Preliminary design and control of a soft exosuit for assisting elbow movements and hand grasping in activities of daily living

Exo Supportive Devices: Summary of Technical Aspects

Human societies have been trying to mitigate the suffering of individuals with physical impairments, with a special effort in the last century. In the 1950s, a new concept arose, finding similarities between animal exoskeletons, and with the goal of medically aiding human movement (for rehabilitation applications). There have been several studies on using exosuits with this purpose in mind. So, the current review offers a critical perspective and a detailed analysis of the steps and key decisions involved in the conception of an exoskeleton. Choices such as design aspects, base materials (structure), actuators (force and motion), energy sources (actuation), and control systems will be discussed, pointing out their advantages and disadvantages. Moreover, examples of exosuits (full-body, upper-body, and lower-body devices) will be presented and described, including their use cases and outcomes. The future of exoskeletons as possible assisted movement solutions will be discussed-pointing to the best options for rehabilitation.

Exoskeletons: A challenge for development

The development of exoskeletons is currently a lengthy process full of challenges. We are proposing a framework to accelerate the process and make the resulting exoskeletons more user-centered. The needed accomplishments in science are described in an effort to lay the foundation for future research projects. Since the early 2000s, exoskeletons have been discussed as an emerging technology in industrial, medical, or military applications. Those systems are designed to support people during manual tasks. At first, those systems lacked broad acceptance. Many models found their niches in ongoing developments and more diverse systems entering the market. There are still applications that are in dire need of such assistance. Due to the lack of experience with body-worn robotics, the development of such systems has been shaped by trial and error. The lack of legacy products results in longer development times. In this paper, a process to generate a framework is presented to display the required research to enable future exoskeleton designers. Owing to their proximity to the user's body, exoskeletons are highly complex systems that need sophisticated subsystems, such as kinematic, control, interaction design, or actuators, to be accepted by users. Due to the wide variety of fields and high user demands, a synchronized multidisciplinary effort is necessary. To achieve this, a process to develop a modular framework for exoskeleton design is proposed. It focuses on user- and use-case-centered solutions for matching kinematics, actuation, and control. To ensure the usefulness of the framework, an evaluation of the incorporated solutions is required.

Upper limb soft robotic wearable devices: a systematic review

INTRODUCTION

Soft robotic wearable devices, referred to as exosuits, can be a valid alternative to rigid exoskeletons when it comes to daily upper limb support. Indeed, their inherent flexibility improves comfort, usability, and portability while not constraining the user's natural degrees of freedom. This review is meant to guide the reader in understanding the current approaches across all design and production steps that might be exploited when developing an upper limb robotic exosuit.

METHODS

The literature research regarding such devices was conducted in PubMed, Scopus, and Web of Science. The investigated features are the intended scenario, type of actuation, supported degrees of freedom, low-level control, high-level control with a focus on intention detection, technology readiness level, and type of experiments conducted to evaluate the device.

RESULTS

A total of 105 articles were collected, describing 69 different devices. Devices were grouped according to their actuation type. More than 80% of devices are meant either for rehabilitation, assistance, or both. The most exploited actuation types are pneumatic (52%) and DC motors with cable transmission (29%). Most devices actuate 1 (56%) or 2 (28%) degrees of freedom, and the most targeted joints are the elbow and the shoulder. Intention detection strategies are implemented in 33% of the suits and include the use of switches and buttons, IMUs, stretch and bending sensors, EMG and EEG measurements. Most devices (75%) score a technology readiness level of 4 or 5.

CONCLUSION

Although few devices can be considered ready to reach the market, exosuits show very high potential for the assistance of daily activities. Clinical trials exploiting shared evaluation metrics are needed to assess the effectiveness of upper limb exosuits on target users.

Smart textiles using fluid-driven artificial muscle fibers

The marriage of textiles with artificial muscles to create smart textiles is attracting great attention from the scientific community and industry. Smart textiles offer many benefits including adaptive comfort and high conformity to objects while providing active actuation for desired motion and force. This paper introduces a new class of programmable smart textiles created from different methods of knitting, weaving, and sticking fluid-driven artificial muscle fibers. Mathematical models are developed to describe the elongation-force relationship of the knitting and weaving textile sheets, followed by experiments to validate the model effectiveness. The new smart textiles are highly flexible, conformable, and mechanically programmable, enabling multimodal motions and shape-shifting abilities for use in broader applications. Different prototypes of the smart textiles are created with experimental validations including various shape-changing instances such as elongation (up to 65%), area expansion (108%), radial expansion (25%), and bending motion. The concept of reconfiguring passive conventional fabrics into active structures for bio-inspired shape-morphing structures is also explored. The proposed smart textiles are expected to contribute to the progression of smart wearable devices, haptic systems, bio-inspired soft robotics, and wearable electronics.

Force and Torque Characterization in the Actuation of a Walking-Assistance, Cable-Driven Exosuit

Soft exosuits stand out when it comes to the development of walking-assistance devices thanks to both their higher degree of wearability, lower weight, and price compared to the bulkier equivalent rigid exoskeletons. In cable-driven exosuits, the acting force is driven by cables from the actuation system to the anchor points; thus, the user’s movement is not restricted by a rigid structure. In this paper, a 3D inverse dynamics model is proposed and integrated with a model for a cable-driven actuation to predict the required motor torque and traction force in cables for a walking-assistance exosuit during gait. Joint torques are to be shared between the user and the exosuit for different design configurations, focusing on both hip and ankle assistance. The model is expected to guide the design of the exosuit regarding aspects such as the location of the anchor points, the cable system design, and the actuation units. An inverse dynamics analysis is performed using gait kinematic data from a public dataset to predict the cable forces and position of the exosuit during gait. The obtained joint reactions and cable forces are compared with those in the literature, and prove the model to be accurate and ready to be implemented in an exosuit control scheme. The results obtained in this study are similar to those found in the literature regarding the walking study itself as well as the forces under which cables operate during gait and the cable position cycle.

Soft, lightweight wearable robots to support the upper limb in activities of daily living: a feasibility study on chronic stroke patients

Stroke can be a devastating condition that impairs the upper limb and reduces mobility. Wearable robots can aid impaired users by supporting performance of Activities of Daily Living (ADLs). In the past decade, soft devices have become popular due to their inherent malleable and low-weight properties that makes them generally safer and more ergonomic. In this study, we present an improved version of our previously developed gravity-compensating upper limb exosuit and introduce a novel hand exoskeleton. The latter uses 3D-printed structures that are attached to the back of the fingers which prevent undesired hyperextension of joints. We explored the feasibility of using this integrated system in a sample of 10 chronic stroke patients who performed 10 ADLs.We observed a significant reduction of 30.3 ± 3.5% (mean ± standard error), 31.2 ± 3.2% and 14.0 ± 5.1% in the mean muscular activity of the Biceps Brachii (BB), Anterior Deltoid (AD) and Extensor Digitorum Communis muscles, respectively. Additionally, we observed a reduction of 14.0 ± 11.5%, 14.7 ± 6.9% and 12.8 ± 4.4% in the coactivation of the pairs of muscles BB and Triceps Brachii (TB), BB and AD, and TB and Pectoralis Major (PM), respectively, typically associated to pathological muscular synergies, without significant degradation of healthy muscular coactivation. There was also a significant increase of elbow flexion angle (12.1±1.5°). These results further cement the potential of using lightweight wearable devices to assist impaired users.

Reducing Waste in 3D Printing Using a Neural Network Based on an Own Elbow Exoskeleton

Traditional rehabilitation systems are evolving into advanced systems that enhance and improve rehabilitation techniques and physical exercise. The reliable assessment and robotic support of the upper limb joints provided by the presented elbow exoskeleton are important clinical goals in early rehabilitation after stroke and other neurological disorders. This allows for not only the support of activities of daily living, but also prevention of the progression neuromuscular pathology through proactive physiotherapy toward functional recovery. The prices of plastics are rising very quickly, as is their consumption, so it makes sense to optimize three dimensional (3D) printing procedures through, for example, improved artificial intelligence-based (AI-based) design or injection simulation, which reduces the use of filament, saves material, reduces waste, and reduces environmental impact. The time and cost savings will not reduce the high quality of the products and can provide a competitive advantage, especially in the case of thinly designed mass products. AI-based optimization allows for one free print after every 6.67 prints (i.e., from materials that were previously wasted).

A compact valveless pressure control source for soft rehabilitation glove

BACKGROUND

Soft pneumatic robots have shown great promises in hand rehabilitation systems as alternatives to conventional rigid systems. However, their application is limited to clinical rehabilitation programs due to their dependency on large-sized compressors as air suppliers. This disadvantage triggered the search for compact portable pneumatic sources.

METHOD

A compact valveless pneumatic source to control the bending angle of a soft actuator is proposed in this paper. The source incorporates two series of serially connected commercially available microcompressors to provide additional pressure and flowrate in two directions. In the proposed design, an inner-loop controller, controls the output characteristics of the source while an outer-loop controller handles the trajectory tracking of the angular position.

RESULTS

Experimental results show that the source is capable of providing up to 160 kPa of output. The controller is able to track up to 2 rad/sec sinusoidal trajectory with a maximum 0.066 rad root-mean-square error.

CONCLUSION

Experimental measurements showed satisfactory results in the maximum ratings and tracking errors whilst relatively low average power was consumed by eliminating control valves.

Soft pneumatic elbow exoskeleton reduces the muscle activity, metabolic cost and fatigue during holding and carrying of loads

To minimize fatigue, sustain workloads, and reduce the risk of injuries, the exoskeleton Carry was developed. Carry combines a soft human-machine interface and soft pneumatic actuation to assist the elbow in load holding and carrying. We hypothesize that the assistance of Carry would decrease, muscle activity, net metabolic rate, and fatigue. With Carry providing 7.2 Nm of assistance, we found reductions of up to 50% for the muscle activity, up to 61% for the net metabolic rate, and up to 99% for fatigue in a group study of 12 individuals. Analyses of operation dynamics and autonomous use demonstrate the applicability of Carry to a variety of use cases, presumably with increased benefits for increased assistance torque. The significant benefits of Carry indicate this device could prevent systemic, aerobic, and/or possibly local muscle fatigue that may increase the risk of joint degeneration and pain due to lifting, holding, or carrying.

A Compact Soft Robotic Wrist Brace With Origami Actuators

Wrist disability caused by a series of diseases or injuries hinders the patient’s capability to perform activities of daily living (ADL). Rehabilitation devices for the wrist motor function have gained popularity among clinics and researchers due to the convenience of self-rehabilitation. The inherent compliance of soft robots enabled safe human-robot interaction and light-weight characteristics, providing new possibilities to develop wearable devices. Compared with the conventional apparatus, soft robotic wearable rehabilitation devices showed advantages in flexibility, cost, and comfort. In this work, a compact and low-profile soft robotic wrist brace was proposed by directly integrating eight soft origami-patterned actuators on the commercially available wrist brace. The linear motion of the actuators was defined by their origami pattern. The extensions of the actuators were constrained by the brace fabrics, deriving the motions of the wrist joint, i.e., extension/flexion, ulnar/radial deviation. The soft actuators were made of ethylene-vinyl acetate by blow molding, achieving mass-production capability, low cost, and high repeatability. The design and fabrication of the soft robotic wrist brace are presented in this work. The experiments on the range of motion, output force, wearing position adaptivity, and performance under disturbance have been carried out with results analyzed. The modular soft actuator approach of design and fabrication of the soft robotic wrist brace has a wide application potential in wearable devices.

Design Criteria of Soft Exogloves for Hand Rehabilitation-Assistance Tasks

This paper establishes design criteria for soft exogloves (SEG) to be used as rehabilitation or assistance devices. This research consists in identifying, selecting, and grouping SEG features based on the analysis of 91 systems that have been proposed during the last decade. Thus, function, mobility, and usability criteria are defined and explicitly discussed to highlight SEG design guidelines. Additionally, this study provides a detailed description of each system that was analysed including application, functional task, palm design, actuation type, assistance mode, degrees of freedom (DOF), target fingers, motions, material, weight, force, pressure (only for fluids), control strategy, and assessment. Such characteristics have been reported according to specific design methodologies and operating principles. Technological trends are contemplated in this contribution with emphasis on SEG design opportunity areas. In this review, suggestions, limitations, and implications are also discussed in order to enhance future SEG developments aimed at stroke survivors or people with hand disabilities.

Design and Validation of a Modular One-To-Many Actuator for a Soft Wearable Exosuit

The size, weight, and power consumption of soft wearable robots rapidly scale with their number of active degrees of freedom. While various underactuation strategies have been proposed, most of them impose hard constrains on the kinetics and kinematics of the device. Here we propose a paradigm to independently control multiple degrees of freedom using a set of modular components, all tapping power from a single motor. Each module consists of three electromagnetic clutches, controlled to convert a constant unidirectional motion in an arbitrary output trajectory. We detail the design and functioning principle of each module and propose an approach to control the velocity and position of its output. The device is characterized in free space and under loading conditions. Finally, we test the performance of the proposed actuation scheme to drive a soft exosuit for the elbow joint, comparing it with the performance obtained using a traditional DC motor and an unpowered-exosuit condition. The exosuit powered by our novel scheme reduces the biological torque required to move by an average of 46.2%, compared to the unpowered condition, but negatively affects movement smoothness. When compared to a DC motor, using the our paradigm slightly deteriorates performance. Despite the technical limitations of the current design, the method proposed in this paper is a promising way to design more portable wearable robots.

Physiological and kinematic effects of a soft exosuit on arm movements

BACKGROUND

Soft wearable robots (exosuits), being lightweight, ergonomic and low power-demanding, are attractive for a variety of applications, ranging from strength augmentation in industrial scenarios, to medical assistance for people with motor impairments. Understanding how these devices affect the physiology and mechanics of human movements is fundamental for quantifying their benefits and drawbacks, assessing their suitability for different applications and guiding a continuous design refinement.

METHODS

We present a novel wearable exosuit for assistance/augmentation of the elbow and introduce a controller that compensates for gravitational forces acting on the limb while allowing the suit to cooperatively move with its wearer. Eight healthy subjects wore the exosuit and performed elbow movements in two conditions: with assistance from the device (powered) and without assistance (unpowered). The test included a dynamic task, to evaluate the impact of the assistance on the kinematics and dynamics of human movement, and an isometric task, to assess its influence on the onset of muscular fatigue.

RESULTS

Powered movements showed a low but significant degradation in accuracy and smoothness when compared to the unpowered ones. The degradation in kinematics was accompanied by an average reduction of 59.20±5.58% (mean ± standard error) of the biological torque and 64.8±7.66% drop in muscular effort when the exosuit assisted its wearer. Furthermore, an analysis of the electromyographic signals of the biceps brachii during the isometric task revealed that the exosuit delays the onset of muscular fatigue.

CONCLUSIONS

The study examined the effects of an exosuit on the characteristics of human movements. The suit supports most of the power needed to move and reduces the effort that the subject needs to exert to counteract gravity in a static posture, delaying the onset of muscular fatigue. We interpret the decline in kinematic performance as a technical limitation of the current device. This work suggests that a powered exosuit can be a good candidate for industrial and clinical applications, where task efficiency and hardware transparency are paramount.

Bio-inspired upper limb soft exoskeleton to reduce stroke-induced complications

Stroke has become the leading cause of disability and the second-leading cause of mortality worldwide. Dyskinesia complications are the major reason of these high death and disability rates. As a tool for rapid motion function recovery in stroke patients, exoskeleton robots can reduce complications and thereby decrease stroke mortality rates. However, existing exoskeleton robots interfere with the wearer's natural motion and damage joints and muscles due to poor human-machine coupling. In this paper, a novel ergonomic soft bionic exoskeleton robot with 7 degrees of freedom was proposed to address these problems based on the principles of functional anatomy and sports biomechanics. First, the human motion system was analysed according to the functional anatomy, and the muscles were modelled as tension lines. Second, a soft bionic robot was established based on the musculoskeletal tension line model. Third, a robot control method mimicking human muscle control principles was proposed and optimized on a humanoid platform manufactured using 3D printing. After the control method was optimized, the motion trajectory similarities between humans and the platform exceeded 87%. Fourth, the force-assisted effect was tested based on electromyogram signals, and the results showed that muscle signals decreased by 58.17% after robot assistance. Finally, motion-assistance experiments were performed with stroke patients. The joint movement level increased by 174% with assistance, which allowed patients to engage in activities of daily living. With this robot, stroke patients could recover their motion functions, preventing complications and decreasing fatality and disability rates.

A soft wearable robot for the shoulder: Design, characterization, and preliminary testing

In this paper, we present a soft wearable robot for the shoulder which has the potential to assist individuals suffering from a range of neuromuscular conditions affecting the shoulder to perform activities of daily living. This wearable robot combines two types of soft textile pneumatic actuators which were custom developed for this particular application to support the upper arm through shoulder abduction and horizontal flexion/extension. The advantage of a textile-based approach is that the robot can be lightweight, low-profile, comfortable and non-restrictive to the wearer, and easy to don like an item of clothing. The actuator's ability to fold flat when not in use allows the robot to be almost invisible under clothing, potentially allowing the user to avoid any stigma associated with using assistive devices in public. To abduct the arm, a textilebased pneumatic actuator was developed to fit within the axilla to push the arm upwards, while a pair of smaller actuators pivot the abduction actuator to allow for horizontal extension and flexion. The individual textile actuators were experimentally evaluated before being integrated into a wearable garment. Human subject testing was performed to evaluate the ability of the robot to assist the arm by monitoring changes in biological muscle activity when comparing the robot powered on and off. Preliminary results show large reductions in muscular effort in targeted muscles, demonstrating the feasibility and promise of such a soft wearable robot for the shoulder.