A Systematic Review on Lower-Limb Industrial Exoskeletons: Evaluation Methods, Evidence, and Future Directions

Kuber, Pranav Madhav; Alemi, Mohammad Mehdi; Rashedi, Ehsan

doi:10.1007/s10439-023-03242-w

Cited by 8 publications

(5 citation statements)

References 64 publications

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“…These structural and actuation differences among exoskeletons can significantly impact the observed variations in the physical-demand measures. As the BSIEs were helpful for reducing the leg demands during the repetitive trunk flexion-extension tasks, our future steps may compare the efficacies of BSIEs and their lower-limb counterparts that enable sitting/leaning postures to negate the need for trunk flexion-extension tasks [41]. Future work could delve into field evaluations, focusing on the muscle demands in the trunk musculature, such as the trapezius and oblique muscles, which are especially relevant for tasks involving asymmetric postures.…”

Section: Discussionmentioning

confidence: 99%

Investigating Spatiotemporal Effects of Back-Support Exoskeletons Using Unloaded Cyclic Trunk Flexion–Extension Task Paradigm

Kuber,

Rashedi

2024

Applied Sciences

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Back-Support Industrial Exoskeletons (BSIEs) are designed to reduce muscle effort during repetitive tasks that involve trunk bending. We recruited twelve participants to perform 30 cycles of 45° trunk bending with/without the assistance of BSIEs and with/without postural asymmetry, first without any back fatigue, and then at the medium–high level of perceived back fatigue. To study the benefits of BSIEs, the effects of being in a fatigued state were assessed by comparing the muscle demands, kinematics, and stability measures during bending, retraction, and their transition portions per cycle across the study conditions. Overall, the BSIEs caused a minimal decrease in the lower-back activity (0–1.8%), caused by the increased demands during the retraction portion. A substantial decrease in leg activity was observed (10–18%). Asymmetry increased the right-lower-back and leg demands. Medium–high fatigue caused an increase in the lower-back activity (8–12%) during bending and retraction. The BSIEs caused slower movements and improved the stability by lowering the maximum distance of the Center of Pressure (COP) during the transition portion, as well as by lowering the mean velocity of the COP during the bending/retraction portions. This controlled study demonstrated the use of a cyclic trunk flexion–extension paradigm to study the effects of BSIEs, and the outcomes can help with understanding the temporal effects of using BSIEs on physiological measures, ultimately benefiting their proper implementation.

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Section: Discussionmentioning

confidence: 99%

Investigating Spatiotemporal Effects of Back-Support Exoskeletons Using Unloaded Cyclic Trunk Flexion–Extension Task Paradigm

Kuber,

Rashedi

2024

Applied Sciences

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“…In response to these challenges, wearable assistive devices, such as Exoskeletons (EXOs), have emerged as promising solutions to augment human capabilities and mitigate the risk of injury. EXOs are typically categorized according to the body region they support, i.e., the upper body (e.g., arm/shoulder/back) or lower body (knee/ankle) [5,6]. Of all body regions, the lumbar region of the lower back is particularly susceptible to injury, with the highest reported injury rate of approximately 17% [7].…”

Section: Introductionmentioning

confidence: 99%

Detecting Fatigue during Exoskeleton-Assisted Trunk Flexion Tasks: A Machine Learning Approach

Kuber,

Godbole,

Rashedi

2024

Applied Sciences

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Back-Support Industrial Exoskeletons (BSIEs) can be beneficial in reducing the risk of injury due to overexertion during trunk flexion tasks. Most real-world tasks include complex body movements, leading to mixed outcomes that necessitate field-based methods for detecting overall physical demands. Monitoring fatigue can be beneficial in this regard to ensure that benefits of BSIEs are translated to the real world. Our experiment included 14 participants, who performed 30 repetitions of 45° trunk-flexion while assisted by a BSIE, first without fatigue and then at medium-high back fatigue (7/10 in the Borg scale). We extracted 135 features from recorded muscle activity, trunk motion, and whole-body stability across bending, transition, and retraction portions of each trunk-flexion cycle. Four classification algorithms, namely Support Vector Machine (SVM), Logistic Regression (LR), Random Forest (RF), and XGBoost (XGB), were implemented to assess fatigue prediction. XGB (Accuracy: 86.1%, Recall: 86%, Specificity: 86.3%) was effective in classifying fatigue with data obtained from a single EMG sensor located on the lower back (erector spinae) muscle. Meanwhile, stability measures showed high predictability with both RF (92.9%, 91.9%, 94.1%) and XGB (93.5, 94.1%, 93.1%). Findings demonstrate the success of force plates, and when replaced by pressure insoles, they can facilitate real-world fatigue detection during BSIE-assisted trunk-flexion tasks.

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“…Exoskeletons are wearable devices designed to provide mechanical support and assistance to the user, augmenting their physical capabilities and reducing the strain on the body [ 4 ]. The assessment of exoskeletons on nurses’ quality of work life is a topic of growing interest and research [ 5 , 6 ]. Understanding the impact of exoskeleton technology on nurses’ well-being, job satisfaction, and overall work performance is crucial for their successful integration into nursing practice [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Exoskeleton technology in nursing practice: assessing effectiveness, usability, and impact on nurses’ quality of work life, a narrative review

Vallée

2024

BMC Nurs

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The use of exoskeletons in nursing practice has gained attention as a potential solution to address the physical demands and risks associated with the profession. This narrative review examines the effectiveness, usability, and impact of exoskeleton technology on nurses’ quality of work life. The review focuses on the reduction of physical strain and fatigue, improved posture and body mechanics, enhanced patient care, usability and acceptance factors, and the broader impact on work life. The effectiveness of exoskeletons in reducing physical strain and fatigue among nurses is supported by evidence showing decreased muscle activation and reduced forces exerted on the body. The usability and acceptance of exoskeletons are critical considerations, including device comfort and fit, ease of use and integration into workflows, user experience and training, compatibility with the work environment, and user feedback for iterative design improvements. The implementation of exoskeletons has the potential to positively impact nurses’ work life by reducing work-related injuries, improving physical well-being, enhancing job satisfaction, and promoting psychological and psychosocial benefits. Additionally, the use of exoskeletons can lead to improved patient care outcomes. Challenges and future directions in the field of exoskeleton technology for nurses include cost and accessibility, adaptability to nursing specialties and tasks, long-term durability and maintenance, integration with personal protective equipment, and ethical considerations. Addressing these challenges and considering future research and development efforts are crucial for the successful integration of exoskeleton technology in nursing practice, ultimately improving nurses’ quality of work life and patient care delivery.

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A Systematic Review on Lower-Limb Industrial Exoskeletons: Evaluation Methods, Evidence, and Future Directions

Cited by 8 publications

References 64 publications

Investigating Spatiotemporal Effects of Back-Support Exoskeletons Using Unloaded Cyclic Trunk Flexion–Extension Task Paradigm

Investigating Spatiotemporal Effects of Back-Support Exoskeletons Using Unloaded Cyclic Trunk Flexion–Extension Task Paradigm

Detecting Fatigue during Exoskeleton-Assisted Trunk Flexion Tasks: A Machine Learning Approach

Exoskeleton technology in nursing practice: assessing effectiveness, usability, and impact on nurses’ quality of work life, a narrative review

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