Long-Term Effects of a Soft Robotic Suit on Gait Characteristics in Healthy Elderly Persons

A State-of-the-Art of Exoskeletons in Line with the WHO's Vision on Healthy Aging: From Rehabilitation of Intrinsic Capacities to Augmentation of Functional Abilities

The global aging population faces significant health challenges, including an increasing vulnerability to disability due to natural aging processes. Wearable lower limb exoskeletons (LLEs) have emerged as a promising solution to enhance physical function in older individuals. This systematic review synthesizes the use of LLEs in alignment with the WHO's healthy aging vision, examining their impact on intrinsic capacities and functional abilities. We conducted a comprehensive literature search in six databases, yielding 36 relevant articles covering older adults (65+) with various health conditions, including sarcopenia, stroke, Parkinson's Disease, osteoarthritis, and more. The interventions, spanning one to forty sessions, utilized a range of LLE technologies such as Ekso®, HAL®, Stride Management Assist®, Honda Walking Assist®, Lokomat®, Walkbot®, Healbot®, Keeogo Rehab®, EX1®, overground wearable exoskeletons, Eksoband®, powered ankle-foot orthoses, HAL® lumbar type, Human Body Posturizer®, Gait Enhancing and Motivation System®, soft robotic suits, and active pelvis orthoses. The findings revealed substantial positive outcomes across diverse health conditions. LLE training led to improvements in key performance indicators, such as the 10 Meter Walk Test, Five Times Sit-to-Stand test, Timed Up and Go test, and more. Additionally, enhancements were observed in gait quality, joint mobility, muscle strength, and balance. These improvements were accompanied by reductions in sedentary behavior, pain perception, muscle exertion, and metabolic cost while walking. While longer intervention durations can aid in the rehabilitation of intrinsic capacities, even the instantaneous augmentation of functional abilities can be observed in a single session. In summary, this review demonstrates consistent and significant enhancements in critical parameters across a broad spectrum of health conditions following LLE interventions in older adults. These findings underscore the potential of LLE in promoting healthy aging and enhancing the well-being of older adults.

Optimization of Torque-Control Model for Quasi-Direct-Drive Knee Exoskeleton Robots Based on Regression Forecasting

The choice of torque curve in lower-limb enhanced exoskeleton robots is a key problem in the control of lower-limb exoskeleton robots. As a human-machine coupled system, mapping from sensor data to joint torque is complex and non-linear, making it difficult to accurately model using mathematical tools. In this research study, the knee torque data of an exoskeleton robot climbing up stairs were obtained using an optical motion-capture system and three-dimensional force-measuring tables, and the inertial measurement unit (IMU) data of the lower limbs of the exoskeleton robot were simultaneously collected. Nonlinear approximations can be learned using machine learning methods. In this research study, a multivariate network model combining CNN and LSTM was used for nonlinear regression forecasting, and a knee joint torque-control model was obtained. Due to delays in mechanical transmission, communication, and the bottom controller, the actual torque curve will lag behind the theoretical curve. In order to compensate for these delays, different time shifts of the torque curve were carried out in the model-training stage to produce different control models. The above model was applied to a lightweight knee exoskeleton robot. The performance of the exoskeleton robot was evaluated using surface electromyography (sEMG) experiments, and the effects of different time-shifting parameters on the performance were compared. During testing, the sEMG activity of the rectus femoris (RF) decreased by 20.87%, while the sEMG activity of the vastus medialis (VM) increased by 17.45%. The experimental results verify the effectiveness of this control model in assisting knee joints in climbing up stairs.

Exercise with a wearable hip-assist robot improved physical function and walking efficiency in older adults

Wearable assistive robotics has emerged as a promising technology to supplement or replace motor functions and to retrain people recovering from an injury or living with reduced mobility. We developed delayed output feedback control for a wearable hip-assistive robot, the EX1, to provide gait assistance. Our purpose in this study was to investigate the effects of long-term exercise with EX1 on gait, physical function, and cardiopulmonary metabolic energy efficiency in elderly people. This study used parallel experimental (exercise with EX1) and control groups (exercise without EX1). A total of 60 community-dwelling elderly persons participated in 18 exercise intervention sessions during 6 weeks, and all participants were assessed at 5 time points: before exercise, after 9 exercise sessions, after 18 sessions, and 1 month and 3 months after the last session. The spatiotemporal gait parameters, kinematics, kinetics, and muscle strength of the trunk and lower extremities improved more after exercise with EX1 than in that without EX1. Furthermore, the effort of muscles over the trunk and lower extremities throughout the total gait cycle (100%) significantly decreased after exercise with EX1. The net metabolic energy costs during walking significantly improved, and functional assessment scores improved more in the experimental group than in the control group. Our findings provide evidence supporting the application of EX1 in physical activity and gait exercise is effective to improve age-related declines in gait, physical function, and cardiopulmonary metabolic efficiency among older adults.

Flexible lower limb exoskeleton systems: A review

BACKGROUND

As an emerging exoskeleton robot technology, flexible lower limb exoskeleton (FLLE) integrates flexible drive and wearable mechanism, effectively solving many problems of traditional rigid lower limb exoskeleton (RLLE) such as higher quality, poorer compliance and relatively poor portability, and has become one of the important development directions in the field of active rehabilitation.

OBJECTIVE

This review focused on the development and innovation process in the field of FLLE in the past decade.

METHOD

Related literature published from 2010 to 2021 were searched in EI, IEEE Xplore, PubMed and Web of Science databases. Seventy target research articles were further screened and sorted through inclusion and exclusion criteria.

RESULTS

FLLE is classified according to different driving modes, and the advantages and disadvantages of passive flexible lower limb exoskeletons and active flexible lower limb exoskeletons are comprehensively summarized.

CONCLUSION

At present, FLLE's research is mainly based on cable drive, bionic pneumatic muscles followed and matured, and new exoskeleton designs based on smart material innovations also trend to diversify. In the future, the development direction of FLLE will be lightweight and drive compliance, and the multi-mode sensory feedback control theory, motion intention recognition theory and human-machine interaction theory will be combined to reduce the metabolic energy consumption of walking.

Performance Assessment of Farm Machinery for Persimmon Fruit Cultivation in a Japanese Mountainous Area

Japanese agriculture is facing a decrease in agricultural workers. Mechanization, both to save time and reduce physical input, is essential to solving this issue. Recent worldwide progress in Internet-of-things technology has enabled the application of remote-controlled and unmanned machinery in agriculture. This study was conducted in the Gojo-Yoshino mountainous region in Nara, Japan, which is famous for its persimmon cultivation. The performance of newly introduced smart agricultural machinery was studied in the field by simulating cultivation work. The results showed that the remote-control weeder, speed sprayer, and remote-control mini crawler carrier saved 90%, 75%, and 5% of weeding, spraying, and harvesting times, respectively, when compared with conventional methods. Such time savings led to an 8% decrease in the total working time spent on persimmon cultivation. In addition, using the speed sprayer showed improvement in the fruit’s quality. Results of the power assist suits did not show a time-saving effect but showed a reduction of physical burden. These results suggest that the mechanization of persimmon cultivation is efficient and labor-saving, and satisfies the need for farmers. However, the high investment costs remain an issue in extending mechanization to the region.

Development of New Soft Wearable Balance Exercise Device Using Pneumatic Gel Muscles

Decreased ability to control posture is correlated with the risk of falls among older individuals. In particular, reactive postural control ability response to even small perturbations is important for fall prevention of older individuals. The current study sought to design a new wearable assistive device for improving balance function by generating small perturbations using pneumatic gel muscle (PGM). Furthermore, we investigated the effects of using the proposed device for balance training. The proposed wearable balance exercise device utilized PGMs possessing various features, such as a lightweight design and the ability to generate small perturbations with a small power source. We investigated the effects of the device on reactive postural control exercises. Seven healthy participants participated in this study. Three-dimensional acceleration data (Ax, Ay, and Az) were measured from participants during a single leg stance in each session. The peak Ax value generated by perturbations and responses significantly differed from baseline peak acceleration. The peak Ay value caused by perturbations was significantly decreased compared with baseline peak acceleration. In addition, the root mean square Ax value of the post-test significantly decreased compared with the pre-test value. Our results revealed that the proposed wearable balance exercise device was able to create small perturbations for assessing reactive postural balance control. Furthermore, the device was able to improve users’ stability.