Aging in 10 Minutes: Do Age Simulation Suits Mimic Physical Decline in Old Age? Comparing Experimental Data with Established Reference Data.

INTRODUCTION: Age simulation suits are increasingly used in health care education. However, empirical evidence that quantifies the simulated performance losses in established geriatric tests and compares those declines with reference data of older adults is scarce. METHODS: In a standardized lab setting, we compared performance of N = 61 participants (46 middle-aged, 15 young adults) with and without age simulation suit, for example in the Timed Up and Go Test (+dual task), Short Physical Performance Battery, grip strength, and 30-Second-Chair- Standing Test. Additionally, we compared the results with suit to established reference values of older adults in different age groups. RESULTS: Reduced performance was observed in both groups when wearing the suit, yet to different degrees dependent on the assessment and user age. For one, larger declines were observed in more challenging and complex tasks across age groups. In addition, comparisons with reference values revealed age-differential "instant aging" effects. DISCUSSION: A simulated "fourth age," where frailty and impairments are accumulating, was not reached in the majority of assessments, especially not among younger participants. In conclusion, existing age simulation suits may have some educational and empathy potential, but so far, they fail in simulating the age period with most serious functional loss.

On the Distribution of Muscle Signals: A Method for Distance-Based Classification of Human Gestures.

We investigate the distribution of muscle signatures of human hand gestures under Dynamic Time Warping. For this we present a k-Nearest-Neighbors classifier using Dynamic Time Warping for the distance estimate. To understand the resulting classification performance, we investigate the distribution of the recorded samples and derive a method of assessing the separability of a set of gestures. In addition to this, we present and evaluate two approaches with reduced real-time computational cost with regards to their effectiveness and the mechanics behind them. We further investigate the impact of different parameters with regards to practical usability and background rejection, allowing fine-tuning of the induced classification procedure.

Preschoolers' Motivation to Over-Imitate Humans and Robots.

From preschool age, humans tend to imitate causally irrelevant actions-they over-imitate. This study investigated whether children over-imitate even when they know a more efficient task solution and whether they imitate irrelevant actions equally from a human compared to a robot model. Five-to-six-year-olds (N = 107) watched either a robot or human retrieve a reward from a puzzle box. First a model demonstrated an inefficient (Trial 1), then an efficient (Trial 2), then again the inefficient strategy (Trial 3). Subsequent to each demonstration, children copied whichever strategy had been demonstrated regardless of whether the model was a human or a robot. Results indicate that over-imitation can be socially motivated, and that humanoid robots and humans are equally likely to elicit this behavior.

Comparison of the Performance of the Leap Motion ControllerTM with a Standard Marker-Based Motion Capture System.

Over the last few years, the Leap Motion Controller™ (LMC) has been increasingly used in clinical environments to track hand, wrist and forearm positions as an alternative to the gold-standard motion capture systems. Since the LMC is marker-less, portable, easy-to-use and low-cost, it is rapidly being adopted in healthcare services. This paper demonstrates the comparison of finger kinematic data between the LMC and a gold-standard marker-based motion capture system, Qualisys Track Manager (QTM). Both systems were time synchronised, and the participants performed abduction/adduction of the thumb and flexion/extension movements of all fingers. The LMC and QTM were compared in both static measuring finger segment lengths and dynamic flexion movements of all fingers. A Bland-Altman plot was used to demonstrate the performance of the LMC versus QTM with Pearson's correlation (r) to demonstrate trends in the data. Only the proximal interphalangeal joint (PIP) joint of the middle and ring finger during flexion/extension demonstrated acceptable agreement (r = 0.9062; r = 0.8978), but with a high mean bias. In conclusion, the study shows that currently, the LMC is not suitable to replace gold-standard motion capture systems in clinical settings. Further studies should be conducted to validate the performance of the LMC as it is updated and upgraded.

Robust Foot Clearance Estimation Based on the Integration of Foot-Mounted IMU Acceleration Data.

This paper introduces a method for the robust estimation of foot clearance during walking, using a single inertial measurement unit (IMU) placed on the subject's foot. The proposed solution is based on double integration and drift cancellation of foot acceleration signals. The method is insensitive to misalignment of IMU axes with respect to foot axes. Details are provided regarding calibration and signal processing procedures. Experimental validation was performed on 10 healthy subjects under three walking conditions: normal, fast and with obstacles. Foot clearance estimation results were compared to measurements from an optical motion capture system. The mean error between them is significantly less than 15 % under the various walking conditions.

Can lower-limb exoskeletons support sit-to-stand motions in frail elderly without crutches? A study combining optimal control and motion capture.

With the global geriatric population expected to reach 1.5 billion by 2050, different assistive technologies have been developed to tackle age-associated movement impairments. Lower-limb robotic exoskeletons have the potential to support frail older adults while promoting activities of daily living, but the need for crutches may be challenging for this population. Crutches aid safety and stability, but moving in an exoskeleton with them can be unnatural to human movements, and coordination can be difficult. Frail older adults may not have the sufficient arm strength to use them, or prolonged usage can lead to upper limb joint deterioration. The research presented in this paper makes a contribution to a more detailed study of crutch-less exoskeleton use, analyzing in particular the most challenging motion, sit-to-stand (STS). It combines motion capture and optimal control approaches to evaluate and compare the STS dynamics with the TWIN exoskeleton with and without crutches. The results show trajectories that are significantly faster than the exoskeleton's default trajectory, and identify the motor torques needed for full and partial STS assistance. With the TWIN exoskeleton's existing motors being able to support 112 Nm (hips) and 88 Nm (knees) total, assuming an ideal contribution from the device and user, the older adult would need to contribute a total of 8 Nm (hips) and 50 Nm (knees). For TWIN to provide full STS assistance, it would require new motors that can exert at least 121 Nm (hips) and 140 Nm (knees) total. The presented optimal control approaches can be replicated on other exoskeletons to determine the torques required with their mass distributions. Future improvements are discussed and the results presented lay groundwork for eliminating crutches when moving with an exoskeleton.

Estimating speaker direction on a humanoid robot with binaural acoustic signals.

To achieve human-like behaviour during speech interactions, it is necessary for a humanoid robot to estimate the location of a human talker. Here, we present a method to optimize the parameters used for the direction of arrival (DOA) estimation, while also considering real-time applications for human-robot interaction scenarios. This method is applied to binaural sound source localization framework on a humanoid robotic head. Real data is collected and annotated for this work. Optimizations are performed via a brute force method and a Bayesian model based method, results are validated and discussed, and effects on latency for real-time use are also explored.

Control of ankle extensor muscle activity in walking cats.

Our objective was to gain insight into the relative importance of feedforward control and different proprioceptive feedback pathways to ongoing ankle extensor activity during walking in the conscious cat. We asked whether the modulation of stance phase muscle activity is due primarily to proprioceptive feedback and whether the same proprioceptive gains and feedforward commands can automatically generate the muscle activity required for changes in walking slope. To test these hypotheses, we analyzed previously collected muscle activity and mechanics data from cats with an isolated medial gastrocnemius muscle walking along a sloped pegway. Models of proprioceptor dynamics predicted afferent activity from the measured muscle mechanics. We modeled muscle activity as the weighted sum of the activity predicted from the different proprioceptive pathways and a simple model of central drive. We determined the unknown model parameters using optimization procedures that minimized the error between the predicted and measured muscle activity. We found that the modulation of muscle activity within the stance phase and across walking slopes is indeed well described by neural control that employs constant central drive and constant proprioceptive feedback gains. Furthermore, it is force feedback from Ib afferents that is primarily responsible for modulating muscle activity; group II afferent feedback makes a small contribution to tonic activity, and Ia afferent feedback makes no contribution. Force feedback combined with tonic central drive appears to provide a simple control mechanism for automatically compensating for changes in terrain without requiring different commands from the brain or even modification of central nervous system gains.

A Quantitative Comparison of Slackline Balancing Capabilities of Experts and Beginners.

Mechanical stability criteria are able to explain balance and robustness during simple motions, however, humans have learned many complex balancing tasks for which science lacks a thorough understanding. In this work, we analyzed slackline balancing to define general balance performance indicators. The goal is to not only measure slackline expertise, but to be able to quantify stability during any balance task. For this, we compared beginners that had never balanced on a slackline before to professional slackline athletes. Further, all participants performed a static balance test, based on which we divided beginners into a balance-experienced and a balance-inexperienced group. On average, the balance experienced group was able to balance twice as long on the slackline and therefore, we showed that this static balance experience is a predictor of slackline balance performance. Based on over 300 balancing trials on the slackline of 20 participants, we then defined and evaluated over 30 balance metrics. The parameters can be grouped into quantification of stability and recovery movements, balance specific skills and balance strategies. We found that normalized angular momentum and center of mass acceleration are measures for overall stability, with lower values representing better stability and fewer recovery movements. We showed that improved hand coordination and adjusted stance leg compliance are valuable skills for balance tasks. especially when controlling external forces. Looking at posture and movement strategies, we found that professional slackliners have adapted a different mean pose with larger inertia and an upright head position, when compared to beginners.

Optimization-Based Motion Generation for Buzzwire Tasks With the REEM-C Humanoid Robot.

Buzzwire tasks are often used as benchmarks and as training environments for fine motor skills and high precision path following. These tasks require moving a wire loop along an arbitrarily shaped wire obstacle in a collision-free manner. While there have been some demonstrations of buzzwire tasks with robotic manipulators using reinforcement learning and admittance control, there does not seem to be any examples with humanoid robots. In this work, we consider the scenario where we control one arm of the REEM-C humanoid robot, with other joints fixed, as groundwork for eventual full-body control. In pursuit of this, we contribute by designing an optimal control problem that generates trajectories to solve the buzzwire in a time optimized manner. This is composed of task-space constraints to prevent collisions with the buzzwire obstacle, the physical limits of the robot, and an objective function to trade-off reducing time and increasing margins from collision. The formulation can be applied to a very general set of wire shapes and the objective and task constraints can be adapted to other hardware configurations. We evaluate this formulation using the arm of a REEM-C humanoid robot and provide an analysis of how the generated trajectories perform both in simulation and on hardware.

Optimization of Dynamic Sit-to-Stand Trajectories to Assess Whole-Body Motion Performance of the Humanoid Robot REEM-C.

To enable the application of humanoid robots outside of laboratory environments, the biped must meet certain requirements. These include, in particular, coping with dynamic motions such as climbing stairs or ramps or walking over irregular terrain. Sit-to-stand transitions also belong to this category. In addition to their actual application such as getting out of vehicles or standing up after sitting, for example, at a table, these motions also provide benefits in terms of performance assessment. Therefore, they have long been used as a sports medical and geriatric assessment for humans. Here, we develop optimized sit-to-stand trajectories using optimal control, which are characterized by their dynamic and humanlike nature. We implement these motions on the humanoid robot REEM-C. Based on the obtained sensor data, we present a unified benchmarking procedure based on two different experimental protocols. These protocols are characterized by their increasing level of difficulty for quantifying different aspects of lower limb performance. We report performance results obtained by REEM-C using two categories of indicators: primary, scenario-specific indicators that assess overall performance (chair height and ankle-to-chair distance) and subsidiary, general indicators that further describe performance. The latter provide a more detailed analysis of the applied motion and are based on metrics such as the angular momentum, zero moment point, capture point, or foot placement estimator. In the process, we identify performance deficiencies of the robot based on the collected data. Thus, this work is an important step toward a unified quantification of bipedal performance in the execution of humanlike and dynamically demanding motions.

Making Bipedal Robot Experiments Reproducible and Comparable: The Eurobench Software Approach.

This study describes the software methodology designed for systematic benchmarking of bipedal systems through the computation of performance indicators from data collected during an experimentation stage. Under the umbrella of the European project Eurobench, we collected approximately 30 protocols with related testbeds and scoring algorithms, aiming at characterizing the performances of humanoids, exoskeletons, and/or prosthesis under different conditions. The main challenge addressed in this study concerns the standardization of the scoring process to permit a systematic benchmark of the experiments. The complexity of this process is mainly due to the lack of consistency in how to store and organize experimental data, how to define the input and output of benchmarking algorithms, and how to implement these algorithms. We propose a simple but efficient methodology for preparing scoring algorithms, to ensure reproducibility and replicability of results. This methodology mainly constrains the interface of the software and enables the engineer to develop his/her metric in his/her favorite language. Continuous integration and deployment tools are then used to verify the replicability of the software and to generate an executable instance independent of the language through dockerization. This article presents this methodology and points at all the metrics and documentation repositories designed with this policy in Eurobench. Applying this approach to other protocols and metrics would ease the reproduction, replication, and comparison of experiments.

Preliminary Study on a Novel Protocol for Improving Familiarity with a Lower-Limb Robotic Exoskeleton in Able-Bodied, First-Time Users.

Lower-limb exoskeletons have been created for different healthcare needs, but no research has been done on developing a proper protocol for users to get accustomed to moving with one. The user manuals provided also do not include such instructions. A pre-test was conducted with the TWIN (IIT), which is a lower-limb exoskeleton made for persons with spinal cord injury. In the pre-test, two healthy, able-bodied graduate students indicated a need for a protocol that can better prepare able-bodied, first-time users to move with an exoskeleton. TWIN was used in this preliminary study and nine users were divided to receive a tutorial or no tutorial before walking with the exoskeleton. Due to COVID-19 regulations, the study could only be performed with healthy, young-to-middle-aged lab members that do not require walking support. The proposed protocol was evaluated with the System Usability Scale, NASA Raw Task Load Index, and two custom surveys. The members who received the tutorial found it easy to follow and helpful, but the tutorial seemed to come at a price of higher perceived mental and physical demands, which could stem from the longer testing duration and the need to constantly recall and apply the things learned from the tutorial. All results presented are preliminary, and it is recommended to include biomechanical analysis and conduct the experiment with more participants in the future. Nonetheless, this proof-of-concept study lays groundwork for future related studies and the protocol will be adjusted, applied, and validated to patients and geriatric users.

Comparing the risk of low-back injury using model-based optimization: Improved technique versus exoskeleton assistance.

Although wearable robotic systems are designed to reduce the risk of low-back injury, it is unclear how effective assistance is, compared to improvements in lifting technique. We use a two-factor block study design to simulate how effective exoskeleton assistance and technical improvements are at reducing the risk of low-back injury when compared to a typical adult lifting a box. The effects of assistance are examined by simulating two different models: a model of just the human participant, and a model of the human participant wearing the SPEXOR exoskeleton. The effects of lifting technique are investigated by formulating two different types of optimal control problems: a least-squares problem which tracks the human participant's lifting technique, and a minimization problem where the model is free to use a different movement. Different lifting techniques are considered using three different cost functions related to risk factors for low-back injury: cumulative low-back load (CLBL), peak low-back load (PLBL), and a combination of both CLBL and PLBL (HYB). The results of our simulations indicate that an exoskeleton alone can make modest reductions in both CLBL and PLBL. In contrast, technical improvements alone are effective at reducing CLBL, but not PLBL. The largest reductions in both CLBL and PLBL occur when both an exoskeleton and technical improvements are used. While all three of the lifting technique cost functions reduce both CLBL and PLBL, the HYB cost function offers the most balanced reduction in both CLBL and PLBL.

Decline in gait propulsion in older adults over age decades.

BACKGROUND: Despite strong evidence that walking speed and forward propulsion decline with increasing age, their relationship is still poorly understood. While changes in the ankle and hip mechanics have been described, few studies have reported the effect of ageing on the whole leg's contribution to propulsion. RESEARCH QUESTION: The aim of this study was to investigate age-related changes in the work performed by the leg on the center of mass (COM) push-off power during walking in adults aged 20-86 years. Specifically, we evaluated how deterioration in COM push-off power relates to changes in ankle and hip kinetics as well as age and walking speed. METHODS: Motion, ground reaction forces and gastrocnemius muscle activity were recorded in 138 adults during overground walking at self-selected speed. Age-related differences in variables between decades were analyzed with an ANOVA, while the relation between COM push-off power and joint kinetic variables, as well as walking speed and biological age, was evaluated using correlations and multiple regression analysis. RESULTS: From the age of 70 years and onwards, COM push-off power was significantly decreased. The decline in COM push-off power was mostly explained by a decline in average ankle push-off power (72 %), and to a lesser extent by peak hip extension moment (3 %). There was no re-distribution of ankle-to-hip push-off power. The decline in COM push-off power seemed more related to walking speed (explaining 54 % of the variance) than biological age (only 4 %). SIGNIFICANCE: Findings indicate that age-related decline in COM push-off power in able-bodied adults starts from the age of 70 years, which is before changes have been found in kinematics, but still later than generally presumed. This decrease in push-off power was more related to walking speed than biological age, which emphasizes the need to better understand the reason for speed decline in older adults.

Slow but Steady: Similar Sit-to-Stand Balance at Seat-Off in Older vs. Younger Adults.

Many older adults suffer injuries due to falls as the ability to safely move between sitting and standing degrades. Unfortunately, while existing measures describe sit-to-stand (STS) performance, they do not directly measure the conditions for balance. To gain insight into the effect of age on STS balance, we analyzed how far 8 older and 10 young adults strayed from a state of static balance and how well each group maintained dynamic balance. Static balance was evaluated using the position of the center-of-mass (COM) and center-of-pressure (COP), relative to the functional base-of-support (BOS). As the name suggests, static balance applies when the linear and angular velocity of the body is small in magnitude, in the range of that observed during still standing. Dynamic balance control was evaluated using a model-based balance metric, the foot-placement-estimator (FPE), relative to the COP and BOS. We found that the older adults stay closer to being statically balanced than the younger participants. The dynamic balance metrics show that both groups keep the FPE safely within the BOS, though the older adults maintain a larger dynamic balance margin. Both groups exhibit similar levels of variability in these metrics. Thus, the conservative STS performance in older adults is likely to compensate for reduced physical ability or reduced confidence, as their dynamic balance control does not seem affected. The presented analysis of both static and dynamic balance allows us to distinguish between STS performance and balance, and as such can contribute to the identification of those older adults prone to falling, thus ultimately reducing the number of falls during STS transfers.

Performance Evaluation of Lower Limb Exoskeletons: A Systematic Review.

Benchmarks have long been used to verify and compare the readiness level of different technologies in many application domains. In the field of wearable robots, the lack of a recognized benchmarking methodology is one important impediment that may hamper the efficient translation of research prototypes into actual products. At the same time, an exponentially growing number of research studies are addressing the problem of quantifying the performance of robotic exoskeletons, resulting in a rich and highly heterogeneous picture of methods, variables and protocols. This review aims to organize this information, and identify the most promising performance indicators that can be converted into practical benchmarks. We focus our analysis on lower limb functions, including a wide spectrum of motor skills and performance indicators. We found that, in general, the evaluation of lower limb exoskeletons is still largely focused on straight walking, with poor coverage of most of the basic motor skills that make up the activities of daily life. Our analysis also reveals a clear bias towards generic kinematics and kinetic indicators, in spite of the metrics of human-robot interaction. Based on these results, we identify and discuss a number of promising research directions that may help the community to attain a comprehensive benchmarking methodology for robot-assisted locomotion more efficiently.

A Quick Turn of Foot: Rigid Foot-Ground Contact Models for Human Motion Prediction.

Computer simulation can be used to predict human walking motions as a tool of basic science, device design, and for surgical planning. One the challenges of predicting human walking is accurately synthesizing both the movements and ground forces of the stance foot. Though the foot is commonly modeled as a viscoelastic element, rigid foot-ground contact models offer some advantages: fitting is reduced to a geometric problem, and the numerical stiffness of the equations of motion is similar in both swing and stance. In this work, we evaluate two rigid-foot ground contact models: the ellipse-foot (a single-segment foot), and the double-circle foot (a two-segment foot). To evaluate the foot models we use three different comparisons to experimental data: first we compare how accurately the kinematics of the ankle frame fit those of the model when it is forced to track the measured center-of-pressure (CoP) kinematics; second, we compare how each foot affects how accuracy of a sagittal plane gait model that tracks a subjects walking motion; and third, we assess how each model affects a walking motion prediction. For the prediction problem we consider a unique cost function that includes terms related to both muscular effort and foot-ground impacts. Although the ellipse-foot is superior to the double-circle foot in terms of fit and the accuracy of the tracking OCP solution, the predictive simulation reveals that the ellipse-foot is capable of producing large force transients due to its geometry: when the ankle quickly traverses its u-shaped trajectory, the body is accelerated the body upwards, and large ground forces result. In contrast, the two-segment double-circle foot produces ground forces that are of a similar magnitude to the experimental subject because the additional forefoot segment plastically contacts the ground, arresting its motion, similar to a human foot.

A reduced muscle model and planar musculoskeletal model fit for the simulation of whole-body movements.

Musculoskeletal models are made to reflect the capacities of the human body in general, and often a specific subject in particular. It remains challenging to both model the musculoskeletal system and then fit the modelled muscles to a specific human subject. We present a reduced muscle model, a planar musculoskeletal model, and a fitting method that can be used to find a feasible set of active and passive muscle parameters for a specific subject. At a minimum, the fitting method requires inverse dynamics data of the subject, a scalar estimate of the peak activation reached during the movement, and a plausible initial estimate for the strength and flexibility of that subject. While additional data can be used to result in a more accurate fit, this data is not required for the method solve for a feasible fit. The minimal input requirements of the proposed fitting method make it well suited for subjects who cannot undergo a maximum voluntary contraction trial, or for whom recording electromyographic data is not possible. To evaluate the model and fitting method we adjust the musculoskeletal model so that it can perform an experimentally recorded stoop-lift of a 15 kg box.