Lower-Limb Exosuits for Rehabilitation or Assistance of Human Movement: A Systematic Review

Joint power, joint work and lower limb muscle activity for transitions between level walking and stair ambulation at three inclinations

To enhance human mobility, training interventions and assistive lower limb wearable robotic designs must draw insights from movement tasks from daily life. This study aimed to analyze joint peak power, limb and joint work, and muscle activity of the lower limb during a series of stair ambulation conditions. We recruited 12 subjects (25.4±4.5 yrs, 180.1±4.6 cm, 74.6±7.9 kg) and studied steady gait and gait transitions between level walking, stair ascent and stair descent for three staircase inclinations (low 19°, normal 30.4°, high 39.6°). Our analysis revealed that joint peak power, limb and joint work, and muscle activity increased significantly compared to level walking and with increasing stair inclination for most of the conditions analyzed. Transition strides had no increased requirements compared to the maxima found for steady level walking and steady stair ambulation. Stair ascent required increased lower limb joint positive peak power and work, while stair descent required increased lower limb joint negative peak power and work compared to level walking. The most challenging condition was high stair inclination, which required approximately thirteen times the total lower limb joint positive and negative net work during ascent and descent, respectively. These findings suggest that training interventions and lower limb wearable robotic designs must consider the major increases in lower limb joint and muscle effort during stair ambulation, with specific attention to the demands of ascent and descent, to effectively improve human mobility.

Effects of soft robotic exosuit on ambulation ability in stroke patients: a systematic review

BACKGROUND

Robot-assisted gait training is incorporated into guidelines for stroke rehabilitation. It is a promising tool combined with conventional therapy for low ambulatory patients. The heavy weight and bulky appearance of a robotic exoskeleton limits its practicality. On the other hand, soft robotic exosuit (SRE) based on its light weight and inconspicuous property, is better tolerated by patients in daily life. The aim of this study is to review the efficacy of the SRE with regard to walking ability and biomechanical properties in stroke patients.

METHODS

Electronic searches were carried out in PubMed, Embase, Cochrane Library, Web of Science, and the Physiotherapy Evidence Database. Clinical trials that investigated the effectiveness of SREs on ambulation ability in patients with post-stroke hemiparesis were eligible. Qualitative data synthesis was subsequently performed.

RESULTS

Nine studies were identified as relevant, involving a total of 83 patients. For the assessment of SRE efficacy, outcome measures were walking ability and biomechanical properties. In terms of both immediate effect and training effect, SREs improved the walking speed, walking distance, peak ankle dorsiflexion angle during swing phase, peak paretic propulsion, stride length and compensated gait in stroke patients.

CONCLUSIONS

SRE improved the ambulation ability of stroke patients in terms of walking ability and biomechanical properties. The small number of studies limits the generalizability of interpretation. More controlled studies with better quality are required to reach a more solid conclusion on this issue.

Sensing and Control Strategies for a Synergy-Based, Cable-Driven Exosuit via a Modular Test Bench

Ageing results in the eventual loss of muscle mass and strength, joint problems, and overall slowing of movements, with a greater risk of suffering falls or other such accidents. The use of gait assistance exoskeletons can help in the active aging of this segment of the population. Given the user specificity of the mechanics and control these devices need, the facility used to test different design parameters is indispensable. This work deals with the modeling and construction of a modular test bench and prototype exosuit to test different mounting and control schemes for a cable-driven exoskeleton or exosuit. The test bench allows the experimental implementation of postural or kinematic synergies to assist multiple joints by using only one actuator and the optimization of the control scheme to better adapt to the characteristics of the specific patient. The design is open to the research community and it is expected to improve the design of cable-driven systems for exosuits.

Soft robotics in wearable and implantable medical applications: Translational challenges and future outlooks

This work explores the recent research conducted towards the development of novel classes of devices in wearable and implantable medical applications allowed by the introduction of the soft robotics approach. In the medical field, the need for materials with mechanical properties similar to biological tissues is one of the first considerations that arises to improve comfort and safety in the physical interaction with the human body. Thus, soft robotic devices are expected to be able of accomplishing tasks no traditional rigid systems can do. In this paper, we describe future perspectives and possible routes to address scientific and clinical issues still hampering the accomplishment of ideal solutions in clinical practice.

Soft Wearable Robots: Development Status and Technical Challenges

In recent years, more and more research has begun to focus on the flexible and lightweight design of wearable robots. During this process, many novel concepts and achievements have been continuously made and shown to the public, while new problems have emerged at the same time, which need to be solved. In this paper, we give an overview of the development status of soft wearable robots for human movement assistance. On the basis of a clear definition, we perform a system classification according to the target assisted joint and attempt to describe the overall prototype design level in related fields. Additionally, it is necessary to sort out the latest research progress of key technologies such as structure, actuation, control and evaluation, thereby analyzing the design ideas and basic characteristics of them. Finally, we discuss the possible application fields, and propose the main challenges of this valuable research direction.

The Impact of COVID on Lower-Limb Exoskeleton Robotic System Patents—A Review

In recent decades, the field of physical rehabilitation, with the help of robotic systems that aid the population of any age with locomotor difficulties, has been evolving rapidly. Several robotic exoskeleton systems of the lower limbs have been proposed in the patent literature and some are even commercially available. Given the above, we are asking ourselves at the end of the COVID-19 pandemic: how much has this pandemic affected both the publication of patents and the application of new ones? How has new patents’ publication volume or application in robotic exoskeleton systems changed? We hypothesize that this pandemic has caused a reduction in the volume of new applications and possibly publications. We compare pandemic analysis and the last decade’s analysis to answer these questions. In this study, we used a set of statistical tests to see if there were any statistically significant changes. Our results show that the pandemic had at least one effect on applying for new patents based on the information analyzed from the three databases examined.