A Review of Lower Limb Exoskeletons

In general, exoskeletons are defined as wearable robotic mechanisms for providing mobility. In the last six decades, many research work have been achieved to enhance the performance of exoskeletons thus developing them to nearly commercialized products. In this paper, a review is made for the lower limb exoskeleton concerning history, classification, selection and development, also a discussion for the most important aspects of comparison between different designs is presented. Further, some concluding remarks are withdrawn which could be useful for future work. Keywords: Exoskeletons, Lower extremity exoskeleton, Wearable robot

State of the Art Lower Limb Robotic Exoskeletons for Elderly Assistance

https://ieeexplore.ieee.org/document/8759880/keywords#keywordsThe number of elderly populations is rapidly increasing. Majority of elderly people face difficulties while walking because the muscular activity or other gait-related parameters start to deteriorate with aging. Therefore, the quality of life among them can be suffered. To make their life more comfortable, service providing robotic solutions in terms of wearable powered exoskeletons should be realized. Assistive powered exoskeletons are capable of providing additional torque to support various activities, such as walking, sit to stand, and stand to sit motions to subjects with mobility impairments. Specifically, the powered exoskeletons try to maintain and keep subjects' limbs on the specified motion trajectory. The state of the art of currently available lower limb assistive exoskeletons for weak and elderly people is presented in this paper. The technology employed in the assistive devices, such as actuation and power supply types, control strategies, their functional abilities, and the mechanism design, is thoroughly described. The outcome of studied literature reveals that there is still much work to be done in the improvement of assistive exoskeletons in terms of their technological aspects, such as choosing proper and effective control methods, developing user friendly interfaces, and decreasing the costs of device to make it more affordable, meanwhile ensuring safe interaction for the end-users

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

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

Development of a 4-DoF Active Upper Limb Orthosis

In this paper, the designs and manufacturing process of a powered upper limb orthosis are presented. The orthosis is an exoskeleton worn on one arm by the user and fixed to the trunk. The orthosis’ architecture, design, and manufacturing process are presented and discussed. Estimations of the ranges of movement related to daily living activities are presented. The preliminary tests to verify the functionality of the design show encouraging results

Novel soft bending actuator based power augmentation hand exoskeleton controlled by human intention

This article presents the development of a soft material power augmentation wearable robot using novel bending soft artificial muscles. This soft exoskeleton was developed as a human hand power augmentation system for healthy or partially hand disabled individuals. The proposed prototype serves healthy manual workers by decreasing the muscular effort needed for grasping objects. Furthermore, it is a power augmentation wearable robot for partially hand disabled or post-stroke patients, supporting and augmenting the fingers’ grasping force with minimum muscular effort in most everyday activities. This wearable robot can fit any adult hand size without the need for any mechanical system changes or calibration. Novel bending soft actuators are developed to actuate this power augmentation device. The performance of these actuators has been experimentally assessed. A geometrical kinematic analysis and mathematical output force model have been developed for the novel actuators. The performance of this mathematical model has been proven experimentally with promising results. The control system of this exoskeleton is created by hybridization between cascaded position and force closed loop intelligent controllers. The cascaded position controller is designed for the bending actuators to follow the fingers in their bending movements. The force controller is developed to control the grasping force augmentation. The operation of the control system with the exoskeleton has been experimentally validated. EMG signals were monitored during the experiments to determine that the proposed exoskeleton system decreased the muscular efforts of the wearer

Design of a wearable active ankle-foot orthosis for both sides

Dissertação de mestrado integrado em Engenharia Biomédica (área de especialização em Biomateriais, Reabilitação e Biomecânica)Portugal is the west European country with the highest rate of stroke-related mortality, being that, of those who suffer cerebrovascular accidents, 40% feature an impairment which can manifest itself through motor sequelae, namely drop foot. An ankle-foot orthosis is often recommended to passively accommodate these motor problems; however, active/powered exoskeletons are also a suitable solution for post-stroke patients. Due to the high complexity of the human ankle joint, one of the problems regarding these active devices is the misalignment occurring between the rehabilitation device and the human joint, which is a cause of parasitic forces, discomfort, and pain. The present master dissertation proposes the development of an adjustable wearable active ankle-foot orthosis that is able to tackle this misalignment issue concerning commercially available lower limb orthotic devices. This work is integrated on the SmartOs – Smart, Stand-alone Active Orthotic System – project that proposes an innovative robotic technology (a wearable mobile lab) oriented to gait rehabilitation. The conceptual design of a standard version of the SmartOs wearable active orthosis was initiated with the analysis of another ankle-foot orthosis – Exo-H2 (Technaid) – from which the necessary design changes were implemented, aiming at the improvement of the established device. In order to achieve a conceptual solution, both the practical knowledge of the Orthos XXI design team and several design methods were used to ensure the accomplishment of the defined requirements. The detailed design process of the standard SmartOs wearable active orthosis prototype is disclosed. With the purpose of validating the design, the critical components were simulated with the resources available in SolidWorks®, and the necessary CAD model’s adaptations were implemented to guarantee a reliable and safe design. The presented design is currently set for further production in Orthos XXI, followed by the mandatory mechanical tests.Portugal é o país da Europa ocidental com maior taxa de mortalidade por acidente vascular cerebral (AVC), sendo que, dos que sofrem acidentes vasculares cerebrais, 40% apresentam uma deficiência que pode manifestar-se por sequelas motoras, nomeadamente o pé pendente. Uma ortótese do tornozelo é recomendada frequentemente para acomodar passivamente esses problemas motores; no entanto, exoesqueletos ativos são também uma solução adequada para pacientes pós-AVC. Devido à alta complexidade da articulação do tornozelo humano, um dos problemas associados a esses dispositivos ativos é o desalinhamento que ocorre entre o dispositivo de reabilitação e a articulação humana, que é uma causa de forças parasitas, desconforto e dor. A presente dissertação de mestrado propõe o desenvolvimento de uma ortótese ativa do tornozelo ajustável e vestível, que seja capaz de resolver esse problema de desalinhamento relativo aos dispositivos ortóticos de membros inferiores disponíveis comercialmente. Este trabalho está integrado no projeto SmartOs - Smart, Stand-alone Active Orthotic System - projeto que propõe uma tecnologia robótica inovadora (wearable mobile lab) direcionada para a reabilitação da marcha. O projeto conceptual de uma versão padrão da ortótese ativa vestível do projeto SmartOs foi iniciado com a análise de outra ortótese do tornozelo – Exo-H2 (Technaid) - a partir da qual foram implementadas as alterações de projeto necessárias, visando o aprimoramento do dispositivo estabelecido. Para se chegar a uma solução conceptual, tanto o conhecimento prático da equipa de projeto da Orthos XXI como os diversos métodos de projeto foram utilizados para garantir o cumprimento dos requisitos definidos. O processo do desenho detalhado da versão padrão da ortótese ativa SmartOs será também divulgado. Com o objetivo de validar o projeto, os componentes críticos foram simulados com os recursos disponíveis no SolidWorks® e as adaptações necessárias do modelo CAD foram implementadas para garantir um projeto fidedigno e seguro. O projeto apresentado está atualmente em preparação para produção na empresa Orthos XXI, depois do qual se seguem os ensaios mecânicos obrigatórios