Evaluation of a Soft Robotic Knee Exosuit for Assistance in Stair Ascent

abstract: Muscular weakness is a common manifestation for Stroke survivors and for patients with Anterior Cruciate Ligament reconstruction leading to reduced functional independence, especially mobility. Several rigid orthotic devices are being designed to assist mobility. However, limitations in majority of these devices are: 1) that they are constrained only to level walking applications, 2) are mostly bulky and rigid lacking user comfort. For these reasons, rehabilitation using soft-robotics can serve as a powerful modality in gait assistance and potentially accelerate functional recovery. The characteristics of soft robotic exosuit is that it’s more flexible, delivers high power to weight ratio, and conforms with the user’s body structure making it a suitable choice. This work explores the implementation of an existing soft robotic exosuit in assisting knee joint mechanism during stair ascent for patients with muscular weakness. The exosuit assists by compensating the lack of joint moment and minimizing the load on the affected limb. It consists of two I-cross-section soft pneumatic actuators encased within a sleeve along with insole sensor shoes and control electronics. The exosuit actuators were mechanically characterized at different angles, in accordance to knee flexion in stair gait, to enable the generation of the desired joint moments. A linear relation between the actuator stiffness and internal pressure as a function of the knee angle was obtained. Results from this characterization along with the insole sensor outputs were used to provide assistance to the knee joint. Analysis of stair gait with and without the exosuit ‘active’ was performed, using surface electromyography (sEMG) sensors, for two healthy participants at a slow walking speed. Preliminary user testing with the exosuit presented a promising 16% reduction in average muscular activity of Vastus Lateralis muscle and a 3.6% reduction on Gluteus Maximus muscle during the stance phase and unrestrained motion during the swing phase of ascent thereby demonstrating the applicability of the soft-inflatable exosuit in rehabilitation.Dissertation/ThesisMasters Thesis Biomedical Engineering 201

Design, control, and pilot study of a lightweight and modular robotic exoskeleton for walking assistance after spinal cord injury

Walking rehabilitation using exoskeletons is of high importance to maximize independence and improve the general well-being of spinal cord injured subjects. We present the design and control of a lightweight and modular robotic exoskeleton to assist walking in spinal cord injured subjects who can control hip flexion, but lack control of knee and ankle muscles. The developed prototype consists of two robotic orthoses, which are powered by a motor-harmonic drive actuation system that controls knee flexion–extension. This actuation module is assembled on standard passive orthoses. Regarding the control, the stance-to-swing transition is detected using two inertial measurement units mounted on the tibial supports, and then the corresponding motor performs a predefined flexion–extension cycle that is personalized to the specific patient’s motor function. The system is portable by means of a backpack that contains an embedded computer board, the motor drivers, and the battery. A preliminary biomechanical evaluation of the gait-assistive device used by a female patient with incomplete spinal cord injury at T11 is presented. Results show an increase of gait speed (+24.11%), stride length (+7.41%), and cadence (+15.56%) when wearing the robotic orthoses compared with the case with passive orthoses. Conversely, a decrease of lateral displacement of the center of mass (-19.31%) and step width (-13.37% right step, -8.81% left step) are also observed, indicating gain of balance. The biomechanical assessment also reports an overall increase of gait symmetry when wearing the developed assistive device.Peer ReviewedPostprint (published version

Knee Exoskeletons Design Approaches to Boost Strength Capability: A Review

Exoesqueleto para incrementar la fuerza en las rodillasThere are different devices to increase the strength capacity of people with walking problems. These devices can be classified into exoskeletons, orthotics, and braces. This review aims to identify the state of the art in the design of these medical devices, based on an analysis of patents and literature. However, there are some difficulties in processing the records due to the lack of filters and standardization in the names, generating discrepancies between the search engines, among others. Concerning the patents, 74 patents were analyzed using search engines such as Google Patents, Derwent, The Lens, Patentscope, and Espacenet over the past ten years. A bibliometric analysis was performed using 63 scientific reports from Web of Science and The Lens in the same period for scientific communications. The results show a trend to use the mechanical design of exoskeletons based on articulated rigid structures and elements that provide force to move the structure. These are generally two types: (a) elastic elements and (b) electromechanical elements. The United States accounts for 32% of the technological patents reviewed. The results suggest that the use of exoskeletons or orthoses customized to the users’ needs will continue to increase over the years due to the worldwide growth in disability, particularly related to mobility difficulties and technologies related to the combined use of springs and actuators

A systematic literature review of evidence for the use of assistive exoskeletons in defence and security use cases

This is the final version. Available on open access from Taylor and Francis via the DOI in this recordData availability statement: Data to accompany this article have been made available in the supplementary materials.Advances in assistive exoskeleton technology, and a boom in related scientific literature, prompted a need to review the potential use of exoskeletons in defence and security. A systematic review examined the evidence for successful augmentation of human performance in activities deemed most relevant to military tasks. Categories of activities were determined a priori through literature scoping and Human Factors workshops with military stakeholders. Workshops identified promising opportunities and risks for integration of exoskeletons into military use cases. The review revealed promising evidence for exoskeletons' capacity to assist with load carriage, manual lifting, and working with tools. However, the review also revealed significant gaps in exoskeleton capabilities and likely performance levels required in the use case scenarios. Consequently, it was recommended that a future roadmap for introducing exoskeletons to military environments requires development of performance criteria for exoskeletons that can be used to implement a human-centred approach to research and development.Defence Science and Technology Laboratory (DSTL

Lower-Limb-Assisting Robotic Exoskeleton Reduces Energy Consumption in Healthy Young Persons during Stair Climbing

Many robotic exoskeletons for lower limb assistance aid walking by reducing energy costs. However, investigations examining stair-climbing assistance have remained limited, generally evaluating reduced activation of related muscles. This study sought to investigate how climbing assistance by a robotic exoskeleton affects energy consumption. Ten healthy young participants wearing a robotic exoskeleton that assists flexion and extension of hip and knee joints walked up nine flights of stairs twice at a self-selected speed with and without stair-climbing assistance. Metabolic cost was assessed by measuring oxygen consumption, heart rate, and the time to climb each flight of stairs. Net oxygen cost (NOC) and total heart beats (THB) were used as measures of metabolic cost, accounting for different climbing speeds. Stair-climbing assistance reduced NOC and THB by 9.3% (P < 0.001) and 6.9% (P = 0.003), respectively, without affecting climbing speed. Despite lack of individual optimization, assistive joint torque applied to the hip and knee joints reduced metabolic cost and cardiovascular burden of stair climbing in healthy young males. These results may be used to improve methods for stair ascent assistance.ope

Ergonomic dual four-bar linkage knee exoskeleton for stair ascent assistance

Introduction: Robotic exoskeletons are emerging technologies that have demonstrated their effectiveness in assisting with Activities of Daily Living. However, kinematic disparities between human and robotic joints can result in misalignment between humans and exoskeletons, leading to discomfort and potential user injuries.Methods: In this paper, we present an ergonomic knee exoskeleton based on a dual four-bar linkage mechanism powered by hydraulic artificial muscles for stair ascent assistance. The device comprises two asymmetric four-bar linkage mechanisms on the medial and lateral sides to accommodate the internal rotation of the knee and address the kinematic discrepancies between these sides. A genetic algorithm was employed to optimize the parameters of the four-bar linkage mechanism to minimize misalignment between human and exoskeleton knee joints. The proposed device was evaluated through two experiments. The first experiment measured the reduction in undesired load due to misalignment, while the second experiment evaluated the device’s effectiveness in assisting stair ascent in a healthy subject.Results: The experimental results indicate that the proposed device has a significantly reduced undesired load compared to the traditional revolute joint, decreasing from 14.15 N and 18.32 N to 1.88 N and 1.07 N on the medial and lateral sides, respectively. Moreover, a substantial reduction in muscle activities during stair ascent was observed, with a 55.94% reduction in surface electromyography signal.Discussion: The reduced undesired load of the proposed dual four-bar linkage mechanism highlights the importance of the adopted asymmetrical design for reduced misalignment and increased comfort. Moreover, the proposed device was effective at reducing the effort required during stair ascent