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Quirk DA, Chung J, Applegate M, Cherin JM, Dalton DM, Awad LN, Walsh CJ. Evaluating adaptiveness of an active back exosuit for dynamic lifting and maximum range of motion. ERGONOMICS 2024; 67:660-673. [PMID: 37482538 PMCID: PMC10803634 DOI: 10.1080/00140139.2023.2240044] [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: 04/19/2023] [Accepted: 07/17/2023] [Indexed: 07/25/2023]
Abstract
Back exosuits deliver mechanical assistance to reduce the risk of back injury, however, minimising restriction is critical for adoption. We developed the adaptive impedance controller to minimise restriction while maintaining assistance by modulating impedance based on the user's movement direction and nonlinear sine curves. The objective of this study was to compare active assistance, delivered by a back exosuit via our adaptive impedance controller, to three levels of assistance from passive elastics. Fifteen participants completed five experimental blocks (4 exosuits and 1 no-suit) consisting of a maximum flexion and a constrained lifting task. While a higher stiffness elastic reduced back extensor muscle activity by 13%, it restricted maximum range of motion (RoM) by 13°. The adaptive impedance approach did not restrict RoM while reducing back extensor muscle activity by 15%, when lifting. This study highlights an adaptive impedance approach might improve usability by circumventing the assistance-restriction trade-off inherent to passive approaches.Practitioner summary: This study demonstrates a soft active exosuit that delivers assistance with an adaptive impedance approach can provide reductions in overall back muscle activity without the impacts of restricted range of motion or perception of restriction and discomfort.
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Affiliation(s)
- D. Adam Quirk
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA
| | - Jinwon Chung
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA
| | - Megan Applegate
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA
| | - Jason M Cherin
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA
| | - Diane M. Dalton
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA
| | - Lou N. Awad
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA
| | - Conor J. Walsh
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA
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2
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Park JH, Madigan ML, Kim S, Nussbaum MA, Srinivasan D. Wearing a back-support exoskeleton alters lower-limb joint kinetics during single-step recovery following a forward loss of balance. J Biomech 2024; 166:112069. [PMID: 38579560 DOI: 10.1016/j.jbiomech.2024.112069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 03/04/2024] [Accepted: 03/30/2024] [Indexed: 04/07/2024]
Abstract
We assessed the effects of a passive, back-support exoskeleton (BSE) on lower-limb joint kinetics during the initiation and swing phases of recovery from a forward loss of balance. Sixteen (8M, 8F) young, healthy participants were released from static forward-leaning postures and attempted to recover their balance with a single-step while wearing a BSE (backXTM) with different levels of support torque and in a control condition. The BSE provided ∼ 15-20 Nm of external hip extension torque on the stepping leg at the end of initiation and beginning of swing phases. Participants were unable to generate sufficient hip flexion torque, power, and work to counteract this external torque, although they sustained hip flexion torque for a more prolonged period, resulting in slightly increased hip contribution to positive leg work (compared to control). However, net positive leg work, and the net contribution of hip joint (human + BSE) to total leg work decreased with BSE use. While all participants had changes in hip joint kinetics, a significant compensatory increase in ankle contribution to positive leg work was observed only among females. Our results suggest that BSE use adversely affects reactive stepping by decreasing the stepping leg kinetic energy for forward propulsion, and that the relative contributions of lower-limb joints to total mechanical work done during balance recovery are altered by BSE use. BSEs may thus need to be implemented with caution for dynamic tasks in occupational settings, as they may impair balance recovery following a forward loss of balance.
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Affiliation(s)
- Jang-Ho Park
- Department of Industrial Engineering, Clemson University, Clemson, SC 29634, USA
| | - Michael L Madigan
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA 24061, USA
| | - Sunwook Kim
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA 24061, USA
| | - Maury A Nussbaum
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA 24061, USA
| | - Divya Srinivasan
- Department of Industrial Engineering, Clemson University, Clemson, SC 29634, USA.
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3
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Banks JJ, Quirk DA, Chung J, Cherin JM, Walsh CJ, Anderson DE. The effect of a soft active back support exosuit on trunk motion and thoracolumbar spine loading during squat and stoop lifts. ERGONOMICS 2024:1-14. [PMID: 38389220 DOI: 10.1080/00140139.2024.2320355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 02/13/2024] [Indexed: 02/24/2024]
Abstract
Back support exosuits aim to reduce tissue demands and thereby risk of injury and pain. However, biomechanical analyses of soft active exosuit designs have been limited. The objective of this study was to evaluate the effect of a soft active back support exosuit on trunk motion and thoracolumbar spine loading in participants performing stoop and squat lifts of 6 and 10 kg crates, using participant-specific musculoskeletal models. The exosuit did not change overall trunk motion but affected lumbo-pelvic motion slightly, and reduced peak compressive and shear vertebral loads at some levels, although shear increased slightly at others. This study indicates that soft active exosuits have limited kinematic effects during lifting, and can reduce spinal loading depending on the vertebral level. These results support the hypothesis that a soft exosuit can assist without limiting trunk movement or negatively impacting skeletal loading and have implications for future design and ergonomic intervention efforts.
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Affiliation(s)
- Jacob J Banks
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Orthopedic Surgery, Harvard Medical School, Boston, MA, USA
| | - David A Quirk
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, USA
| | - Jinwon Chung
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, USA
| | - Jason M Cherin
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, USA
| | - Conor J Walsh
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, USA
| | - Dennis E Anderson
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Orthopedic Surgery, Harvard Medical School, Boston, MA, USA
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4
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Mohamed Refai MI, Moya-Esteban A, van Zijl L, van der Kooij H, Sartori M. Benchmarking commercially available soft and rigid passive back exoskeletons for an industrial workplace. WEARABLE TECHNOLOGIES 2024; 5:e6. [PMID: 38510984 PMCID: PMC10952052 DOI: 10.1017/wtc.2024.2] [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: 06/20/2023] [Revised: 12/22/2023] [Accepted: 01/19/2024] [Indexed: 03/22/2024]
Abstract
Low-back pain is a common occupational hazard for industrial workers. Several studies show the advantages of using rigid and soft back-support passive exoskeletons and exosuits (exos) to reduce the low-back loading and risk of injury. However, benefits of using these exos have been shown to be task-specific. Therefore, in this study, we developed a benchmarking approach to assess exos for an industrial workplace at Hankamp Gears B.V. We assessed two rigid (Laevo Flex, Paexo back) and two soft (Auxivo Liftsuit 1.0, and Darwing Hakobelude) exos for tasks resembling the workplace. We measured the assistive moment provided by each exo and their respective influence on muscle activity as well as the user's perception of comfort and exertion. Ten participants performed four lifting tasks (Static hold, Asymmetric, Squat, and Stoop), while their electromyography and subjective measures were collected. The two rigid exos provided the largest assistance during the Dynamic tasks. Reductions in erector spinae activity were seen to be task-specific, with larger reductions for the two rigid exos. Overall, Laevo Flex offered a good balance between assistive moments, reductions in muscle activity, as well as user comfort and reductions in perceived exertion. Thus, we recommend benchmarking exos for intended use in the industrial workplace. This will hopefully result in a better adoption of the back-support exoskeletons in the workplace and help reduce low-back pain.
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Affiliation(s)
| | - Alejandro Moya-Esteban
- Department of Biomechanical Engineering, University of Twente, Enschede, The Netherlands
| | - Lynn van Zijl
- Department of Biomechanical Engineering, University of Twente, Enschede, The Netherlands
| | - Herman van der Kooij
- Department of Biomechanical Engineering, University of Twente, Enschede, The Netherlands
| | - Massimo Sartori
- Department of Biomechanical Engineering, University of Twente, Enschede, The Netherlands
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5
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Yuan R, Wang Q, Xu H, Yu H, Shi P. Control strategies for trunk exoskeletons based on motion intent recognition: A review. NeuroRehabilitation 2024; 54:575-597. [PMID: 38943405 DOI: 10.3233/nre-240066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2024]
Abstract
BACKGROUND Wearable trunk exoskeletons hold immense potential in fields such as healthcare and industry. Previous research has indicated that intention recognition control plays a crucial role in users' daily use of exoskeletons. OBJECTIVE This review aims to discuss the characteristics of intention recognition control schemes for intelligent trunk exoskeletons under different control objectives over the past decade. METHODS Considering the relatively late development of active trunk exoskeletons, we selected papers published in the last decade (2013 to 2023) from the Web of Science, PubMed, and IEEE Xplore databases. In total, 50 articles were selected and examined based on four control objectives. RESULTS In general, we found that researchers focus on trunk exoskeleton devices designed for assistance and motor augmentation, which rely more on body movement signals as a source for intention recognition. CONCLUSION Based on these results, we identify and discuss several promising research directions that may help to attain a widely accepted control methods, thereby advancing further development of trunk exoskeleton technology.
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Affiliation(s)
- Ruyu Yuan
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
| | - Qingqing Wang
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
| | - Haipeng Xu
- Physical Education Department, University of Shanghai for Science and Technology, Shanghai, China
| | - Hongliu Yu
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
| | - Ping Shi
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
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Zhu K, Phan PT, Sharma B, Davies J, Thai MT, Hoang TT, Nguyen CC, Ji A, Nicotra E, La HM, Vo-Doan TT, Phan HP, Lovell NH, Do TN. A Smart, Textile-Driven, Soft Exosuit for Spinal Assistance. SENSORS (BASEL, SWITZERLAND) 2023; 23:8329. [PMID: 37837159 PMCID: PMC10575006 DOI: 10.3390/s23198329] [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: 09/10/2023] [Revised: 10/04/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023]
Abstract
Work-related musculoskeletal disorders (WMSDs) are often caused by repetitive lifting, making them a significant concern in occupational health. Although wearable assist devices have become the norm for mitigating the risk of back pain, most spinal assist devices still possess a partially rigid structure that impacts the user's comfort and flexibility. This paper addresses this issue by presenting a smart textile-actuated spine assistance robotic exosuit (SARE), which can conform to the back seamlessly without impeding the user's movement and is incredibly lightweight. To detect strain on the spine and to control the smart textile automatically, a soft knitting sensor that utilizes fluid pressure as a sensing element is used. Based on the soft knitting hydraulic sensor, the robotic exosuit can also feature the ability of monitoring and rectifying human posture. The SARE is validated experimentally with human subjects (N = 4). Through wearing the SARE in stoop lifting, the peak electromyography (EMG) signals of the lumbar erector spinae are reduced by 22.8% ± 12 for lifting 5 kg weights and 27.1% ± 14 in empty-handed conditions. Moreover, the integrated EMG decreased by 34.7% ± 11.8 for lifting 5 kg weights and 36% ± 13.3 in empty-handed conditions. In summary, the artificial muscle wearable device represents an anatomical solution to reduce the risk of muscle strain, metabolic energy cost and back pain associated with repetitive lifting tasks.
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Affiliation(s)
- Kefan Zhu
- Graduate School of Biomedical Engineering, Faculty of Engineering, UNSW Sydney, Kensington Campus, Sydney, NSW 2052, Australia; (K.Z.); (B.S.); (J.D.); (M.T.T.); (T.T.H.); (C.C.N.); (A.J.); (E.N.); (N.H.L.)
| | - Phuoc Thien Phan
- Graduate School of Biomedical Engineering, Faculty of Engineering, UNSW Sydney, Kensington Campus, Sydney, NSW 2052, Australia; (K.Z.); (B.S.); (J.D.); (M.T.T.); (T.T.H.); (C.C.N.); (A.J.); (E.N.); (N.H.L.)
| | - Bibhu Sharma
- Graduate School of Biomedical Engineering, Faculty of Engineering, UNSW Sydney, Kensington Campus, Sydney, NSW 2052, Australia; (K.Z.); (B.S.); (J.D.); (M.T.T.); (T.T.H.); (C.C.N.); (A.J.); (E.N.); (N.H.L.)
| | - James Davies
- Graduate School of Biomedical Engineering, Faculty of Engineering, UNSW Sydney, Kensington Campus, Sydney, NSW 2052, Australia; (K.Z.); (B.S.); (J.D.); (M.T.T.); (T.T.H.); (C.C.N.); (A.J.); (E.N.); (N.H.L.)
| | - Mai Thanh Thai
- Graduate School of Biomedical Engineering, Faculty of Engineering, UNSW Sydney, Kensington Campus, Sydney, NSW 2052, Australia; (K.Z.); (B.S.); (J.D.); (M.T.T.); (T.T.H.); (C.C.N.); (A.J.); (E.N.); (N.H.L.)
- College of Engineering and Computer Science, VinUniversity, Hanoi 100000, Vietnam
| | - Trung Thien Hoang
- Graduate School of Biomedical Engineering, Faculty of Engineering, UNSW Sydney, Kensington Campus, Sydney, NSW 2052, Australia; (K.Z.); (B.S.); (J.D.); (M.T.T.); (T.T.H.); (C.C.N.); (A.J.); (E.N.); (N.H.L.)
| | - Chi Cong Nguyen
- Graduate School of Biomedical Engineering, Faculty of Engineering, UNSW Sydney, Kensington Campus, Sydney, NSW 2052, Australia; (K.Z.); (B.S.); (J.D.); (M.T.T.); (T.T.H.); (C.C.N.); (A.J.); (E.N.); (N.H.L.)
| | - Adrienne Ji
- Graduate School of Biomedical Engineering, Faculty of Engineering, UNSW Sydney, Kensington Campus, Sydney, NSW 2052, Australia; (K.Z.); (B.S.); (J.D.); (M.T.T.); (T.T.H.); (C.C.N.); (A.J.); (E.N.); (N.H.L.)
| | - Emanuele Nicotra
- Graduate School of Biomedical Engineering, Faculty of Engineering, UNSW Sydney, Kensington Campus, Sydney, NSW 2052, Australia; (K.Z.); (B.S.); (J.D.); (M.T.T.); (T.T.H.); (C.C.N.); (A.J.); (E.N.); (N.H.L.)
| | - Hung Manh La
- Advanced Robotics and Automation Lab, Computer Science and Engineering, University of Nevada, Reno, NV 89512, USA;
| | - Tat Thang Vo-Doan
- School of Mechanical & Mining Engineering, The University of Queensland, St. Lucia, QLD 4072, Australia;
| | - Hoang-Phuong Phan
- School of Mechanical and Manufacturing Engineering, Faculty of Engineering, UNSW Sydney, Kensington Campus, Sydney, NSW 2052, Australia;
- Tyree Foundation Institute of Health Engineering (IHealthE), UNSW Sydney, Sydney, NSW 2052, Australia
| | - Nigel H. Lovell
- Graduate School of Biomedical Engineering, Faculty of Engineering, UNSW Sydney, Kensington Campus, Sydney, NSW 2052, Australia; (K.Z.); (B.S.); (J.D.); (M.T.T.); (T.T.H.); (C.C.N.); (A.J.); (E.N.); (N.H.L.)
- Tyree Foundation Institute of Health Engineering (IHealthE), UNSW Sydney, Sydney, NSW 2052, Australia
| | - Thanh Nho Do
- Graduate School of Biomedical Engineering, Faculty of Engineering, UNSW Sydney, Kensington Campus, Sydney, NSW 2052, Australia; (K.Z.); (B.S.); (J.D.); (M.T.T.); (T.T.H.); (C.C.N.); (A.J.); (E.N.); (N.H.L.)
- Tyree Foundation Institute of Health Engineering (IHealthE), UNSW Sydney, Sydney, NSW 2052, Australia
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7
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Refai MIM, Sridar S, Govaerts R, Chini G, Varrecchia T, Del Ferraro S, Falcone T, De Bock S, Molinaro V, Elprama SA, Jacobs A, Ranavolo A, De Pauw K, van der Kooij H, Sartori M. Does a Soft Actuated Back Exosuit Influence Multimodal Physiological Measurements and User Perception During an Industry Inspired Task? IEEE Int Conf Rehabil Robot 2023; 2023:1-6. [PMID: 37941262 DOI: 10.1109/icorr58425.2023.10304777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Back support soft exosuits are promising solutions to reduce risk of musculoskeletal injuries at workplaces resulting from physically demanding and repetitive lifting tasks. Design of novel active exosuits address the impact on the muscle activity and metabolic costs but do not consider other critical aspects such as comfort and user perception during the intended tasks. Thus, in this study, we describe a novel soft active exosuit in line with its impact on physiological and subjective measures during lifting. We tested four healthy participants who performed repetitive lifting tasks with and without this exosuit. The exosuit provided assistance proportional to the lumbar flexion angle measured using an inertial measurement unit. We measured the participant's multimodal physiological measures including surface electromyography, metabolic cost, heart rate, and skin temperature. We also measured subjective scores on user exertion, task load, and device acceptability. All participants perceived a reduction in task load when using the exosuit. Three participants showed reduction of muscle activity for the erector spinae muscles. The metabolic costs and heart rate reserve reduced for two participants, with similar trends for skin temperature. For future development of workplace exosuits, we recommend incorporating assessments of both physiological and subjective measures, considering the user-dependent response to the exosuit.
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Wei W, Tan F, Zhang H, Mao H, Fu M, Samuel OW, Li G. Surface electromyogram, kinematic, and kinetic dataset of lower limb walking for movement intent recognition. Sci Data 2023; 10:358. [PMID: 37280249 DOI: 10.1038/s41597-023-02263-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 05/23/2023] [Indexed: 06/08/2023] Open
Abstract
Surface electromyogram (sEMG) offers a rich set of motor information for decoding limb motion intention that serves as a control input to Intelligent human-machine synergy systems (IHMSS). Despite growing interest in IHMSS, the current publicly available datasets are limited and can hardly meet the growing demands of researchers. This study presents a novel lower limb motion dataset (designated as SIAT-LLMD), comprising sEMG, kinematic, and kinetic data with corresponding labels acquired from 40 healthy humans during 16 movements. The kinematic and kinetic data were collected using a motion capture system and six-dimensional force platforms and processed using OpenSim software. The sEMG data were recorded using nine wireless sensors placed on the subjects' thigh and calf muscles on the left limb. Besides, SIAT-LLMD provides labels to classify the different movements and different gait phases. Analysis of the dataset verified the synchronization and reproducibility, and codes for effective data processing are provided. The proposed dataset can serve as a new resource for exploring novel algorithms and models for characterizing lower limb movements.
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Affiliation(s)
- Wenhao Wei
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), and the SIAT Branch, Shenzhen Institute of Artificial Intelligence and Robotics for Society, Shenzhen, 518055, China
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, Guangdong, 518055, China
| | - Fangning Tan
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), and the SIAT Branch, Shenzhen Institute of Artificial Intelligence and Robotics for Society, Shenzhen, 518055, China
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, Guangdong, 518055, China
| | - Hang Zhang
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, Guangdong, 518055, China
| | - He Mao
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), and the SIAT Branch, Shenzhen Institute of Artificial Intelligence and Robotics for Society, Shenzhen, 518055, China
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, Guangdong, 518055, China
| | - Menglong Fu
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, Guangdong, 518055, China
| | - Oluwarotimi Williams Samuel
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), and the SIAT Branch, Shenzhen Institute of Artificial Intelligence and Robotics for Society, Shenzhen, 518055, China.
- School of Computing and Engineering, University of Derby, Derby, DE22 3AW, UK.
- Data Science Research Center, University of Derby, Derby, DE22 3AW, UK.
| | - Guanglin Li
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), and the SIAT Branch, Shenzhen Institute of Artificial Intelligence and Robotics for Society, Shenzhen, 518055, China.
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, Guangdong, 518055, China.
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9
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Bhardwaj S, Shinde AB, Singh R, Vashista V. Manipulating device-to-body forces in passive exosuit: An experimental investigation on the effect of moment arm orientation using passive back-assist exosuit emulator. WEARABLE TECHNOLOGIES 2023; 4:e17. [PMID: 38487771 PMCID: PMC10936296 DOI: 10.1017/wtc.2023.12] [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: 10/12/2022] [Revised: 04/03/2023] [Accepted: 04/28/2023] [Indexed: 03/17/2024]
Abstract
Passive exosuits have been vastly researched in the past decade for lifting tasks to alleviate the mechanical loading on the spine and reduce the lower back muscle activities in lifting tasks. Despite promising advantages of exosuits, factors such as comfort directly influence the user's acceptability of such body-worn devices. Exosuits' routing/anchoring points, which transmit device-to-body forces, remain the leading cause of discomfort among users. In the present study, we sought to investigate the effect of the routing element, that is, the "moment arm," in altering the device-to-body forces and perceived discomfort. We first presented a simplified human-exosuit model to establish insight into the effect of the moment arm on the device-to-body forces acting at the shoulder (FS) and waist (FW). Further, an experimental investigation was conducted on 10 participants with six different exosuit moment arm configurations (C1, C2, C3, C4, C5, and C6) to investigate their effect on the device-to-body forces, perceived discomfort, and muscle activity using a passive back-assist exosuit emulator in a lifting/lowering task. Configuration C4 was found to be most beneficial in reducing device-to-body forces at the shoulder and waist by up to 44.6 and 22.2%, respectively, during lifting. Subjective scores also comprehended with the device-to-body forces, indicating that C4 produces significantly less discomfort for participants. The outcome of the study illustrates the importance of selecting an appropriate moment arm configuration for passive back support exosuits in alleviating the device-to-body forces and perceived discomfort.
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Affiliation(s)
- Siddharth Bhardwaj
- Human-Centered Robotics Lab, Indian Institute of Technology Gandhinagar, Gandhinagar, India
| | - Akshayraj B. Shinde
- Human-Centered Robotics Lab, Indian Institute of Technology Gandhinagar, Gandhinagar, India
| | - Randheer Singh
- Human-Centered Robotics Lab, Indian Institute of Technology Gandhinagar, Gandhinagar, India
| | - Vineet Vashista
- Human-Centered Robotics Lab, Indian Institute of Technology Gandhinagar, Gandhinagar, India
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10
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Kuber PM, Alemi MM, Rashedi E. A Systematic Review on Lower-Limb Industrial Exoskeletons: Evaluation Methods, Evidence, and Future Directions. Ann Biomed Eng 2023:10.1007/s10439-023-03242-w. [PMID: 37248409 DOI: 10.1007/s10439-023-03242-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 05/14/2023] [Indexed: 05/31/2023]
Abstract
Industrial tasks that involve frequent sitting/standing transitions and squatting activities can benefit from lower-limb industrial exoskeletons; however, their use is not as widespread as their upper-body counterparts. In this review, we examined 23 articles that evaluated the effects of using Wearable Chair (WC) and Squat-assist (SA) exoskeletons. Evaluations mainly included assessment of muscular demands in the thigh, shank, and upper/lower back regions. Both types of devices were found to lessen muscular demands in the lower body by 30-90%. WCs also reduced low-back demands (~ 37%) and plantar pressure (54-80%) but caused discomfort/unsafe feeling in participants. To generalize outcomes, we suggest standardizing approaches used for evaluating the devices. Along with addressing low adoption through design upgrades (e.g., ground and body supports/attachments), we recommend that researchers thoroughly evaluate temporal effects on muscle fatigue, metabolic rate, and stability of wearers. Although lower-limb exoskeletons were found to be beneficial, discrepancies in experimental protocols (posture/task/measures) were discovered. We also suggest simulating more realistic conditions, such as walking/sitting interchangeability for WCs and lifting loads for SA devices. The presented outcomes could help improve the design/evaluation approaches, and implementation of lower limb wearable devices across industries.
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Affiliation(s)
- Pranav Madhav Kuber
- Biomechanics and Ergonomics Lab, Industrial and Systems Engineering Department, Rochester Institute of Technology, 1 Lomb Memorial Dr, Rochester, NY, 14623, USA
| | - Mohammad Mehdi Alemi
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA
- Training Services, MathWorks, Natick, MA, USA
| | - Ehsan Rashedi
- Biomechanics and Ergonomics Lab, Industrial and Systems Engineering Department, Rochester Institute of Technology, 1 Lomb Memorial Dr, Rochester, NY, 14623, USA.
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11
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Kranenborg SE, Greve C, Reneman MF, Roossien CC. Side-effects and adverse events of a shoulder- and back-support exoskeleton in workers: A systematic review. APPLIED ERGONOMICS 2023; 111:104042. [PMID: 37146320 DOI: 10.1016/j.apergo.2023.104042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 04/20/2023] [Accepted: 04/27/2023] [Indexed: 05/07/2023]
Abstract
INTRODUCTION While the biomechanical effects of exoskeletons are well studied, research about potential side-effects and adverse events are limited. The aim of this systematic review was to provide an overview of the side-effects and adverse events on shoulder- and back-support exoskeletons during work tasks. METHODS Four in-field studies and 32 laboratory studies were included in this review, reporting on n = 18 shoulder exoskeletons, n = 9 back exoskeletons, n = 1 full body with a supernumerary arm, and n = 1 combination of shoulder and back exoskeleton. RESULTS The most frequent side-effect reported is discomfort (n = 30), followed by a limited usability of the exoskeleton (n = 16). Other identified side-effects and adverse events were changes in muscle activity, mobility, task performance, balance and posture, neurovascular supply, gait parameters and precision. An incorrect fit of the exoskeleton and the decreased degrees of freedom are most often reported as causes of these side-effects. Two studies did not find any side-effects. This review also showed that there are differences in the occurrence of side-effects in gender, age, and physical fitness. Most studies (89%) were conducted in a laboratory setting. Most studies (97%) measured short-term effects only. Psychological and social side-effects or adverse events were not reported. Side-effects and adverse events for active exoskeletons were understudied (n = 4). CONCLUSION It was concluded that the evidence for side-effects and adverse events is limited. If available, it mainly consists of reports of mild discomfort and limited usability. Generalisation is limited because studies were conducted in lab settings and measured short term only, and most participants were young male workers.
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Affiliation(s)
- S E Kranenborg
- University of Groningen, University Medical Center Groningen, Department of Human Movement Science, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands
| | - C Greve
- University of Groningen, University Medical Center Groningen, Department of Human Movement Science, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands.
| | - M F Reneman
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands
| | - C C Roossien
- University of Groningen, University Medical Center Groningen, Department of Human Movement Science, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands
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Walter T, Stutzig N, Siebert T. Active exoskeleton reduces erector spinae muscle activity during lifting. Front Bioeng Biotechnol 2023; 11:1143926. [PMID: 37180043 PMCID: PMC10168292 DOI: 10.3389/fbioe.2023.1143926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/10/2023] [Indexed: 05/15/2023] Open
Abstract
Musculoskeletal disorders (MSD) are a widespread problem, often regarding the lumbar region. Exoskeletons designed to support the lower back could be used in physically demanding professions with the intention of reducing the strain on the musculoskeletal system, e.g., by lowering task-related muscle activation. The present study aims to investigate the effect of an active exoskeleton on back muscle activity when lifting weights. Within the framework of the study, 14 subjects were asked to lift a 15 kg box with and without an active exoskeleton which allows the adjustment of different levels of support, while the activity of their M. erector spinae (MES) was measured using surface electromyography. Additionally, the subjects were asked about their overall rating of perceived exertion (RPE) during lifting under various conditions. Using the exoskeleton with the maximum level of support, the muscle activity was significantly lower than without exoskeleton. A significant correlation was found between the exoskeleton's support level and the reduction of MES activity. The higher the support level, the lower the observed muscle activity. Furthermore, when lifting with the maximum level of support, RPE was found to be significantly lower than without exoskeleton too. A reduction in the MES activity indicates actual support for the movement task and might indicate lower compression forces in the lumbar region. It is concluded that the active exoskeleton supports people noticeably when lifting heavy weights. Exoskeletons seem to be a powerful tool for reducing load during physically demanding jobs and thus, their use might be helpful in lowering the risk of MSD.
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Affiliation(s)
- Tobias Walter
- Motion and Exercise Science, University of Stuttgart, Stuttgart, Germany
| | - Norman Stutzig
- Motion and Exercise Science, University of Stuttgart, Stuttgart, Germany
| | - Tobias Siebert
- Motion and Exercise Science, University of Stuttgart, Stuttgart, Germany
- Stuttgart Center for Simulation Science, University of Stuttgart, Stuttgart, Germany
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van Sluijs RM, Wehrli M, Brunner A, Lambercy O. Evaluation of the physiological benefits of a passive back-support exoskeleton during lifting and working in forward leaning postures. J Biomech 2023; 149:111489. [PMID: 36806003 DOI: 10.1016/j.jbiomech.2023.111489] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/18/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023]
Abstract
Musculoskeletal disorders affecting the back are highly prevalent in fields of occupation involving repetitive lifting and working in forward leaning postures. Back-support exoskeletons are developed to relieve workers in physically demanding occupations. This study investigates the physiological effects of a lightweight exoskeleton which provides support through textile springs worn on the back. We hypothesized that wearing such a passive back-support exoskeleton reduces muscle activity of the back and hip muscles, while not influencing abdominal muscle activity and movement kinematics during typical occupational tasks. We collected electromyography data from the main back and hip muscles as well as whole body kinematics data via optical motion tracking during a set of relevant weight lifting tasks corresponding to typical work conditions. In our sample of 30 healthy volunteers, wearing the exoskeleton significantly reduced muscle activity, with reductions up to 25.59% during forward leaning and 20.52% during lifting in the main back and hip muscles (Erector Spinae at thoracic and lumbar level and Quadratus Lumborum). Simultaneously, no changes in knee and hip range of motion were observed. The stretch of the textile springs correlated with the body mass index and chest circumference of the wearer, and depended on posture, but not on the lifted load. The LiftSuit exoskeleton relieved back and hip muscles during typically straining occupational tasks, while biomechanical parameters were preserved. This suggests that passive lift-support exoskeletons can be safely used to relieve workers during lifting and forward leaning tasks.
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Affiliation(s)
- Rachel M van Sluijs
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland; Auxivo AG, Zurich, Switzerland
| | - Michael Wehrli
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Annina Brunner
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Olivier Lambercy
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
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A Statistical Parametric Mapping Analysis Approach for the Evaluation of a Passive Back Support Exoskeleton on Mechanical Loading During a Simulated Patient Transfer Task. J Appl Biomech 2023; 39:22-33. [PMID: 36649717 DOI: 10.1123/jab.2022-0126] [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: 05/12/2022] [Revised: 09/26/2022] [Accepted: 11/18/2022] [Indexed: 01/18/2023]
Abstract
This study assessed the effectiveness of a passive back support exoskeleton during a mechanical loading task. Fifteen healthy participants performed a simulated patient transfer task while wearing the Laevo (version 2.5) passive back support exoskeleton. Collected metrics encompassed L5-S1 joint moments, back and abdominal muscle activity, lower body and back kinematics, center of mass displacement, and movement smoothness. A statistical parametric mapping analysis approach was used to overcome limitations from discretization of continuous data. The exoskeleton reduced L5-S1 joint moments during trunk flexion, but wearing the device restricted L5-S1 joint flexion when flexing the trunk as well as hip and knee extension, preventing participants from standing fully upright. Moreover, wearing the device limited center of mass motion in the caudal direction and increased its motion in the anterior direction. Therefore, wearing the exoskeleton partly reduced lower back moments during the lowering phase of the patient transfer task, but there were some undesired effects such as altered joint kinematics and center of mass displacement. Statistical parametric mapping analysis was useful in determining the benefits and hindrances produced by wearing the exoskeleton while performing the simulated patient transfer task and should be utilized in further studies to inform design and appropriate usage.
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Liang J, Zhang Q, Liu Y, Wang T, Wan G. A review of the design of load-carrying exoskeletons. SCIENCE CHINA. TECHNOLOGICAL SCIENCES 2022; 65:2051-2067. [PMID: 36032505 PMCID: PMC9392988 DOI: 10.1007/s11431-022-2145-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/07/2022] [Indexed: 06/15/2023]
Abstract
The increasing necessity of load-carrying activities has led to greater human musculoskeletal damage and an increased metabolic cost. With the rise of exoskeleton technology, researchers have begun exploring different approaches to developing wearable robots to augment human load-carrying ability. However, there is a lack of systematic discussion on biomechanics, mechanical designs, and augmentation performance. To achieve this, extensive studies have been reviewed and 108 references are selected mainly from 2013 to 2022 to address the most recent development. Other earlier 20 studies are selected to present the origin of different design principles. In terms of the way to achieve load-carrying augmentation, the exoskeletons reviewed in this paper are sorted by four categories based on the design principles, namely load-suspended backpacks, lower-limb exoskeletons providing joint torques, exoskeletons transferring load to the ground and exoskeletons transferring load between body segments. Specifically, the driving modes of active and passive, the structure of rigid and flexible, the conflict between assistive performance and the mass penalty of the exoskeleton, and the autonomy are discussed in detail in each section to illustrate the advances, challenges, and future trends of exoskeletons designed to carry loads.
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Affiliation(s)
- JieJunYi Liang
- State Key Laboratory of Digital Manufacturing Equipment and Technology, Huazhong University of Science and Technology, Wuhan, 430074 China
| | - QinHao Zhang
- State Key Laboratory of Digital Manufacturing Equipment and Technology, Huazhong University of Science and Technology, Wuhan, 430074 China
| | - Yang Liu
- State Key Laboratory of Digital Manufacturing Equipment and Technology, Huazhong University of Science and Technology, Wuhan, 430074 China
| | - Tao Wang
- State Key Laboratory of Digital Manufacturing Equipment and Technology, Huazhong University of Science and Technology, Wuhan, 430074 China
| | - GuangFu Wan
- State Key Laboratory of Digital Manufacturing Equipment and Technology, Huazhong University of Science and Technology, Wuhan, 430074 China
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Assessment of a Passive Lumbar Exoskeleton in Material Manual Handling Tasks under Laboratory Conditions. SENSORS 2022; 22:s22114060. [PMID: 35684682 PMCID: PMC9185583 DOI: 10.3390/s22114060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/21/2022] [Accepted: 05/24/2022] [Indexed: 12/10/2022]
Abstract
Manual material handling tasks in industry cause work-related musculoskeletal disorders. Exoskeletons are being introduced to reduce the risk of musculoskeletal injuries. This study investigated the effect of using a passive lumbar exoskeleton in terms of moderate ergonomic risk. Eight participants were monitored by electromyogram (EMG) and motion capture (MoCap) while performing tasks with and without the lumbar exoskeleton. The results showed a significant reduction in the root mean square (VRMS) for all muscles tracked: erector spinae (8%), semitendinosus (14%), gluteus (5%), and quadriceps (10.2%). The classic fatigue parameters showed a significant reduction in the case of the semitendinosus: 1.7% zero-crossing rate, 0.9% mean frequency, and 1.12% median frequency. In addition, the logarithm of the normalized Dimitrov’s index showed reductions of 11.5, 8, and 14% in erector spinae, semitendinosus, and gluteus, respectively. The calculation of range of motion in the relevant joints demonstrated significant differences, but in almost all cases, the differences were smaller than 10%. The findings of the study indicate that the passive exoskeleton reduces muscle activity and introduces some changes of strategies for motion. Thus, EMG and MoCap appear to be appropriate measurements for designing an exoskeleton assessment procedure.
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