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Hussain M, Kong YK, Park SS, Shim HH, Park J. Exoskeleton Usability Questionnaire: a preliminary evaluation questionnaire for the lower limb industrial exoskeletons. ERGONOMICS 2024; 67:1198-1207. [PMID: 38111360 DOI: 10.1080/00140139.2023.2289856] [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: 05/10/2023] [Accepted: 11/26/2023] [Indexed: 12/20/2023]
Abstract
Exoskeleton robots are a promising solution to reduce musculoskeletal disorders (MSDs) in different work environments, but a specific usability scale for evaluating them is lacking. This study aimed to develop and verify a preliminary Exoskeleton Usability Questionnaire (EUQ) for the lower limb exoskeletons by creating a draft survey questionnaire from existing questions in prior studies. An experiment was conducted with 20 participants who performed a specific task while wearing three lower limb robots and provided subjective feedback using the developed questionnaire. Data were analysed using exploratory and confirmatory factor analysis (CFA), resulting in a usability evaluation questionnaire for exoskeleton robots clustered into four main factors: mobility, adjustability, handling and safety. This study's findings are expected to be useful in evaluating the usability of the lower limb exoskeletons in both general production sites and agricultural work, which can aid in reducing the prevalence of lower limb MSDs.Practitioner Summary: This study developed a preliminary subjective usability evaluation questionnaire for exoskeleton robots. The questionnaire is clustered into four main factors: mobility, adjustability, handling and safety. These findings provide a valuable tool for assessing exoskeleton usability, potentially reducing musculoskeletal disorders (MSDs) in various work environments.
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Affiliation(s)
- Muhammad Hussain
- Department of Computer Science, University of York, York, UK
- Department of Industrial and Management Engineering, Incheon National University (INU), Incheon, Republic of Korea
| | - Yong-Ku Kong
- Department of Industrial Engineering, Sungkyunkwan University (SKKU), Suwon, Republic of Korea
| | - Sang-Soo Park
- Department of Industrial Engineering, Sungkyunkwan University (SKKU), Suwon, Republic of Korea
| | - Hyun-Ho Shim
- Department of Industrial Engineering, Sungkyunkwan University (SKKU), Suwon, Republic of Korea
| | - Jaehyun Park
- Department of Industrial and Management Engineering, Incheon National University (INU), Incheon, Republic of Korea
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2
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Kim S, Ojelade A, Moore A, Gutierrez N, Harris-Adamson C, Barr A, Srinivasan D, Rempel DM, Nussbaum MA. Understanding contributing factors to exoskeleton use-intention in construction: a decision tree approach using results from an online survey. ERGONOMICS 2024; 67:1208-1221. [PMID: 38085690 DOI: 10.1080/00140139.2023.2289859] [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: 05/10/2023] [Accepted: 11/27/2023] [Indexed: 12/28/2023]
Abstract
Work-related musculoskeletal disorders (WMSDs) are a major health concern in the construction industry. Occupational exoskeletons (EXOs) are a promising ergonomic intervention to help reduce WMSD risk. Their adoption, however, has been low in construction. To understand the contributing factors to EXO use-intention and assist in future decision-making, we built decision trees to predict responses to each of three EXO use-intention questions (Try, Voluntary Use, and Behavioural Intention), using online survey responses. Variable selection and hyperparameter tuning were used respectively to reduce the number of potential predictors and improve prediction performance. The importance of variables in each final tree was calculated to understand which variables had a greater influence. The final trees had moderate prediction performance. The root node of each tree included EXOs becoming standard equipment, fatigue reduction, or performance increase. Important variables were found to be quite specific to different decision trees. Practical implications of the findings are discussed.Practitioner summary: This study used decision trees to identify key factors influencing the use-intention of occupational exoskeletons (EXOs) in construction, using online survey data. Key factors identified included EXOs becoming standard equipment, fatigue reduction, and performance improvement. Final trees provide intuitive visual representations of the decision-making process for workers to use EXOs.
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Affiliation(s)
- Sunwook Kim
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Aanuoluwapo Ojelade
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Albert Moore
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Nancy Gutierrez
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | | | - Alan Barr
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Divya Srinivasan
- Department of Industrial Engineering, Clemson University, Clemson, SC, USA
| | - David M Rempel
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Maury A Nussbaum
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, USA
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Mauck MC, Aylward AF, Barton CE, Birckhead B, Carey T, Dalton DM, Fields AJ, Fritz J, Hassett AL, Hoffmeyer A, Jones SB, McLean SA, Mehling WE, O'Neill CW, Schneider MJ, Williams DA, Zheng P, Wasan AD. [Evidence-based interventions to treat chronic low back pain: treatment selection for a personalized medicine approach : German version]. Schmerz 2024:10.1007/s00482-024-00798-x. [PMID: 38381187 DOI: 10.1007/s00482-024-00798-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 02/22/2024]
Abstract
INTRODUCTION Chronic low back pain (cLBP) is highly prevalent in the United States and globally, resulting in functional impairment and lowered quality of life. While many treatments are available for cLBP, clinicians have little information about which specific treatment(s) will work best for individual patients or subgroups of patients. The Back Pain Research Consortium, part of the National Institutes of Health Helping to End Addiction Long-termSM (HEAL) Initiative, will conduct a collaborative clinical trial, which seeks to develop a personalized medicine algorithm to optimize patient and provider treatment selection for patients with cLBP. OBJECTIVE The primary objective of this article is to provide an update on evidence-based cLBP interventions and describe the process of reviewing and selecting interventions for inclusion in the clinical trial. METHODS A working group of cLBP experts reviewed and selected interventions for inclusion in the clinical trial. The primary evaluation measures were strength of evidence and magnitude of treatment effect. When available in the literature, duration of effect, onset time, carryover effect, multimodal efficacy, responder subgroups, and evidence for the mechanism of treatment effect or biomarkers were considered. CONCLUSION The working group selected 4 leading, evidence-based treatments for cLBP to be tested in the clinical trial and for use in routine clinical treatment. These treatments include (1) duloxetine, (2) acceptance and commitment therapy, (3) a classification-based exercise and manual therapy intervention, and (4) a self-management approach. These interventions each had a moderate to high level of evidence to support a therapeutic effect and were from different therapeutic classes.
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Affiliation(s)
- Matthew C Mauck
- Department of Anesthesiology, University of North Carolina at Chapel Hill, CB#7011, 27599-7010, Chapel Hill, NC, USA.
| | - Aileen F Aylward
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Chloe E Barton
- Department of Anesthesiology, University of North Carolina at Chapel Hill, CB#7011, 27599-7010, Chapel Hill, NC, USA
| | - Brandon Birckhead
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Timothy Carey
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Diane M Dalton
- Department of Physical Therapy, Boston University, College of Health and Rehabilitation Sciences, Sargent, Boston, MA, USA
| | - Aaron J Fields
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, Kalifornien, USA
| | - Julie Fritz
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, USA
| | - Afton L Hassett
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | - Anna Hoffmeyer
- University of North Carolina at Chapel Hill, Collaborative Studies Coordinating Center, Chapel Hill, NC, USA
| | - Sara B Jones
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Samuel A McLean
- Department of Anesthesiology, University of North Carolina at Chapel Hill, CB#7011, 27599-7010, Chapel Hill, NC, USA
| | - Wolf E Mehling
- Department of Family and Community Medicine, University of California San Francisco, San Francisco, Kalifornien, USA
| | - Conor W O'Neill
- Section of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, Kalifornien, USA
| | - Michael J Schneider
- Department of Physical Therapy and Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - David A Williams
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | - Patricia Zheng
- Section of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, Kalifornien, USA
| | - Ajay D Wasan
- Departments of Anesthesiology and Perioperative Medicine and Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Lazzaroni M, Chini G, Draicchio F, Di Natali C, Caldwell DG, Ortiz J. Control of a Back-Support Exoskeleton to Assist Carrying Activities. IEEE Int Conf Rehabil Robot 2023; 2023:1-6. [PMID: 37941236 DOI: 10.1109/icorr58425.2023.10304691] [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 exoskeletons are commonly used in the workplace to reduce low back pain risk for workers performing demanding activities. However, for the assistance of tasks differing from lifting, back-support exoskeletons potential has not been exploited extensively. This work focuses on the use of an active back-support exoskeleton to assist carrying. A control strategy is designed that modulates the exoskeleton torques to comply with the task assistance requirements. In particular, two gait phase detection frameworks are exploited to adapt the exoskeleton assistance according to the legs' motion. The control strategy is assessed through an experimental analysis on ten subjects. Carrying task is performed without and with the exoskeleton assistance. Results prove the potential of the presented control in assisting the task without hindering the gait movement and improving the usability experienced by users. Moreover, the exoskeleton assistance significantly reduces the lumbar load associated with the task, demonstrating its promising use for risk mitigation in the workplace.
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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: 5] [Impact Index Per Article: 5.0] [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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6
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So BCL, Hua C, Chen T, Gao Q, Man SS. Biomechanical assessment of a passive back-support exoskeleton during repetitive lifting and carrying: Muscle activity, kinematics, and physical capacity. JOURNAL OF SAFETY RESEARCH 2022; 83:210-222. [PMID: 36481011 DOI: 10.1016/j.jsr.2022.08.017] [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: 08/27/2021] [Revised: 04/24/2022] [Accepted: 08/25/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Most people have experienced low back pain (LBP) more or less in their lifetime. Heavier load weight could increase the risk of LBP, especially in repetitive lifting and carrying tasks. The risk could also increase with the frequency of lifting. This study aims to investigate the effects of a passive back-support exoskeleton (PBSE) on trunk muscle activation, kinematics, and physical capacity in a repetitive lifting task and a carrying task in consideration of load weights in a laboratory setting. RESULTS Results showed that using the PBSE, the activities of the thoracic erector spinae and lumbar erector spinae muscles were reduced significantly by nearly 7% MVC and 3% MVC in the repetitive lifting task and the carrying task, respectively. There was no significant effect of the PBSE on the spine kinematics and physical capacity. PRACTICAL APPLICATIONS This study supports the use of the PBSE to reduce trunk muscle activity in repetitive lifting and carrying tasks.
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Affiliation(s)
- Billy Chun Lung So
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Chunzhuo Hua
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Tingting Chen
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Qingwen Gao
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Siu Shing Man
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
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7
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Evidence-based interventions to treat chronic low back pain: treatment selection for a personalized medicine approach. Pain Rep 2022; 7:e1019. [PMID: 36203645 PMCID: PMC9529058 DOI: 10.1097/pr9.0000000000001019] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/26/2022] [Indexed: 11/25/2022] Open
Abstract
Literature on current treatments for chronic low back pain (cLBP) were reviewed and 4 interventions were recommended for inclusion in a multisite cLBP clinical trial. Introduction: Objective: Methods: Conclusion:
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8
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Golabchi A, Chao A, Tavakoli M. A Systematic Review of Industrial Exoskeletons for Injury Prevention: Efficacy Evaluation Metrics, Target Tasks, and Supported Body Postures. SENSORS 2022; 22:s22072714. [PMID: 35408328 PMCID: PMC9002381 DOI: 10.3390/s22072714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 01/25/2023]
Abstract
Industrial workplaces expose workers to a high risk of injuries such as Work-related Musculoskeletal Disorders (WMSDs). Exoskeletons are wearable robotic technologies that can be used to reduce the loads exerted on the body's joints and reduce the occurrence of WMSDs. However, current studies show that the deployment of industrial exoskeletons is still limited, and widespread adoption depends on different factors, including efficacy evaluation metrics, target tasks, and supported body postures. Given that exoskeletons are not yet adopted to their full potential, we propose a review based on these three evaluation dimensions that guides researchers and practitioners in properly evaluating and selecting exoskeletons and using them effectively in workplaces. Specifically, evaluating an exoskeleton needs to incorporate: (1) efficacy evaluation metrics based on both subjective (e.g., user perception) and objective (e.g., physiological measurements from sensors) measures, (2) target tasks (e.g., manual material handling and the use of tools), and (3) the body postures adopted (e.g., squatting and stooping). This framework is meant to guide the implementation and assessment of exoskeletons and provide recommendations addressing potential challenges in the adoption of industrial exoskeletons. The ultimate goal is to use the framework to enhance the acceptance and adoption of exoskeletons and to minimize future WMSDs in industrial workplaces.
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Affiliation(s)
- Ali Golabchi
- Department of Civil and Environmental Engineering, University of Alberta, Edmonton, AB T6G 1H9, Canada;
| | - Andrew Chao
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, AB T6G 1H9, Canada;
| | - Mahdi Tavakoli
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, AB T6G 1H9, Canada;
- Correspondence:
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Babič J, Laffranchi M, Tessari F, Verstraten T, Novak D, Šarabon N, Ugurlu B, Peternel L, Torricelli D, Veneman JF. Challenges and solutions for application and wider adoption of wearable robots. WEARABLE TECHNOLOGIES 2021; 2:e14. [PMID: 38486636 PMCID: PMC10936284 DOI: 10.1017/wtc.2021.13] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 08/25/2021] [Accepted: 09/18/2021] [Indexed: 03/17/2024]
Abstract
The science and technology of wearable robots are steadily advancing, and the use of such robots in our everyday life appears to be within reach. Nevertheless, widespread adoption of wearable robots should not be taken for granted, especially since many recent attempts to bring them to real-life applications resulted in mixed outcomes. The aim of this article is to address the current challenges that are limiting the application and wider adoption of wearable robots that are typically worn over the human body. We categorized the challenges into mechanical layout, actuation, sensing, body interface, control, human-robot interfacing and coadaptation, and benchmarking. For each category, we discuss specific challenges and the rationale for why solving them is important, followed by an overview of relevant recent works. We conclude with an opinion that summarizes possible solutions that could contribute to the wider adoption of wearable robots.
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Affiliation(s)
- Jan Babič
- Laboratory for Neuromechanics and Biorobotics, Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia
| | - Matteo Laffranchi
- Rehab Technologies Lab, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Federico Tessari
- Rehab Technologies Lab, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Tom Verstraten
- Robotics & Multibody Mechanics Research Group, Vrije Universiteit Brussel and Flanders Make, Brussels, Belgium
| | - Domen Novak
- University of Wyoming, Laramie, Wyoming, USA
| | - Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
| | - Barkan Ugurlu
- Biomechatronics Laboratory, Faculty of Engineering, Ozyegin University, Istanbul, Turkey
| | - Luka Peternel
- Delft Haptics Lab, Department of Cognitive Robotics, Delft University of Technology, Delft, The Netherlands
| | - Diego Torricelli
- Cajal Institute, Spanish National Research Council, Madrid, Spain
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10
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Gorsic M, Song Y, Johnson AP, Dai B, Novak D. Simultaneously varying back stiffness and trunk compression in a passive trunk exoskeleton during different activities: A pilot study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:4886-4890. [PMID: 34892304 DOI: 10.1109/embc46164.2021.9630081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Passive trunk exoskeletons support the human body with mechanical elements like springs and trunk compression, allowing them to guide motion and relieve the load on the spine. However, to provide appropriate support, elements of the exoskeleton (e.g., degree of compression) should be intelligently adapted to the current task. As it is not currently clear how adjusting different exoskeleton elements affects the wearer, this study preliminarily examines the effects of simultaneously adjusting both exoskeletal spinal column stiffness and trunk compression in a passive trunk exoskeleton. Six participants performed four dynamic tasks (walking, sit-to-stand, lifting a 20-lb box, lifting a 40-lb box) and experienced unexpected perturbations both without the exoskeleton and in six exoskeleton configurations corresponding to two compression levels and three stiffness levels. While results are preliminary due to the small sample size and relatively small increases in stiffness, they indicate that both compression and stiffness may affect kinematics and electromyography, that the effects may differ between activities, and that there may be interaction effects between stiffness and compression. As the next step, we will conduct a larger study with the same protocol more participants and larger stiffness increases to systematically evaluate the effects of different exoskeleton characteristics on the wearer.Clinical Relevance- Trunk exoskeletons can support wearers during a variety of different tasks, but their configuration may need to be intelligently adjusted to provide appropriate support. This pilot study provides information about the effects of exoskeleton back stiffness and trunk compression on the wearer, which can be used as a basis for more effective device design and usage.
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Hass D, Miller BA, Dai B, Novak D, Gorsic M. Design and Pilot Evaluation of a Prototype Sensorized Trunk Exoskeleton. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:4537-4541. [PMID: 34892226 DOI: 10.1109/embc46164.2021.9630445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Trunk exoskeletons are wearable devices that support wearers during physically demanding tasks by reducing biomechanical loads and increasing stability. In this paper, we present a prototype sensorized passive trunk exoskeleton, which includes five motion processing units (3-axis accelerometers and gyroscopes with onboard digital processing), four one-axis flex sensors along the exoskeletal spinal column, and two one-axis force sensors for measuring the interaction force between the wearer and exoskeleton. A pilot evaluation of the exoskeleton was conducted with two wearers, who performed multiple everyday tasks (sitting on a chair and standing up, walking in a straight line, picking up a box with a straight back, picking up a box with a bent back, bending forward while standing, bending laterally while standing) while wearing the exoskeleton. Illustrative examples of the results are presented as graphs. Finally, potential applications of the sensorized exoskeleton as the basis for a semi-active exoskeleton design or for audio/haptic feedback to guide the wearer are discussed.
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12
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Goršič M, Song Y, Dai B, Novak D. Evaluation of the HeroWear Apex back-assist exosuit during multiple brief tasks. J Biomech 2021; 126:110620. [PMID: 34293602 PMCID: PMC8453127 DOI: 10.1016/j.jbiomech.2021.110620] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/11/2021] [Accepted: 07/05/2021] [Indexed: 11/16/2022]
Abstract
Trunk exoskeletons are wearable devices that support humans during physically demanding tasks by reducing biomechanical loads on the back. While most trunk exoskeletons are rigid devices, more lightweight soft exoskeletons (exosuits) have recently been developed. One such exosuit is the HeroWear Apex, which achieved promising results in the developers' own work but has not been independently evaluated. This paper thus presents an evaluation of the Apex with 20 adult participants during multiple brief tasks: standing up from a stool with a symmetric or asymmetric load, lifting a unilateral or bilateral load from the floor to waist level, lifting the same bilateral load with a 90-degree turn to the right, lowering a bilateral load from waist level to floor, and walking while carrying a bilateral load. The tasks were performed in an ABA-style protocol: first with exosuit assistance disengaged, then with it engaged, then disengaged again. Four measurement types were taken: electromyography (of the erector spinae, rectus abdominis, and middle trapezius), trunk kinematics, self-report ratings, and heart rate. The exosuit decreased the erector spinae electromyogram by about 15% during object lifting and lowering tasks; furthermore, participants found the exosuit mildly to moderately helpful. No adverse effects on other muscles or during non-lifting tasks were noted, and a decrease in middle trapezius electromyogram was observed for one task. This confirms that the HeroWear Apex could reduce muscle demand and fatigue. The results may transfer to other exoskeletons with similar design principles, and may inform researchers working with other wearable devices.
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Affiliation(s)
- Maja Goršič
- Department of Electrical and Computer Engineering, University of Wyoming
| | - Yu Song
- Division of Kinesiology and Health, University of Wyoming
| | - Boyi Dai
- Division of Kinesiology and Health, University of Wyoming
| | - Domen Novak
- Department of Electrical and Computer Engineering, University of Wyoming.
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13
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Kermavnar T, de Vries AW, de Looze MP, O'Sullivan LW. Effects of industrial back-support exoskeletons on body loading and user experience: an updated systematic review. ERGONOMICS 2021; 64:685-711. [PMID: 33369518 DOI: 10.1080/00140139.2020.1870162] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/22/2020] [Indexed: 06/12/2023]
Abstract
This study is an updated systematic review of papers published in the last 5 years on industrial back-support exoskeletons. The research questions were aimed at addressing the recent findings regarding objective (e.g. body loading, user performance) and subjective evaluations (e.g. user satisfaction), potential side effects, and methodological aspects of usability testing. Thirteen studies of active and twenty of passive exoskeletons were identified. The exoskeletons were tested during lifting and bending tasks, predominantly in laboratory settings and among healthy young men. In general, decreases in participants' back-muscle activity, peak L5/S1 moments and spinal compression forces were reported. User endurance during lifting and static bending improved, but performance declined during tasks that required increased agility. The overall user satisfaction was moderate. Some side effects were observed, including increased abdominal/lower-limb muscle activity and changes in joint angles. A need was identified for further field studies, involving industrial workers, and reflecting actual work situations. Practitioner summary: Due to increased research activity in the field, a systematic review was performed of recent studies on industrial back-support exoskeletons, addressing objective and subjective evaluations, side effects, and methodological aspects of usability testing. The results indicate the efficiency of exoskeletons in back-load reduction and a need for further studies in real work situations. Abbrevaitions: BB: biceps brachii; BF: biceps femoris; CoM: centre of mass; DA: deltoideus anterior; EMG: electromyography; ES: erector spinae; ES-C: erector spinae-cervical; ESI: erector spinae iliocostalis; ESI-L: erector spinae iliocostalis-lumborum; ESL: erector spinae longissimus; ES-L: erector spinae-lumbar; ESL-L: erector spinae longissimus-lumborum; ESL-T: erector spinae longissimus-thoracis; ES-T: erector spinae-thoracic; GM: glutaeus maximus; LBP: low back pain; LD: latissimus dorsi; LPD: local perceived discomfort scale; LPP: local perceived pressure scale; MS: multifidus spinae; MSD: musculoskeletal disorder; M-SFS: modified spinal function sort; NMV: no mean value provided; OA: obliquus abdominis (internus and externus); OEA: obliquus externus abdominis; OIA : obliquus internus abdominis; RA: rectus abdominis; RF: rectus femoris; RoM: range of motion; SUS: system usability scale; T: trapezius (pars Ascendens and Descendens); TA: trapezius pars ascendens; TC: mid-cervical trapezius; TD: trapezius pars descendens; VAS: visual analog scale; VL: vastus lateralis; VM: vastus medialis.
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Affiliation(s)
| | | | | | - Leonard W O'Sullivan
- School of Design, Confirm Smart Manufacturing Centre and Health Research Institute, University of Limerick, Limerick, Ireland
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14
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Towards a Functional Performance Validation Standard for Industrial Low-Back Exoskeletons: State of the Art Review. SENSORS 2021; 21:s21030808. [PMID: 33530377 PMCID: PMC7865790 DOI: 10.3390/s21030808] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 12/26/2022]
Abstract
While the research interest for exoskeletons has been rising in the last decades, missing standards for their rigorous evaluation are potentially limiting their adoption in the industrial field. In this context, exoskeletons for worker support have the aim to reduce the physical effort required by humans, with dramatic social and economic impact. Indeed, exoskeletons can reduce the occurrence and the entity of work-related musculoskeletal disorders that often cause absence from work, resulting in an eventual productivity loss. This very urgent and multifaceted issue is starting to be acknowledged by researchers. This article provides a systematic review of the state of the art for functional performance evaluation of low-back exoskeletons for industrial workers. We report the state-of-the-art evaluation criteria and metrics used for such a purpose, highlighting the lack of a standard for this practice. Very few studies carried out a rigorous evaluation of the assistance provided by the device. To address also this topic, the article ends with a proposed framework for the functional validation of low-back exoskeletons for the industry, with the aim to pave the way for the definition of rigorous industrial standards.
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15
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Kozinc Ž, Babič J, Šarabon N. Comparison of Subjective Responses of Low Back Pain Patients and Asymptomatic Controls to Use of Spinal Exoskeleton during Simple Load Lifting Tasks: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E161. [PMID: 33379316 PMCID: PMC7795241 DOI: 10.3390/ijerph18010161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/25/2020] [Accepted: 12/25/2020] [Indexed: 12/31/2022]
Abstract
Spinal exoskeletons have been suggested as an approach for the prevention and rehabilitation of occupational low back pain (LBP). While the state-of-the-art exoskeletons were shown to substantially unload the back, user acceptance is still limited. Perceived discomfort and restriction of freedom of movement are commonly reported. In this pilot study, we explored the differences in subjective responses and user impressions to using passive spinal exoskeleton during a set of simple lifting tasks between LBP patients (n = 12) and asymptomatic individuals (n = 10). Visual analog scales (0-10) were used for all assessments. Overall, the results showed mostly similar responses or slightly more positive responses to the exoskeleton from LBP patients. Most notably, the LBP patients reported a statistically significant (p = 0.048) higher willingness to use the device daily (5.36 ± 4.05) compared to the control group (2.00 ± 1.85) and also gave the device a higher overall grade (6.58 ± 1.98 vs. 4.30 ± 2.26; p = 0.021). This study has demonstrated that individuals with current LBP responded more favorably to the use of the spinal exoskeleton for simple lifting tasks. This implies that current exoskeletons could be appropriate for LBP rehabilitation, but not preventions, as pain-free individuals are less willing to use such devices. Future studies should explore whether different exoskeleton designs could be more appropriate for people with no LBP issues.
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Affiliation(s)
- Žiga Kozinc
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia;
- Andrej Marušič Institute, University of Primorska, Muzejski trg 2, SI-6000 Koper, Slovenia
| | - Jan Babič
- Laboratory for Neuromechanics and Biorobotics, Jožef Stefan Institute, Jamova cesta 39, SI-1000 Ljubljana, Slovenia;
| | - Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia;
- Andrej Marušič Institute, University of Primorska, Muzejski trg 2, SI-6000 Koper, Slovenia
- InnoRenew CoE, Human Health Department, Livade 6, SI-6310 Izola, Slovenia
- S2P, Science to Practice, Ltd., Laboratory for Motor Control and Motor Behavior, Tehnološki Park 19, SI-1000 Ljubljana, Slovenia
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