RESUMO
This study evaluated the effects of a back-support exoskeleton on the trunk and hip joint angles, lower back muscle activity and heart rate during four patient handling tasks: assisting a patient from sitting to lying, laterally repositioning the patient and turning the patient in two directions. Eight participants performed these tasks with and without the exoskeleton. Results demonstrated a significant reduction in the lower back muscle activity, but less pronounced effects for other tasks involving minimal trunk flexion. Hip flexion angles were reduced for all tasks when the exoskeleton was worn. The amount of reduction in the muscle activity and changes in the trunk and hip angles varied by task. The exoskeleton did not affect the heart rate across all tasks. The exoskeleton appeared to be more effective in tasks requiring substantial trunk flexion, indicating its potential benefits for reducing lower back muscle strain during such activities.
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The anterior and posterior iliac spine markers frequently used to define the pelvis, are commonly occluded during three-dimensional (3D) motion capture. The occlusion of these markers leads to the use of various tracking marker configurations on the pelvis, which affect kinematic results. The purpose of this investigation was to examine the agreement of CODA pelvis kinematic results when two different tracking marker configurations were used during roofing tasks. 3D motion data were collected on seven male subjects while mimicking two roofing tasks. Hip joint angles (HJAs) were computed using the CODA pelvis with two different tracking marker configurations, the trochanter tracking method (TTM), and virtual pelvis tracking method (VPTM). Agreement between tracking marker configurations was assessed using cross-correlations, bivariate correlations, mean absolute differences (MADs), and Bland-Altman (BA) plots. The correlations displayed no time lag and strong agreement (all r > 0.83) between the HJA from the VPTM and TTM, suggesting the timing occurrence of variables are comparable between the two tracking marker configurations. The MAD between the VPTM and TTM displayed magnitude differences, but most of the differences were within a clinically acceptable range. Caution should still be used when comparing kinematic results between various tracking marker configurations, as differences exist.
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Musculoskeletal Disorders (MSDs) remain a major concern for workers in the healthcare industry. Healthcare workers are at high risk of work-related MSDs mainly caused by overexertion from manually handling patients. Exoskeletons may be a useful tool to help reduce the risk of MSDs during patient handling. As a review study, we surveyed articles focusing on applying exoskeletons to patient handling tasks specifically. We also reviewed relevant government databases and other studies related to Safe Patient Handling and Mobility (SPHM) programs and exoskeleton applications in general. The exoskeletons specifically designed for patient handling were found to be sparse. To have a better understanding of the needs and challenges of developing and using exoskeletons for reducing risks of work-related MSDs in healthcare workers during patient handling, this critical review (1) provided an overview of the existing issues and projected future burdens related to work-related MSDs during patient handling tasks, (2) recognized current and potential roles and applications of existing exoskeletons, and (3) identified challenges and needs for future exoskeleton products. In conclusion, we do not expect exoskeletons to replace the existing SPHM programs, but rather play a complementary role to these multi-pronged programs. We expect that emerging exoskeleton products can be introduced to uncontrolled or specialized healthcare environments. There are various expectations and requirements for an exoskeleton used in different healthcare settings. Additionally, introducing certain types of exoskeletons for patients to assist them during treatment and rehabilitation may help reduce the MSD risks to the healthcare workers.
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Industrial exoskeletons have been used to assist workers during occupational activities, such as overhead work, tool-use, mobility, stooping/squatting, and/or load carrying in various industries. Despite the promise of reducing the risk of work-related musculoskeletal disorders, there is a lack of sufficient evidence to support the safe and effective use of industrial exoskeletons. To assess the merits and residual risks of various types of exoskeletons in different work settings, more comprehensive evaluation procedures are needed. This review study aims to provide an overview of the existing viable and promising methods for evaluating the effectiveness of industrial exoskeletons. The different evaluation methods are organized into three categories-in vitro, in vivo, and in silico studies. The limitations and challenges in different types of evaluation approaches are also discussed. In summary, this review sheds light on choosing appropriate evaluation approaches and may help with decision-making during the development, evaluation, and application of industrial exoskeletons.
Assuntos
Exoesqueleto Energizado , HumanosRESUMO
Hiking is a common recreational activity that provides numerous health benefits, such as reduced risk of heart disease, reduced blood pressure, and improved cardiorespiratory fitness. The use of specifically designed trekking poles has become popular among participants seeking to alleviate sore knees and increase balance and stability while walking. This review provides an overview of physiologic and biomechanical responses elicited when trekking poles are used during outdoor activities, such as hiking or Nordic walking, and discusses the clinical implications of the use of trekking poles. Google Scholar, PubMed, and ScienceDirect databases, as well as university library catalogues, were searched for literature published between 1980 and 2019. The keywords used to search the literature were hiking poles, trekking poles, and Nordic walking and their combination with physiological responses, ground reaction forces, joint forces, spatiotemporal parameters, kinematics, electromyography, and/or balance. The related topics included the academic disciplines of biomechanics, sports science, and wilderness medicine. Reference lists of located studies were also reviewed for additional sources. During free, unloaded walking, users should compare the cost and benefit of using poles: Trekking poles decrease lower extremity loading and forces but increase cardiovascular demand. When carrying a large external load, trekking poles may offer benefit by decreasing lower extremity muscle activity and increasing balance and stability.