The Influence of Circular Physical Human–Machine Interfaces of Three Shoulder Exoskeletons on Tissue Oxygenation

Abstract

Occupational shoulder exoskeletons need to provide meaningful torques to achieve the desired support, thereby high pressures can occur within the physical human–machine interface (pHMI) of exoskeletons that may lead to discomfort, pain, or soft tissue injuries. This pilot study investigates the effects of occurring circumferential pressures within the pHMI in three different shoulder exoskeletons on the tissue oxygenation underneath the interfaces in resting position and dynamic use of the exoskeletons in 12 healthy subjects using near-infrared spectroscopy. Similar to standard Vascular Occlusion Tests, the tissue oxygen decreases while wearing the exoskeletons at rest (−2.1 (1.4) %/min). Dynamic use of the exoskeleton enhances the decrease in tissue oxygen (−7.3 (4.1) %/min) significantly and leads to greater resaturation after reopening the interface compared to resting position. This can be a sign of restricted blood supply to the upper extremity while wearing the exoskeleton. The shape and width of the circular interfaces showed no effect on the tissue oxygenation during use. Tissue oxygenation can be established as an additional safety criterion of exoskeletal pHMIs. The design of pHMI of shoulder exoskeletons should be reconsidered, e.g., in terms of open structures or the elasticity of closure straps to avoid occlusion effects.

Measurements of Electrodermal Activity, Tissue Oxygen Saturation, and Visual Analog Scale for Different Cuff Pressures

“…Numerous studies explored the effects of tissue compression on blood circulation and microvasculature [18][19][20]. Linnenberg et al [21] reported that high-pressure tissue compression during the use of rehabilitation robots can cause discomfort, pain, or soft tissue damage owing to ischemia. Their findings revealed a decrease in tissue oxygenation of 4.1% per minute at the robot's binding parts during rest.…”