Systematic Evaluation of a Knee Exoskeleton Misalignment Compensation Mechanism Using a Robotic Dummy Leg.

The objective and quantitative assessment of physical human-exoskeletons interaction (pHEI) represents a pressing necessity in the wearable robots field. This process remains of difficult execution, especially for early stage devices, in which the inclusion of human testing could pose ethical and safety concerns. This manuscript proposes a methodology for pHEI assessment based on an active dummy leg named Leg Replica, which is able to sense interaction forces while wearing an exoskeleton. We tested this methodology on a wearable active knee exoskeleton prototype, with the goal to evaluate the effects of a misalignment compensation mechanism. Through this methodology, it was possible to show how the misalignment compensation mechanism was able to reduce the interaction forces during passive exoskeleton motion. Such reduction was less evident when the exoskeleton was active. The tests allowed to identify specific points of improvements for the exoskeleton, enabling a more specific upgrade of the device based on these experimental results. This study demonstrates the ability of the proposed methodology to objectively benchmark different aspects of pHEI, and to accelerate the iterative development of new devices prior to human testing.

Validation of Estimators for Weight-Bearing and Shoulder Joint Loads Using Instrumented Crutches.

This research paper aimed to validate two methods for measuring loads during walking with instrumented crutches: one method to estimate partial weight-bearing on the lower limbs and another to estimate shoulder joint reactions. Currently, gait laboratories, instrumented with high-end measurement systems, are used to extract kinematic and kinetic data, but such facilities are expensive and not accessible to all patients. The proposed method uses instrumented crutches to measure ground reaction forces and does not require any motion capture devices or force platforms. The load on the lower limbs is estimated by subtracting the forces measured by the crutches from the subject's total weight. Since the model does not consider inertia contribution in dynamic conditions, the estimation improves with low walking cadence when walking with the two-point contralateral and the three-point partial weight-bearing patterns considered for the validation tests. The shoulder joint reactions are estimated using linear regression, providing accurate values for the forces but less accurate torque estimates. The crutches data are acquired and processed in real-time, allowing for immediate feedback, and the system can be used outdoors in real-world walking conditions. The validation of this method could lead to better monitoring of partial weight-bearing and shoulder joint reactions, which could improve patient outcomes and reduce complications.

Development of a Portable Low-Cost System for the Metrological Verification of Wheelchair Roller Ergometers.

Wheelchair ergometers are widely used in research, clinical practice, and sports environments. The majority of wheelchair ergometers are roller systems that allow for wheelchair propulsion in the personal wheelchair on one or two (instrumented) rollers. Oftentimes these systems are only statically calibrated. However, wheelchair propulsion is dynamic by nature, requiring a dynamic validation process. The aim of the current project was to present a low-cost portable system for the dynamic metrological verification of wheelchair roller ergometers, based on an instrumented reference wheel. The tangential force on the roller is determined, along with its uncertainty, from the reference wheel properties, and compared with the force measured by the ergometer. Uncertainty of this reference wheel system was found to be lower than the one of the ergometer used, indicating that this novel approach can be used for the metrological verification of ergometers.

Experimental Procedure for the Metrological Characterization of Time-of-Flight Cameras for Human Body 3D Measurements.

Time-of-flight cameras are widely adopted in a variety of indoor applications ranging from industrial object measurement to human activity recognition. However, the available products may differ in terms of the quality of the acquired point cloud, and the datasheet provided by the constructors may not be enough to guide researchers in the choice of the perfect device for their application. Hence, this work details the experimental procedure to assess time-of-flight cameras' error sources that should be considered when designing an application involving time-of-flight technology, such as the bias correction and the temperature influence on the point cloud stability. This is the first step towards a standardization of the metrological characterization procedure that could ensure the robustness and comparability of the results among tests and different devices. The procedure was conducted on Kinect Azure, Basler Blaze 101, and Basler ToF 640 cameras. Moreover, we compared the devices in the task of 3D reconstruction following a procedure involving the measure of both an object and a human upper-body-shaped mannequin. The experiment highlighted that, despite the results of the previously conducted metrological characterization, some devices showed evident difficulties in reconstructing the target objects. Thus, we proved that performing a rigorous evaluation procedure similar to the one proposed in this paper is always necessary when choosing the right device.

Characterization and Evaluation of Human-Exoskeleton Interaction Dynamics: A Review.

Exoskeletons and exosuits have witnessed unprecedented growth in recent years, especially in the medical and industrial sectors. In order to be successfully integrated into the current society, these devices must comply with several commercialization rules and safety standards. Due to their intrinsic coupling with human limbs, one of the main challenges is to test and prove the quality of physical interaction with humans. However, the study of physical human-exoskeleton interactions (pHEI) has been poorly addressed in the literature. Understanding and identifying the technological ways to assess pHEI is necessary for the future acceptance and large-scale use of these devices. The harmonization of these evaluation processes represents a key factor in building a still missing accepted framework to inform human-device contact safety. In this review, we identify, analyze, and discuss the metrics, testing procedures, and measurement devices used to assess pHEI in the last ten years. Furthermore, we discuss the role of pHEI in safety contact evaluation. We found a very heterogeneous panorama in terms of sensors and testing methods, which are still far from considering realistic conditions and use-cases. We identified the main gaps and drawbacks of current approaches, pointing towards a number of promising research directions. This review aspires to help the wearable robotics community find agreements on interaction quality and safety assessment testing procedures.

Load Auditory Feedback Boosts Crutch Usage in Subjects With Central Nervous System Lesions: A Pilot Study.

Background: Crutches are the most common walking aids prescribed to improve mobility in subjects with central nervous system (CNS) lesions. To increase adherence to the appropriate level of crutch usage, providing load-related auditory feedback (aFB) may be a useful approach. We sensorized forearm crutches and developed a custom software to provide aFB information to both user and physical therapist (PhT). Aim: Evaluate aFB effects on load control during gait by a self-controlled case series trial. Methods: A single experimental session was conducted enrolling 12 CNS lesioned participants. Load on crutch was recorded during 10 Meter Walk Test performed with and without aFB. In both cases, crutch load data, and gait speed were recorded. Usability and satisfaction questionnaires were administered to participants and PhTs involved. Results: Reliable data were obtained from eight participants. Results showed that compared to the no FB condition, aFB yielded a significant reduction in the mean load on the crutches during gait (p = 0.001). The FB did not influence gait speed or fatigue (p > 0.05). The experience questionnaire data indicated a positive experience regarding the use of aFB from both participants' and PhTs' perspectives. Conclusion: aFB significantly improves compliance with crutch use and does not affect gait speed or fatigue by improving the load placed on crutches. The FB is perceived by users as helpful, safe, and easy to learn, and does not interfere with attention or concentration while walking. Furthermore, the PhTs consider the system to be useful, easy to learn and reliable.

Validation of Marker-Less System for the Assessment of Upper Joints Reaction Forces in Exoskeleton Users.

This paper presents the validation of a marker-less motion capture system used to evaluate the upper limb stress of subjects using exoskeletons for locomotion. The system fuses the human skeletonization provided by commercial 3D cameras with forces exchanged by the user to the ground through upper limbs utilizing instrumented crutches. The aim is to provide a low cost, accurate, and reliable technology useful to provide the trainer a quantitative evaluation of the impact of assisted gait on the subject without the need to use an instrumented gait lab. The reaction forces at the upper limbs' joints are measured to provide a validation focused on clinically relevant quantities for this application. The system was used simultaneously with a reference motion capture system inside a clinical gait analysis lab. An expert user performed 20 walking tests using instrumented crutches and force platforms inside the observed volume. The mechanical model was applied to data from the system and the reference motion capture, and numerical simulations were performed to assess the internal joint reaction of the subject's upper limbs. A comparison between the two results shows a root mean square error of less than 2% of the subject's body weight.

An Experimental Method to Estimate Upper Limbs Inertial Parameters During Handcycling.

This study proposes an experimental method to estimate personalized inertial parameters of upper limbs during handcycling by using a planar dynamic model. The handle forces are expressed as a product of a matrix describing the kinematics terms and a vector of inertial parameters of arm and forearm. The parameters are estimated by measuring the handle forces during a suitable "passive test" and inverting the mentioned matrix. The data were acquired while an operator actuated the handle and the subject's muscles were relaxed. To validate the estimation procedure, it was applied to a custom-made artificial arm mechanism, and the results were compared with its known parameters. The method was then used to estimate the inertial parameters of 6 human subjects. The estimated parameters were used to compute the exchanged forces and compared with the measured ones obtaining an average error of 14% both for Fx and Fy. These errors are significantly smaller than those obtained using dynamic parameters extracted from the literature to compute the forces, which were 50% for Fx and 19% for Fy. An individual evaluation of inertial parameters better describes interaction forces during handcycling, especially for subjects whose body structures are different from the average population.