.2022.103290] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Musculoskeletal Disorders (MSDs) remain a major concern for workers in the healthcare industry. Healthcare workers are at high risk of work-related MSDs mainly caused by overexertion from manually handling patients. Exoskeletons may be a useful tool to help reduce the risk of MSDs during patient handling. As a review study, we surveyed articles focusing on applying exoskeletons to patient handling tasks specifically. We also reviewed relevant government databases and other studies related to Safe Patient Handling and Mobility (SPHM) programs and exoskeleton applications in general. The exoskeletons specifically designed for patient handling were found to be sparse. To have a better understanding of the needs and challenges of developing and using exoskeletons for reducing risks of work-related MSDs in healthcare workers during patient handling, this critical review (1) provided an overview of the existing issues and projected future burdens related to work-related MSDs during patient handling tasks, (2) recognized current and potential roles and applications of existing exoskeletons, and (3) identified challenges and needs for future exoskeleton products. In conclusion, we do not expect exoskeletons to replace the existing SPHM programs, but rather play a complementary role to these multi-pronged programs. We expect that emerging exoskeleton products can be introduced to uncontrolled or specialized healthcare environments. There are various expectations and requirements for an exoskeleton used in different healthcare settings. Additionally, introducing certain types of exoskeletons for patients to assist them during treatment and rehabilitation may help reduce the MSD risks to the healthcare workers.
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Affiliation(s)
- Liying Zheng
- Health Effects Laboratory Division, National Institute for
Occupational Safety and Health, Morgantown, WV, USA
- Corresponding author.
(L. Zheng)
| | - Ashley L. Hawke
- Health Effects Laboratory Division, National Institute for
Occupational Safety and Health, Morgantown, WV, USA
| | - Kimeran Evans
- Division of Physical Therapy, School of Medicine, West
Virginia University, Morgantown, WV, USA
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