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Quirk DA, Chung J, Schiller G, Cherin JM, Arens P, Sherman DA, Zeligson ER, Dalton DM, Awad LN, Walsh CJ. Reducing Back Exertion and Improving Confidence of Individuals with Low Back Pain with a Back Exosuit: A Feasibility Study for Use in BACPAC. PAIN MEDICINE (MALDEN, MASS.) 2023; 24:S175-S186. [PMID: 36794907 PMCID: PMC10403307 DOI: 10.1093/pm/pnad003] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/04/2023] [Accepted: 01/10/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVE Low back pain (LBP) is hallmarked by activity limitations, especially for tasks involving bending. Back exosuit technology reduces low back discomfort and improves self-efficacy of individuals with LBP during bending and lifting tasks. However, the biomechanical efficacy of these devices in individuals with LBP is unknown. This study sought to determine biomechanical and perceptual effects of a soft active back exosuit designed to assist individuals with LBP sagittal plane bending. To understand patient-reported usability and use cases for this device. METHODS Fifteen individuals with LBP performed two experimental lifting blocks once with and without an exosuit. Trunk biomechanics were measured by muscle activation amplitudes, and whole-body kinematics and kinetics. To evaluate device perception, participants rated task effort, low back discomfort, and their level of concern completing daily activities. RESULTS The back exosuit reduced peak back extensor: moments by 9%, and muscle amplitudes by 16% when lifting. There were no changes in abdominal co-activation and small reductions maximum trunk flexion compared to lifting without an exosuit. Participants reported lower task effort, back discomfort, and concern about bending and lifting with an exosuit compared to without. CONCLUSIONS This study demonstrates a back exosuit not only imparts perceptual benefits of reduced task effort, discomfort, and increased confidence in individuals with LBP but that it achieves these benefits through measurable biomechanical reductions in back extensor effort. The combined effect of these benefits implies back exosuits might be a potential therapeutic aid to augment physical therapy, exercises, or daily activities.
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Affiliation(s)
- D Adam Quirk
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States
| | - Jinwon Chung
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States
| | - Gregory Schiller
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Jason M Cherin
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
| | - Philipp Arens
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
| | - David A Sherman
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Emma R Zeligson
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Diane M Dalton
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Lou N Awad
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Conor J Walsh
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States
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De Bock S, Ghillebert J, Govaerts R, Tassignon B, Rodriguez-Guerrero C, Crea S, Veneman J, Geeroms J, Meeusen R, De Pauw K. Benchmarking occupational exoskeletons: An evidence mapping systematic review. APPLIED ERGONOMICS 2022; 98:103582. [PMID: 34600307 DOI: 10.1016/j.apergo.2021.103582] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To provide an overview of protocols assessing the effect of occupational exoskeletons on users and to formulate recommendations towards a literature-based assessment framework to benchmark the effect of occupational exoskeletons on the user. METHODS PubMed (MEDLINE), Web of Science database and Scopus were searched (March 2, 2021). Studies were included if they investigated the effect of one or more occupational exoskeletons on the user. RESULTS In total, 139 eligible studies were identified, encompassing 33, 25 and 18 unique back, shoulder and other exoskeletons, respectively. Device validation was most frequently conducted using controlled tasks while collecting muscle activity and biomechanical data. As the exoskeleton concept matures, tasks became more applied and the experimental design more representative. With that change towards realistic testing environments came a trade-off with experimental control, and user experience data became more valuable. DISCUSSION This evidence mapping systematic review reveals that the assessment of occupational exoskeletons is a dynamic process, and provides literature-based assessment recommendations. The homogeneity and repeatability of future exoskeleton assessment experiments will increase following these recommendations. The current review recognises the value of variability in evaluation protocols in order to obtain an overall overview of the effect of exoskeletons on the users, but the presented framework strives to facilitate benchmarking the effect of occupational exoskeletons on the users across this variety of assessment protocols.
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Affiliation(s)
- Sander De Bock
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium; Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium.
| | - Jo Ghillebert
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium; Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Renée Govaerts
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium; Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Bruno Tassignon
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Carlos Rodriguez-Guerrero
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium; Department of Mechanical Engineering, Faculty of Applied Sciences, Vrije Universiteit Brussel and Flanders Make, 1050, Brussels, Belgium; COST (European Cooperation in Science and Technology) Action 16116, Wearable Robots for Augmentation, Assistance or Substitution of Human Motor Functions, Belgium
| | - Simona Crea
- COST (European Cooperation in Science and Technology) Action 16116, Wearable Robots for Augmentation, Assistance or Substitution of Human Motor Functions, Belgium; The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy; IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Jan Veneman
- COST (European Cooperation in Science and Technology) Action 16116, Wearable Robots for Augmentation, Assistance or Substitution of Human Motor Functions, Belgium; Hocoma AG, Volketswil, Switzerland
| | - Joost Geeroms
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium; Department of Mechanical Engineering, Faculty of Applied Sciences, Vrije Universiteit Brussel and Flanders Make, 1050, Brussels, Belgium
| | - Romain Meeusen
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium; Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium; Strategic Research Program 'Exercise and the Brain in Health and Disease: The Added Value of Human-Centered Robotics', Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Kevin De Pauw
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium; Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium; Strategic Research Program 'Exercise and the Brain in Health and Disease: The Added Value of Human-Centered Robotics', Vrije Universiteit Brussel, 1050, Brussels, Belgium
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