Search Results (21)

Biomimetic robotics and sensor technologies are reshaping the landscape of healthcare and rehabilitation. Despite significant progress across various domains, many areas within healthcare still demand further bio-inspired innovations. To advance this field effectively, it is essential to synthesize existing research, identify persistent knowledge gaps, and establish clear frameworks to guide future developments. This systematic review addresses these needs by analyzing 89 peer-reviewed sources retrieved from the Scopus database, focusing on the application of biomimetic robotics and sensing technologies in healthcare and rehabilitation contexts. The findings indicate a predominant focus on enhancing human mobility and support, with rehabilitative and assistive technologies comprising 61.8% of the reviewed literature. Additionally, 12.36% of the studies incorporate intelligent control systems and Artificial Intelligence (AI), reflecting a growing trend toward adaptive and autonomous solutions. Further technological advancements are demonstrated by research in bioengineering applications (13.48%) and innovations in soft robotics with smart actuation mechanisms (11.24%). The development of medical robots (7.87%) and wearable robotics, including exosuits (10.11%), underscores specific progress in clinical and patient-centered care. Moreover, the emergence of transdisciplinary approaches, present in 6.74% of the studies, highlights the increasing convergence of diverse fields in tackling complex healthcare challenges. By consolidating current research efforts, this review aims to provide a comprehensive overview of the state of the art, serving as a foundation for future investigations aimed at improving healthcare outcomes and enhancing quality of life. Full article

Stroke is one of the leading causes of long-term disability worldwide, often resulting in motor impairments that limit the ability to perform daily activities independently. Conventional rehabilitation exoskeletons, while effective, are typically rigid, bulky, and expensive, limiting their usability outside of clinical settings. In response to these challenges, this work presents the development and validation of a novel soft exosuit designed for elbow flexion rehabilitation, incorporating a multi-wire Shape Memory Alloy (SMA) actuator capable of both position and force control. The proposed system features a lightweight and ergonomic textile-based design, optimized for user comfort, ease of use, and low manufacturing cost. A sequential activation strategy was implemented to improve the dynamic response of the actuator, particularly during the cooling phase, which is typically a major limitation in SMA-based systems. The performance of the multi-bundle actuator was compared with a single-bundle configuration, demonstrating superior trajectory tracking and reduced thermal accumulation. Surface electromyography tests confirmed a decrease in muscular effort during assisted flexion, validating the device’s assistive capabilities. With a total weight of 0.6 kg and a fabrication cost under EUR 500, the proposed exosuit offers a promising solution for accessible and effective home-based rehabilitation. Full article

Military operators performing vehicle maintenance work are at times subject to onerous tasks such as lifting and transporting heavy loads, potentially in confined spaces. As this presents a risk for developing musculoskeletal injury, it is of interest to evaluate if a passive back-support exosuit could help reduce back muscle load. This study used wireless electromyographic (EMG) sensors to evaluate the biomechanical effects of exosuits during lifting tasks. Ten male participants performed military-relevant lifting tasks with and without wearing the exosuit in randomised orders. The lifting tasks included (1) vertical lifts of different weights (15 and 25 kg) onto different platform heights (0.5 m and 1.2 m) and (2) a lateral walk task across 4 m in a confined space while carrying a 39 kg weight. EMG activities of three back muscle groups (longissimus, iliocostalis, and multifidus) were measured and normalised to maximal isometric back extension tasks. The results showed no significant differences in muscle activation between conditions in most lifting tasks, except for a reduction in longissimus muscle activity when using the exosuit during lateral walking. Individual responses varied substantially, with some participants showing reduced muscle activity, while others did not. These findings highlight the challenges in implementing exosuits in reducing back muscle load during military lifting tasks. While passive back-support exosuits may provide benefits to some users, their effectiveness varies among individuals and may be task-dependent. Full article

This article investigates a cable-driven experimental setup to simulate elbow joint assistance in the sagittal plane provided by an exosuit. Cable-driven exosuits, particularly fabric-based designs, significantly enhance rehabilitation by enabling targeted joint exercises and promoting functional recovery. To achieve an optimal design, these devices require an analysis of the cable tension, reaction forces, and moments and their dependency on the anchor position. This study presents a cable-driven experimental setup with two rigid bars and variable anchor positions, designed to mimic the human forearm, upper arm, and elbow joint, to evaluate the performance of a potential cable-driven exosuit. Based on the experimental setup, a static model was developed to validate the measured cable tension and estimate the reaction force at the joint and the moments at the anchor positions. Furthermore, based on the observations, an optimization problem was defined to identify optimal anchor positions to improve the exosuit’s design. The optimal position on the forearm and upper arm is studied between 15% and 50% distance from the elbow joint. Our findings suggest that prioritizing user comfort requires both anchor points to be as far away from the elbow joint as possible, i.e., 50% distance, whereas, for optimal exosuit performance, the forearm anchor position can be adjusted based on the joint angle while keeping the upper arm anchor position at the farthest point. The findings in the current work can be used to decide the anchor point position for designing an elbow exosuit. Full article

Soft exoskeletons (exosuits) are expected to provide a comfortable wearing experience and compliant assistance compared with traditional rigid exoskeleton robots. In this paper, an exosuit with twisted string actuators (TSAs) is developed to provide high-strength and variable-stiffness actuation for hemiplegic patients. By formulating the analytic model of the TSA and decoding the human impedance characteristic, the human-exosuit coupled dynamic model is constructed. An adaptive impedance controller is designed to transfer the skills of the patient’s healthy limb (HL) to the bilateral impaired limb (IL) with a mirror training strategy, including the movement trajectory and stiffness profiles. A reinforcement learning (RL) algorithm is proposed to optimize the robotic assistance by adapting the impedance model parameters to the subject’s performance. Experiments are conducted to demonstrate the effectiveness and superiority of the proposed method. Full article

Lower limb exoskeletons have been developed to improve functionality and assist with daily activities in various environments. Although these systems utilize sensors for gait phase detection, they lack anticipatory information about environmental changes, which limits their adaptability. This paper presents a vision-based intelligent gait environment detection algorithm for a lightweight ankle exosuit designed to enhance gait stability and safety for stroke patients, particularly during stair negotiation. The proposed system employs YOLOv8 for real-time environment classification, combined with a long short-term memory (LSTM) network for spatio-temporal feature extraction, enabling the precise detection of environmental transitions. An experimental study evaluated the classification algorithm and soft ankle exosuit performance through three conditions using kinematic analysis and muscle activation measurements. The algorithm achieved an overall accuracy of over 95% per class, which significantly enhanced the exosuit’s ability to detect environmental changes, and thereby improved its responsiveness to various conditions. Notably, the exosuit increased the ankle dorsiflexion angles and reduced the muscle activation during the stair ascent, which enhanced the foot clearance. The results of this study indicate that advanced spatio-temporal feature analysis and environment classification improve the exoskeleton’s gait assistance, improving adaptability in complex environments for stroke patients. Full article

Soft exosuits have emerged as potent assistive tools for walking support and rehabilitation training. However, most existing soft exosuit systems rely on preset assistance modes, which may not accurately align with individual physiological states and movement requirements, leading to variable user experiences and efficacy. While existing human-in-the-loop (HIL) research predominantly focuses on optimizing metabolic cost and torque difference parameters, there is a notable absence of real-time monitoring methods that closely reflect the human body’s physiological state and strategies that dynamically indicate walking efficiency. Motivated by this, we developed a novel personalized power-assist system. This system optimizes the power-assist output of the hip joint by monitoring the user’s physiological and motion signals in real time, including heart rate (HR), blood oxygen saturation (SpO₂), and inertial measurement unit (IMU) data, to assist hip flexion based on feedback. The findings from a metabolic expenditure trial demonstrate that the innovative soft exosuit, which is based on a Physiological State Monitoring Control (PSMC) system, achieves a reduction of 7.81% in metabolic expenditure during treadmill walking at a speed of 3.5 km/h compared to walking without the assistance of the exosuit. Additionally, during continuous exercise with varying intensities, the metabolic consumption level is reduced by 5.1%, 5.8%, and 8.2% at speeds of 2, 4, and 6 km per hour, respectively. These results support the design of a novel hip flexion-assisting soft exosuit, demonstrating that applying different assistance forces in consideration of different physiological states is a reasonable approach to reducing metabolic consumption. Full article

The light weight and compliance of exosuits are valuable benefits not present rigid exoskeleton devices, yet these intriguing features make it challenging to properly model and simulate their interaction with the musculoskeletal system. Tendon-driven exosuits adopt an electrical motor combined with pulleys and cable transmission in the actuation stage. An important aspect of the design of these systems for the load transfer efficacy and comfort of the user is the anchor point positioning. In this paper, we propose a framework, whose first purpose is as a design methodology for the synthesis of an exosuit device, achieved by optimizing the anchor point location. The optimization procedure finds the best 3D position of the anchor points based on the interaction forces between the exosuit and the upper arm. The computation of the forces is based on the combination of a mathematical model of a wrist–elbow exosuit and a dynamic model of the upper arm. Its second purpose is the simulation of the kinematic and physiological effects of the interaction between the arm, the exosuit, and the complex upper limb musculoskeletal system. It offers insights into muscular and exoskeleton loading during operation. The presented experiments involve the development and validation of personalized musculoskeletal models, with kinematic, anthropometric, and electromyographic data measured in a load-lifting task. Simulation of the exosuit operation—coupled with the musculoskeletal model—showed the efficacy of the suit in assisting the wrist and elbow muscles and provided interesting highlights about the impact of the assistance on shoulder muscles. Finally, we provide a possible design of an elbow and wrist exosuit based on the optimized results. Full article

Medical robotics nowadays can prevent, treat, or alleviate numerous severe conditions, including the dire consequences of stroke. Our objective was to determine the effect of employing a robotic soft exoskeleton in therapy on the development of the early mobilization, gait, and coordination in stroke patients. The ReStore™ Soft Exo-Suit, a wearable exosuit developed by a leading company with exoskeleton technology, was utilized. It is a powered, lightweight device intended for use in stroke rehabilitation for people with lower limb disability. We performed a randomized clinical intervention, using a before–after trial design in a university hospital setting. A total of 48 patients with a history of stroke were included, of whom 39 were randomized and 30 completed the study. Interventions: Barthel Index and modified Rankin scale (mRS) patients were randomly assigned to a non-physical intervention control (n = 9 of 39 completed, 30 withdrew before baseline testing), or to a high-intensity agility program (15 sessions, 5 weeks, n = 30 completed). The main focus of assessment was on the Modified Rankin Scale. Additionally, we evaluated secondary factors including daily life functionality, five dimensions of health-related quality of life, the Beck depression inventory, the 6 min walk test (6MWT), the Berg Balance Scale (BBS), and static balance (center of pressure). The Robot-Assisted Gait Therapy (ROB/RAGT) program led to significant improvements across various measures, including a 37% improvement in Barthel Index scores, a 56% increase in 10 m walking speed, and a 68% improvement in 6 min walking distance, as well as notable enhancements in balance and stability. Additionally, the intervention group demonstrated significant gains in all these aspects compared to the control group. In conclusion, the use of robotic therapy can be beneficial in stroke rehabilitation. These devices support the restoration and improvement of movement in various ways and contribute to restoring balance and stability. Full article

Pediatric patients can suffer from different motor disorders that limit their neurological and motor development and hinder their independence. If treated at the very early stages of development, those limitations can be palliated or even removed. However, manual interventions are not completely effective due to the restrictions in terms of time, force, or tracking experienced by the physiotherapists. The knee flexo-extension is crucial for walking and often affected by disorders such as spasticity or lack of force in the posterior chain. This article focuses on the development of a knee exosuit to follow angular trajectories mimicking the maximum and minimum peaks present in the knee flexo-extension profiles of healthy individuals during walking. The proposed exosuit is based on shape memory alloy actuators along with four inertial sensors that close the control loop. The whole device is controlled through a two-level controller and has an hybrid rigid–flexible design to overcome the different issues present in the literature. The device was proven to be feasible for this type of application, with replicable and consistent behavior, reducing the price and weight of existing exosuits and enhancing patient comfort. Full article

Lower-back pain (LBP) is a major cause of occupational disability and morbidity. This study investigates the effectiveness of a fabric-based pneumatic exosuit in reducing discomfort and lumbar muscle activation in healthy individuals who are performing manual-handling tasks. The suit combines the comfort of soft exosuits and the support of rigid exoskeletons. Ten healthy subjects performed a circuit of lifting tasks, simulating manual-handling work, with and without AireLevate support. We assessed the comfort levels and ease of task completion via a questionnaire after each manual-handling task. There was no difference in spinal range of motion, local discomfort, or general discomfort of activities with or without the AireLevate. There was a statistically significant reduction in muscle activation of the erector spinae at the L-5 level with AireLevate support (p < 0.02). This study demonstrates the exosuit’s ability in reducing lower-back muscle activation during manual-handling tasks, while maintaining comfort and mobility. Practitioner summary: We developed a soft exosuit which was shown to significantly reduce the muscle action of the erector muscles of the lumbar spine. In addition, participants perceived that the suit was easy to use and did not limit manual-handling tasks. Full article

In recent years, exoskeleton test methods for industrial exoskeletons have evolved to include simulated laboratory and field environments. Physiological, kinematic, and kinetic metrics, as well as subjective surveys, are used to evaluate exoskeleton usability. In particular, exoskeleton fit and usability can also impact the safety of exoskeletons and their effectiveness at reducing musculoskeletal injuries. This paper surveys the state of the art in measurement methods applied to exoskeleton evaluation. A notional classification of the metrics based on exoskeleton fit, task efficiency, comfort, mobility, and balance is proposed. In addition, the paper describes the test and measurement methods used in supporting the development of exoskeleton and exosuit evaluation methods to assess their fit, usability, and effectiveness in industrial tasks such as peg in hole, load align, and applied force. Finally, the paper includes a discussion of how the metrics can be applied towards a systematic evaluation of industrial exoskeletons, current measurement challenges, and future research directions. Full article

Flexibility and light weight have become the development trends in the field of exoskeleton research. With high movement flexibility, low movable inertia and excellent wearable comfort, such a type of system is gradually becoming an exclusive candidate for applications such as military defense, rehabilitation training and industrial production. In this paper, aiming at assisting the walking of human lower limbs, a soft exosuit is investigated and developed based on the considerations of fabric structure, sensing system, cable-driven module, and control strategy, etc. Evaluation experiments are also conducted to verify its effectiveness. A fabric optimization of the flexible suit is performed to realize the tight bond between human and machine. Through the configuration of sensor nodes, the motion intention perception system is constructed for the lower limb exosuit. A flexible actuation unit with a Bowden cable is designed to improve the efficiency of force transmission. In addition, a position control strategy based on division of the gait phase is applied to achieve active assistance during plantar flexion of the ankle joint. Finally, to verify the assistive effectiveness of the proposed lower extremity exosuit, experiments including a physiological metabolic test and a muscle activation test are conducted. The experiment results show that the exosuit proposed in this paper can effectively reduce the metabolic consumption and muscle output of the human body. The design and methodology proposed in this paper can be extended to similar application scenarios. Full article

Exoskeletons and exosuits (collectively termed EXOs) have the potential to reduce the risk of work-related musculoskeletal disorders (WMSDs) by protecting workers from exertion and muscle fatigue due to physically demanding, repetitive, and prolonged work in construction workplaces. However, the use of EXOs in construction is in its infancy, and much of the knowledge required to drive the acceptance, adoption, and application of this technology is still lacking. The objective of this research is to identify the facilitators, barriers, and corresponding solutions to foster the adoption of EXOs in construction workplaces through a sequential, multistage Delphi approach. Eighteen experts from academia, industry, and government gathered in a workshop to provide insights and exchange opinions regarding facilitators, barriers, and potential solutions from a holistic perspective with respect to business, technology, organization, policy/regulation, ergonomics/safety, and end users (construction-trade professionals). Consensus was reached regarding all these perspectives, including top barriers and potential solution strategies. The outcomes of this study will help the community gain a comprehensive understanding of the potential for EXO use in the construction industry, which may enable the development of a viable roadmap for the evolution of EXO technology and the future of EXO-enabled workers and work in construction workplaces. Full article

Soft wearable robots are attracting immense attention owing to their high usability and wearability. In particular, studies on soft exosuits have achieved remarkable progress. Walking is one of the most basic human actions in daily life. During walking, the ankle joint has considerable influence. Therefore, an exosuit design paradigm having a light and simple structure was developed with the goal of fabricating a soft exosuit that supports the ankle. The new exosuit matches the performance of existing exosuits while being as comfortable as everyday wear. A walking test through a combination with a mobile actuator system, which can maximize these advantages, was also conducted. The combination with the mobile system demonstrates the potential of using the new ankle exosuit as inner wear that maximizes the advantages of a lighter and simpler design. The exosuit design paradigm could serve as an effective guideline for manufacturing assistive exosuits for various body parts in the future. Full article