A Systematic Review of Industrial Exoskeletons for Injury Prevention: Efficacy Evaluation Metrics, Target Tasks, and Supported Body Postures
Abstract
:1. Introduction
2. Methods
2.1. Literature Search
2.2. Eligibility Criteria
2.3. Data Analysis
3. Results
3.1. Exoskeleton Types
3.2. Efficacy Evaluation Metrics
3.3. Body Posture
3.4. Target Tasks
3.5. Integration of Evaluation Features
4. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Operator | Criteria | Value |
---|---|---|
OR | Keywords | Exoskeleton exosuit wearable robot |
OR | Keywords | Occupational work industrial |
AND | Year | 1990 and 2021 |
AND | Language | English |
Excluded Keywords | ||
---|---|---|
Active/semi-passive exoskeletons | Military | Controlled-based exoskeletons |
Rehabilitation | Enhancement of medical/surgical experience | Neuroprosthesis |
Physical therapy | Virtual reality-based evaluation | Simulation modelling based evaluation |
Study | Exoskeleton | Study Method | Evaluation | Findings |
---|---|---|---|---|
[10] | Used their own Device | Participants:
| Measurements:
| ↑ Loads on LES muscle activity and variance between participants ↓ Lumbar erector spinae activity ↓ Average percent 14.4% (SD 4.5%) for LES and 27.6% (SD 8.6%) for TES Usability
|
[11] | VT-Lowe’s exoskeleton | Participants:
| Measurements:
| ↓ EMG for squat (peak: 35.4%, mean: 31.4%) ↓ Freestyle (peak: 32.3%, mean: 30.5%) ↓ Stoop lifting (peak: 27%, mean: 25.9%).
|
[12] | SPEXOR | Participants:
| Measurements:
| ↓ L5-S1 compression forces Lifting: ↓ Peak L5-S1 compression forces by 972 ± 216 N (14 ± 3%)
|
[13] | VT-Lowe’s Exosuit | Participants:
| Measurements:
| ↑ 1.5 degree in ankle dorsiflexion ↓ 2.6 degree in knee flexion ↓ 2.3 degrees in SHK angle |
[14] | PLAD | Participants:
| Measurements:
| ↓ Erector spinae activity (mean of thoracic and lumbar) in comparison to the no-PLAD condition for the stoop (37%), squat (38%), and freestyle (37%) lifts ↓ L4/L5 flexion moment for the stoop (19.0%), squat (18.4%), and freestyle (17.4%) lifts without changing peak lumbar flexion |
[15] | Laevo V2.56 | Participants:
| Measurements:
| ↓ Median/peak activity of the erector spinae (≤6%) ↓ Biceps femoris (≤28%) ↓ Rectus abdominis (≤6%) ↑ Median/peak activity of the vastus lateralis (≤69%) ↑ Trapezius descendent (≤19%), and median knee (≤6%) ↑ Hip flexion angles (≤11%), ↓ Heart rate: 5 bpm (η2p = 0.40) ↑ Minimal, median, and maximal knee flexion by 3.0° (>100%), 4.9° (22.9%), ↑ maximal knee flexion by 2.2° (4.6%), ↑ 11.0% maximal hip flexion angle (6.7°) in a stoop lifting style |
[16] | A new passive trunk exoskeleton system | Participants:
| Measurements:
| ↑ Muscle activity of TES, LES, RA, and EO with increasing lifting load
↓ Discomfort scores (42.40%) of the lower back at max load |
[17] | BackX ACLaevo V2.5 | Participants:
| Measurements:
| ↑ COP median frequency and mean velocity during bipedal stance
|
[18] | FLx and V22 (strongArm Technologies) | Participants:
| Measurements:
| ↓ Peak torso flexion at the shin
|
[19] | Spexor | Participants:
| Measurements:
|
|
[20] | Skelex 360 | Participants:
| Measurements:
| ↓ RPE for all activities except applying to wall ↓ EMG amplitudes of three agonist muscles (Trapezius and Medial Deltoid, and Biceps Brachii) ↓ EMG values in suit for most tasks |
[21] | Laevo V2.56 | Participants:
| Measurements:
|
↑ Perceived task difficulty for stair climbing and TUG
↑ Knee extensor activity by ~20% |
[22] | ShoulderX Mate Paexo | Participants:
| Measurements:
| ↓ Shoulder muscle activity for all three exoskeletons
|
[23] | SIAT lower limb exoskeleton with crutches | Participants:
| Measurements:
|
In the exosuit experiment, the arms’ fatigue in Feedback was lower than the fatigue in NoFeedback
|
[24] | EksoVestprototype | Participants:
| Measurements:
| ↓ Peak (up to ∼45%) and median muscle activity of several shoulder muscle groups (up to ∼50%)
|
[25] | EksoVest Prototype | Participants:
| Measurements:
| ↓ Maximum shoulder abduction ROM by ~10% ↑ Mean center of pressure velocity in the anteroposterior direction by ∼12%
↓ Peak AP shear (by 29.5%) and compressive forces (by 19.3%) |
[26] | HeroWear Apex | Participants:
| Measurements:
| ↓ Mean EMG value with the engaged exosuit ~85% ↓ Peak ES EMG was similar to mean EMG ↓ Trunk flexion/extension ROM during asymmetric dumbbell lifting
|
[27] | BackX and Laevo | Participants:
| Measurements:
| ↓ Lumbar flexion changes of <~140
|
[28] | PAEXO | Participants:
| Measurements:
| ↓EMG, heart rate, and oxygen rate |
[29] | Laevo and BackX | Participants:
| Measurements:
| ↓ Peak levels of trunk extensor muscle activity (by ~9–20%) ↓ Reduced energy expenditure (by ~8–14%)
|
[30] | BackX and Laevo | Participants:
| Measurements:
|
↓ Only two of the conditions using Laevo
|
[31] | PULE | Participants:
| Measurements:
| ~20% of the participants reported discomfort, excessive force, or loss of range of motion at the arms
↓ RPDs for shoulders, upper arms, and forearms wearing the PULE |
[32] | Fawcett Exovest (arm), EksoWorks (shoulder), FORTIS (full) | Participants:
| Measurements:
|
↓ Quality with the highest precision requirement |
[33] | BackX, Laevo | Participants:
| Measurements:
| ↓ peak activity of the trunk extensor muscles (by ~10–28%) and energy expenditure (by ~4–13%)
|
[34] | Levitate AIRFRAME | Participants:
| Measurements:
| ↓ Dangerous levels to 30% of the work time with the suit ↓ Deltoid (34%) and the trapezius (18%) muscular activities
|
[35] | ShoulderX | Participants:
| Measurements:
| ↓ Wearer’s shoulder flexor muscle activity of UT, AD ↑ Strength of shoulderX by up to 80%.
|
[36] | Skel-Ex | Participants:
| Measurements:
| ↓ Cardiac cost when wearing the PAD
|
[37] | Chairless Chair | Participants:
| Measurements:
| ↓ Physical load up to 64% of the subject’s body mass
↓ Gastrocnemius activity ~25%) |
[38] | Crimson Dynamics, Skelex V1 | Participants:
| Measurements:
| ↓ Shoulders, anterior (right), shoulders, posterior, spine and whole-body using Crimson Dynamics’s device ↓ Elbow (right), neck, and spine for the Skelex exoskeleton |
[39] | Ekso Vest, Ottobock Paexo, Comau Mate | Participants:
| Measurements:
|
|
[40] | Paexo | Participants:
| Measurements:
| ↓ Shoulder physical strain and global physiological strain, without increasing low back strain nor degrading balance using Paexo
|
[41] | Prototype developed by IUVO | Participants:
| Measurements:
|
↑ Precision and ↓ RPE when using the exosuit |
[42] | ShoulderX, Skelex V2 | Participants:
| Measurements:
| ↓ Upper trapezius activity (up to 46%) and heart rate in isolated tasks ↓ Up to 26% upper trapezius activity reduction using both exoskeletons
|
[43] | Skelex MARK 1.3 | Participants:
| Measurements:
| ↓ User acceptance and the intention of use |
[44] | Chairless Chair | Participants:
| Measurements:
|
|
[45] | EksoBionics’ EksoVest | Participants:
| Measurements:
| ↓ Average heart rate 3–18% in 65% of participants ↓ Heart rate range by 5–62% in 75% of participants
|
[46] | Spexor | Participants:
| Measurements:
| ↓ Net metabolic cost of lifting by 18%
|
[47] | Laevo | Participants:
| Measurements:
| ↑ Objective performance in static forward bending ↓ Performance in tasks, such as walking, carrying, and ladder climbing
|
[48] | Laevo | Participants:
| Measurements:
| ↓ Mechanical work generation ↑ Metabolic costs by 17% ↑ Abdominal muscle activity |
[49] | Laevo | Participants:
| Measurements:
| ↑ Overall effort and discomfort in the neck, shoulders, thoracic region, lumbar region and hips, and thighs ↓ Muscle activity between 0.8 and 3.8% of the back muscles |
[50] | MeBot-EXO | Participants:
| Measurements:
| ↓ Muscle activity (by 35%~61%) in the static holding experiment ↓ Metabolic cost of energy (by 22%) |
[51] | Laevo | Participants:
| Measurements:
| ↓ Muscle activity (by 35–38%) and lower discomfort in the low back in assembly task ↓ Hip extensor activity ↑ Discomfort in the chest region ↑ Endurance time from 3.2 to 9.7 min in the static holding task |
Purpose | Exoskeleton | Number of Papers |
---|---|---|
Back support | BackX (SuitX), Laevo™ V2.5, SPEXOR, Apex | 20 |
Shoulder support | ShoulderX (SuitX), SkelEx V1/V2 (SkelEX), Skelex 360 (Skelex)),CDYS (Crimson Dynamics), Mate (Comau), PAEXO (Ottobock), EksoVest (EksoBionics), AIRFRAMETM (Levitate), SPEXOR (SPEXOR) | 18 |
Leg support | LegX (SuitX) | 1 |
Standing/Sitting support | Chairless Chair (Noonee) | 2 |
Type | Metric | Measurement Device/Method | Purpose | Application for Exoskeleton Experiments |
---|---|---|---|---|
Objective | Electromyography (EMG) | Surface electrodes placed on skin | Record the electrical activity produced by skeletal muscles | Measure the magnitude of maximal voluntary isometric contraction (MVIC) |
Energy Expenditure | Indirect calorimetry | Measure the oxygen and carbon dioxide consumption | Determine the change in calories | |
Electrocardiogram (ECG, EKG) | Surface electrodes placed on chest | Record the electrical activity produced by heart muscles | Determine the changes in heart rate | |
Motion Capture | Motion sensors | Record the body movement during a physical activity | Determine the body kinematics | |
Subjective | Rate of Perceived Exertion (RPE) | Borg’s scale | Rate the perceived exertion after a defined physical activity | Determine the physical demands |
Discomfort Survey | Questionnaire | Measure body local discomfort | Determine the physical discomfort | |
General feedback | Questionnaire | Record the user feedback and comments | Determine the usability and acceptance |
Study | Evaluation Metric | Posture | Task |
---|---|---|---|
[10] | EMG; Subjective | Squat; Stoop; Freestyle | Manual handling |
[11] | EMG | Squat; Stoop; Freestyle; Asymmetric | Manual handling |
[12] | EMG; Force plate; Motion capture | Squat; Stoop; Freestyle | Manual handling |
[13] | Motion Capture | Stoop; Squat; Freestyle | Manual Handling |
[14] | EMG; Motion capture | Stoop; Squat; Freestyle | Manual handling |
[15] | EMG; Motion capture; Heart rate | Stoop; Squat | Manual handling |
[16] | EMG; Subjective | Stoop; Squat | Manual handling |
[17] | Force platform (Center of Pressure) | - | Balance |
[18] | Motion capture; Force platform | Squat | Manual handling |
[19] | Subjective; Performance | Squat; Stoop | Walking; Climbing; Manual handling |
[20] | EMG; Subjective | Overhead work | Use of tool |
[21] | EMG; Motion capture; Heart rate; Subjective | - | Stairs; Manual handling; Static task |
[22] | EMG; Vibration of shoulders | Overhead work | Use of tool |
[23] | EMG; Hand Grip (fatigue) | - | Walking |
[24] | EMG; Subjective | Overhead work | Use of tool |
[25] | EMG; Force plate; Motion capture | Overhead work | Use of tool; Balance; Walking |
[26] | EMG; Motion capture; Heart rate; Subjective | - | Manual handling |
[27] | EMG; Motion capture; Subjective | - | Static task |
[28] | EMG; Motion Capture; Heart rate; Oxygen consumption | Overhead work | Use of tool |
[29] | EMG; Motion Capture; Subjective; Oxygen consumption | - | Manual handling |
[30] | EMG; Motion capture; Subjective | - | Static task |
[31] | EMG; Subjective | Overhead work | Use of tool |
[32] | EMG; Subjective; Performance | Overhead work | Use of tool |
[33] | EMG; Subjective; Oxygen consumption | Standing; Kneeling | Manual handling |
[34] | EMG; Motion Capture | Overhead work | Use of tool |
[35] | EMG | Overhead work | Use of tool |
[36] | Subjective; Heart rate | Overhead work | Use of tool |
[37] | EMG; Motion capture; Subjective; Force platform | - | Static tasks |
[38] | Subjective | Overhead work | Use of tool |
[39] | Motion capture; Subjective; Range of motion | Overhead work | Use of tool |
[40] | EMG; Motion capture; Subjective; Heart rate; Force plate; Oxygen consumption | Overhead work | Use of tool |
[41] | Subjective; Video review | Stoop | Manual handling; Static task |
[42] | EMG; Subjective; Heart rate | Overhead work | Use of tool |
[43] | Subjective | Overhead work | Use of tool |
[44] | Performance; Force plate | - | Static tasks; Inducing falls |
[45] | Subjective; Heart rate | Overhead work | Use of tool |
[46] | EMG; Force Plate; Oxygen consumption | - | Manual handling |
[47] | Subjective; Performance | Squat; Stoop | Walking; Climbing; Manual handling |
[48] | EMG; Motion capture; Oxygen consumption | - | Manual handling; Walking |
[49] | EMG; Subjective | - | Manual handling |
[50] | EMG; Oxygen consumption | Stoop | Static task |
[51] | EMG; Motion capture; Subjective | Stoop | Static task |
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Golabchi, A.; Chao, A.; Tavakoli, M. A Systematic Review of Industrial Exoskeletons for Injury Prevention: Efficacy Evaluation Metrics, Target Tasks, and Supported Body Postures. Sensors 2022, 22, 2714. https://doi.org/10.3390/s22072714
Golabchi A, Chao A, Tavakoli M. A Systematic Review of Industrial Exoskeletons for Injury Prevention: Efficacy Evaluation Metrics, Target Tasks, and Supported Body Postures. Sensors. 2022; 22(7):2714. https://doi.org/10.3390/s22072714
Chicago/Turabian StyleGolabchi, Ali, Andrew Chao, and Mahdi Tavakoli. 2022. "A Systematic Review of Industrial Exoskeletons for Injury Prevention: Efficacy Evaluation Metrics, Target Tasks, and Supported Body Postures" Sensors 22, no. 7: 2714. https://doi.org/10.3390/s22072714