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

Emerging trends in upper-limb embedded devices: A qualitative research study

Framework This paper explores how a qualitative systematic literature review (SLR) can contribute to our understanding of the trends in upper-limb wearable devices. These devices are pieces of electronic equipment that can be worn as accessories, such as watches, or embedded in clothing, including gloves and sleeves, and could play an essential role in subjects' quality of life after any occurrence that affects their possibility to perform basic activities autonomously. Moreover, these devices can be used to improve manual performance tasks like surgical or precision tasks, and even more so when performed under extreme ambient temperature conditions. Goals and Methods: A SLR on upper-limb embedded devices was conducted based on scientific documents retrieved from the Scopus database. Two research questions were outlined: "How has this technology been evolving?" and "What is the trend according to the fields of application?". The combination of keywords (upper-limb* AND wearable* AND device*) was used in the title, abstract, and keywords fields. Results: A total of 555 documents were obtained. Descriptive statistical and bibliometric analyses were conducted, identifying trends, knowledge gaps, and the future direction of research. The free software VOSviewer was used to construct data visualization bibliometric maps of the co-authorship and co-citation network. A subset of 26 documents was considered for the critical qualitative synthesis. This step facilitated the visualization and exploration of the interconnectedness among authors and the citation patterns within the literature. Combining the information gathered enables addressing the extent and the emerging trends in upper-limb embedded devices' development according to the field they are applied. Final considerations: With this research, a starting point in developing a proof of concept of a novel device aimed at improving dexterity in challenging environments is established

Adaptive Assistance With An Active And Soft Back-Support Exosuit To Unknown External Loads Via Model-Based Estimates Of Internal Lumbosacral Moments

State of the art controllers for back exoskeletons largely rely on body kinematics. This results in control strategies which cannot provide adaptive support under unknown external loads. We developed a neuromechanical model-based controller (NMBC) for a soft back exosuit, wherein assistive forces were proportional to the active component of lumbosacral joint moments, derived from real-time electromyography-driven models. The exosuit provided adaptive assistance forces with no a priori information on the external loading conditions. Across 10 participants, who stoop-lifted 5 and 15 kg boxes, our NMBC was compared to a non-adaptive virtual spring-based control(VSBC), in which exosuit forces were proportional to trunk inclination. Peak cable assistive forces were modulated across weight conditions for NMBC (5kg: 2.13 N/kg; 15kg: 2.82 N/kg) but not for VSBC (5kg: 1.92 N/kg; 15kg: 2.00 N/kg). The proposed NMBC strategy resulted in larger reduction of cumulative compression forces for 5 kg (NMBC: 18.2%; VSBC: 10.7%) and 15 kg conditions (NMBC: 21.3%; VSBC: 10.2%). Our proposed methodology may facilitate the adoption of non-hindering wearable robotics in real-life scenarios

Environment-based Assistance Modulation for a Hip Exosuit via Computer Vision

Just like in humans vision plays a fundamental role in guiding adaptive locomotion, when designing the control strategy for a walking assistive technology, Computer Vision may bring substantial improvements when performing an environment-based assistance modulation. In this work, we developed a hip exosuit controller able to distinguish among three different walking terrains through the use of an RGB camera and to adapt the assistance accordingly. The system was tested with seven healthy participants walking throughout an overground path comprising of staircases and level ground. Subjects performed the task with the exosuit disabled (Exo Off), constant assistance profile (Vision Off ), and with assistance modulation (Vision On). Our results showed that the controller was able to promptly classify in real-time the path in front of the user with an overall accuracy per class above the 85%, and to perform assistance modulation accordingly. Evaluation related to the effects on the user showed that Vision On was able to outperform the other two conditions: we obtained significantly higher metabolic savings than Exo Off, with a peak of about -20% when climbing up the staircase and about -16% in the overall path, and than Vision Off when ascending or descending stairs. Such advancements in the field may yield to a step forward for the exploitation of lightweight walking assistive technologies in real-life scenarios

These legs were made for propulsion: advancing the diagnosis and treatment of post-stroke propulsion deficits

Advances in medical diagnosis and treatment have facilitated the emergence of precision medicine. In contrast, locomotor rehabilitation for individuals with acquired neuromotor injuries remains limited by the dearth of (i) diagnostic approaches that can identify the specific neuromuscular, biomechanical, and clinical deficits underlying impaired locomotion and (ii) evidence-based, targeted treatments. In particular, impaired propulsion by the paretic limb is a major contributor to walking-related disability after stroke; however, few interventions have been able to target deficits in propulsion effectively and in a manner that reduces walking disability. Indeed, the weakness and impaired control that is characteristic of post-stroke hemiparesis leads to heterogeneous deficits that impair paretic propulsion and contribute to a slow, metabolically-expensive, and unstable gait. Current rehabilitation paradigms emphasize the rapid attainment of walking independence, not the restoration of normal propulsion function. Although walking independence is an important goal for stroke survivors, independence achieved via compensatory strategies may prevent the recovery of propulsion needed for the fast, economical, and stable gait that is characteristic of healthy bipedal locomotion. We posit that post-stroke rehabilitation should aim to promote independent walking, in part, through the acquisition of enhanced propulsion. In this expert review, we present the biomechanical and functional consequences of post-stroke propulsion deficits, review advances in our understanding of the nature of post-stroke propulsion impairment, and discuss emerging diagnostic and treatment approaches that have the potential to facilitate new rehabilitation paradigms targeting propulsion restoration.R01 AG067394 - NIA NIH HHS; R01 HD095975 - NICHD NIH HHS; K01 HD079584 - NICHD NIH HHSPublished versio

A Fabric-based Pneumatic Actuator for the Infant Elbow: Design and Comparative Kinematic Analysis

This paper focuses on the design and systematic evaluation of fabric-based, bellow-type soft pneumatic actuators to assist with flexion and extension of the elbow, intended for use in infant wearable devices. Initially, the performance of a range of actuator variants was explored via simulation. The actuator variants were parameterized based on the shape, number, and size of the cells present. Subsequently, viable actuator variants identified from the simulations were fabricated and underwent further testing on a physical model based on an infant's body anthropometrics. The performance of these variants was evaluated based on kinematic analyses using metrics including movement smoothness, path length, and elbow joint angle. Internal pressure of the actuators was also attained. Taken together, results reported herein provide valuable insights about the suitability of several actuator designs to serve as components for pediatric wearable assistive devices