Dynamic and Static Assistive Strategies for a Tailored Occupational Back-Support Exoskeleton: Assessment on Real Tasks Carried Out by Railway Workers.

This study on occupational back-support exoskeletons performs a laboratory evaluation of realistic tasks with expert workers from the railway sector. Workers performed both a static task and a dynamic task, each involving manual material handling (MMH) and manipulating loads of 20 kg, in three conditions: without an exoskeleton, with a commercially available passive exoskeleton (Laevo v2.56), and with the StreamEXO, an active back-support exoskeleton developed by our institute. Two control strategies were defined, one for dynamic tasks and one for static tasks, with the latter determining the upper body's gravity compensation through the Model-based Gravity Compensation (MB-Grav) approach. This work presents a comparative assessment of the performance of active back support exoskeletons versus passive exoskeletons when trialled in relevant and realistic tasks. After a lab characterization of the MB-Grav strategy, the experimental assessment compared two back-support exoskeletons, one active and one passive. The results showed that while both devices were able to reduce back muscle activation, the benefits of the active device were triple those of the passive system regarding back muscle activation (26% and 33% against 9% and 11%, respectively), while the passive exoskeleton hindered trunk mobility more than the active mechanism.

Control of a Back-Support Exoskeleton to Assist Carrying Activities.

Back-support exoskeletons are commonly used in the workplace to reduce low back pain risk for workers performing demanding activities. However, for the assistance of tasks differing from lifting, back-support exoskeletons potential has not been exploited extensively. This work focuses on the use of an active back-support exoskeleton to assist carrying. A control strategy is designed that modulates the exoskeleton torques to comply with the task assistance requirements. In particular, two gait phase detection frameworks are exploited to adapt the exoskeleton assistance according to the legs' motion. The control strategy is assessed through an experimental analysis on ten subjects. Carrying task is performed without and with the exoskeleton assistance. Results prove the potential of the presented control in assisting the task without hindering the gait movement and improving the usability experienced by users. Moreover, the exoskeleton assistance significantly reduces the lumbar load associated with the task, demonstrating its promising use for risk mitigation in the workplace.

Lyapunov stability of cable-driven manipulators with synthetic fibre cables regulated by non-linear full-state feedback controller.

Robotic manipulators provide advantages in working environments regarding efficiency and safety, which is further increased in the case of elastic joint manipulators, whose mechanical compliance reduces the energy involved in collisions with workers. Cable-driven manipulators are elastic joint manipulators particularly suitable for industrial inspection thanks to the relocation of actuators outside hostile environments, increasing the manipulator payload-to-weight ratio. Recently, synthetic fibre cables are substituting steel cables due to their better-performing mechanical properties, but their visco-elastic behaviour must be compensated in the controller design. The key novelty of this work is using the four elements model, which includes the viscous behaviour, to design a non-linear full-state feedback controller for cable-driven manipulators. Furthermore, the mathematical proof of the closed-loop Lyapunov stability is provided.

Elbow-sideWINDER (Elbow-side Wearable INDustrial Ergonomic Robot): design, control, and validation of a novel elbow exoskeleton.

Musculoskeletal Disorders associated with the elbow are one of the most common forms of work-related injuries. Exoskeletons have been proposed as an approach to reduce and ideally eliminate these injuries; however, exoskeletons introduce their own problems, especially discomfort due to joint misalignment. The Elbow-sideWINDER with its associated control strategy is a novel elbow exoskeleton to assist elbow flexion/extension during occupational tasks. This study describes the exoskeleton showing how this can minimize discomfort caused by joint misalignment, maximize assistive performance, and provide increased robustness and reliability in real worksites. The proposed medium-level control strategy can provide effective assistive torque using three control units as follows: an arm kinematics estimator, a load estimator, and a friction compensator. The combined hardware/software system of the Elbow-sideWINDER is tested in load-lifting tasks (2 and 7 kg). This experiment focuses on the reduction in the activation level of the biceps brachii and triceps brachii in both arms and the change in the range of motion of the elbow during the task. It is shown that using the Elbow-sideWINDER, the biceps brachii, responsible for the elbow flexion, was significantly less activated (up to 38.8% at 2 kg and 25.7% at 7 kg, on average for both arms). For the triceps brachii, the muscle activation was reduced by up to 37.0% at 2 kg and 35.1% at 7 kg, on average for both arms. When wearing the exoskeleton, the range of motion of the elbow was reduced by up to 13.0° during the task, but it was within a safe range and could be compensated for by other joints such as the waist or knees. There are extremely encouraging results that provide good indicators and important clues for future improvement of the Elbow-sideWINDER and its control strategy.

Quasi-passive lower limbs exosuit: an in-depth assessment of fatigue, kinematic and muscular patterns while comparing assistive strategies on an expert subject's gait analysis.

Wearable robots are becoming a valuable solution that helps injured, and elderly people regain mobility and improve clinical outcomes by speeding up the rehabilitation process. The XoSoft exosuit identified several benefits, including improvement of assistance, usability, and acceptance with a soft, modular, bio-mimetic, and quasi-passive exoskeleton. This study compares two assistive configurations: (i) a bilateral hip flexion (HA, hips-assistance) and (ii) a bilateral hip flexion combined with ankle plantarflexion (HAA, hips-ankles-assistance) with the main goal of evaluating compensatory actions and synergetic effects generated by the human- exoskeleton interaction. A complete description of this complex interaction scenario with this actuated exosuit is evaluated during a treadmill walking task, using several indices to quantify the human-robot interaction in terms of muscular activation and fatigue, metabolic expenditure, and kinematic motion patterns. Evidence shows that the HAA biomimetic controller is synergetic with the musculature and performs better concerning the other control strategy. The experimentation demonstrated a metabolic expenditure reduction of 8% of Metabolic Equivalent of Task (MET), effective assistance of the muscular activation of 12.5%, a decrease of the muscular fatigue of 0.6% of the mean frequency, and a significant reduction of the compensatory actions, as discussed in this work. Compensatory effects are present in both assistive configurations, but the HAA modality provides a 47% reduction of compensatory effects when considering muscle activation.

Online Ergonomic Evaluation in Realistic Manual Material Handling Task: Proof of Concept.

Work-related musculoskeletal disorders are globally one of the leading causes of work-related injuries. They significantly impact worker health and business costs. Work task ergonomic risk indices have been developed that use observational assessments to identify potential injuries, and allow safety managers to promptly intervene to mitigate the risks. However, these assessments are very subjective and difficult to perform in real time. This work provides a technique that can digitalize this process by developing an online algorithm to calculate the NIOSH index and provide additional data for ergonomic risk assessment. The method is based on the use of inertial sensors, which are easily found commercially and can be integrated into the industrial environment without any other sensing technology. This preliminary study demonstrates the effectiveness of the first version of the Online Lifting Index (On-LI) algorithm on a common industrial logistic task. The effectiveness is compared to the standard ergonomic assessment method. The results report an average error of 3.6% compared to the NIOSH parameters used to calculate the ergonomic risk and a relative error of the Lifting Index of 2.8% when compared to observational methods.

Assessment methodology for human-exoskeleton interactions: Kinetic analysis based on muscle activation.

During the development and assessment of an exoskeleton, many different analyzes need to be performed. The most frequently used evaluate the changes in muscle activations, metabolic consumption, kinematics, and kinetics. Since human-exoskeleton interactions are based on the exchange of forces and torques, the latter of these, kinetic analyzes, are essential and provide indispensable evaluation indices. Kinetic analyzes, however, require access to, and use of, complex experimental apparatus, involving many instruments and implicating lengthy data analysis processes. The proposed methodology in this paper, which is based on data collected via EMG and motion capture systems, considerably reduces this burden by calculating kinetic parameters, such as torque and power, without needing ground reaction force measurements. This considerably reduces the number of instruments used, allows the calculation of kinetic parameters even when the use of force sensors is problematic, does not need any dedicated software, and will be shown to have high statistical validity. The method, in fact, combines data found in the literature with those collected in the laboratory, allowing the analysis to be carried out over a much greater number of cycles than would normally be collected with force plates, thus enabling easy access to statistical analysis. This new approach evaluates the kinetic effects of the exoskeleton with respect to changes induced in the user's kinematics and muscular activation patterns and provides indices that quantify the assistance in terms of torque (AMI) and power (API). Following the User-Center Design approach, which requires driving the development process as feedback from the assessment process, this aspect is critical. Therefore, by enabling easy access to the assessment process, the development of exoskeletons could be positively affected.

µRALP and Beyond: Micro-Technologies and Systems for Robot-Assisted Endoscopic Laser Microsurgery.

Laser microsurgery is the current gold standard surgical technique for the treatment of selected diseases in delicate organs such as the larynx. However, the operations require large surgical expertise and dexterity, and face significant limitations imposed by available technology, such as the requirement for direct line of sight to the surgical field, restricted access, and direct manual control of the surgical instruments. To change this status quo, the European project µRALP pioneered research towards a complete redesign of current laser microsurgery systems, focusing on the development of robotic micro-technologies to enable endoscopic operations. This has fostered awareness and interest in this field, which presents a unique set of needs, requirements and constraints, leading to research and technological developments beyond µRALP and its research consortium. This paper reviews the achievements and key contributions of such research, providing an overview of the current state of the art in robot-assisted endoscopic laser microsurgery. The primary target application considered is phonomicrosurgery, which is a representative use case involving highly challenging microsurgical techniques for the treatment of glottic diseases. The paper starts by presenting the motivations and rationale for endoscopic laser microsurgery, which leads to the introduction of robotics as an enabling technology for improved surgical field accessibility, visualization and management. Then, research goals, achievements, and current state of different technologies that can build-up to an effective robotic system for endoscopic laser microsurgery are presented. This includes research in micro-robotic laser steering, flexible robotic endoscopes, augmented imaging, assistive surgeon-robot interfaces, and cognitive surgical systems. Innovations in each of these areas are shown to provide sizable progress towards more precise, safer and higher quality endoscopic laser microsurgeries. Yet, major impact is really expected from the full integration of such individual contributions into a complete clinical surgical robotic system, as illustrated in the end of this paper with a description of preliminary cadaver trials conducted with the integrated µRALP system. Overall, the contribution of this paper lays in outlining the current state of the art and open challenges in the area of robot-assisted endoscopic laser microsurgery, which has important clinical applications even beyond laryngology.

Geometry-aware manipulability learning, tracking, and transfer.

Body posture influences human and robot performance in manipulation tasks, as appropriate poses facilitate motion or the exertion of force along different axes. In robotics, manipulability ellipsoids arise as a powerful descriptor to analyze, control, and design the robot dexterity as a function of the articulatory joint configuration. This descriptor can be designed according to different task requirements, such as tracking a desired position or applying a specific force. In this context, this article presents a novel manipulability transfer framework, a method that allows robots to learn and reproduce manipulability ellipsoids from expert demonstrations. The proposed learning scheme is built on a tensor-based formulation of a Gaussian mixture model that takes into account that manipulability ellipsoids lie on the manifold of symmetric positive-definite matrices. Learning is coupled with a geometry-aware tracking controller allowing robots to follow a desired profile of manipulability ellipsoids. Extensive evaluations in simulation with redundant manipulators, a robotic hand and humanoids agents, as well as an experiment with two real dual-arm systems validate the feasibility of the approach.

Equivalent Weight: Connecting Exoskeleton Effectiveness with Ergonomic Risk during Manual Material Handling.

Occupational exoskeletons are becoming a concrete solution to mitigate work-related musculoskeletal disorders associated with manual material handling activities. The rationale behind this study is to search for common ground for exoskeleton evaluators to engage in dialogue with corporate Health & Safety professionals while integrating exoskeletons with their workers. This study suggests an innovative interpretation of the effect of a lower-back assistive exoskeleton and related performances that are built on the benefit delivered through reduced activation of the erector spinae musculature. We introduce the concept of "equivalent weight" as the weight perceived by the wearer, and use this to explore the apparent reduced effort needed when assisted by the exoskeleton. Therefore, thanks to this assistance, the muscles experience a lower load. The results of the experimental testing on 12 subjects suggest a beneficial effect for the back that corresponds to an apparent reduction of the lifted weight by a factor of 37.5% (the perceived weight of the handled objects is reduced by over a third). Finally, this analytical method introduces an innovative approach to quantify the ergonomic benefit introduced by the exoskeletons' assistance. This aims to assess the ergonomic risk to support the adoption of exoskeletons in the workplace.

Versatile and non-versatile occupational back-support exoskeletons: A comparison in laboratory and field studies.

Assistive strategies for occupational back-support exoskeletons have focused, mostly, on lifting tasks. However, in occupational scenarios, it is important to account not only for lifting but also for other activities. This can be done exploiting human activity recognition algorithms that can identify which task the user is performing and trigger the appropriate assistive strategy. We refer to this ability as exoskeleton versatility. To evaluate versatility, we propose to focus both on the ability of the device to reduce muscle activation (efficacy) and on its interaction with the user (dynamic fit). To this end, we performed an experimental study involving healthy subjects replicating the working activities of a manufacturing plant. To compare versatile and non-versatile exoskeletons, our device, XoTrunk, was controlled with two different strategies. Correspondingly, we collected muscle activity, kinematic variables and users' subjective feedbacks. Also, we evaluated the task recognition performance of the device. The results show that XoTrunk is capable of reducing muscle activation by up to in lifting and in carrying. However, the non-versatile control strategy hindered the users' natural gait (e.g., reduction of hip flexion), which could potentially lower the exoskeleton acceptance. Detecting carrying activities and adapting the control strategy, resulted in a more natural gait (e.g., increase of hip flexion). The classifier analyzed in this work, showed promising performance (online accuracy > 91%). Finally, we conducted 9 hours of field testing, involving four users. Initial subjective feedbacks on the exoskeleton versatility, are presented at the end of this work.

Toward Emotion Recognition From Physiological Signals in the Wild: Approaching the Methodological Issues in Real-Life Data Collection.

Emotion, mood, and stress recognition (EMSR) has been studied in laboratory settings for decades. In particular, physiological signals are widely used to detect and classify affective states in lab conditions. However, physiological reactions to emotional stimuli have been found to differ in laboratory and natural settings. Thanks to recent technological progress (e.g., in wearables) the creation of EMSR systems for a large number of consumers during their everyday activities is increasingly possible. Therefore, datasets created in the wild are needed to insure the validity and the exploitability of EMSR models for real-life applications. In this paper, we initially present common techniques used in laboratory settings to induce emotions for the purpose of physiological dataset creation. Next, advantages and challenges of data collection in the wild are discussed. To assess the applicability of existing datasets to real-life applications, we propose a set of categories to guide and compare at a glance different methodologies used by researchers to collect such data. For this purpose, we also introduce a visual tool called Graphical Assessment of Real-life Application-Focused Emotional Dataset (GARAFED). In the last part of the paper, we apply the proposed tool to compare existing physiological datasets for EMSR in the wild and to show possible improvements and future directions of research. We wish for this paper and GARAFED to be used as guidelines for researchers and developers who aim at collecting affect-related data for real-life EMSR-based applications.

Actuation Selection for Assistive Exoskeletons: Matching Capabilities to Task Requirements.

Selecting actuators for assistive exoskeletons involves decisions in which designers usually face contrasting requirements. While certain choices may depend on the application context or design philosophy, it is generally desirable to avoid oversizing actuators in order to obtain more lightweight and transparent systems, ultimately promoting the adoption of a given device. In many cases, the torque and power requirements can be relaxed by exploiting the contribution of an elastic element acting in mechanical parallel. This contribution considers one such case and introduces a methodology for the evaluation of different actuator choices resulting from the combination of different motors, reduction gears, and parallel stiffness profiles, helping to match actuator capabilities to the task requirements. Such methodology is based on a graphical tool showing how different design choices affect the actuator as a whole. To illustrate the approach, a back-support exoskeleton for lifting tasks is considered as a case study.

Pneumatic Quasi-Passive Actuation for Soft Assistive Lower Limbs Exoskeleton.

There is a growing international interest in developing soft wearable robotic devices to improve mobility and daily life autonomy as well as for rehabilitation purposes. Usability, comfort and acceptance of such devices will affect their uptakes in mainstream daily life. The XoSoft EU project developed a modular soft lower-limb exoskeleton to assist people with low mobility impairments. This paper presents the bio-inspired design of a soft, modular exoskeleton for lower limb assistance based on pneumatic quasi-passive actuation. The design of a modular reconfigurable prototype and its performance are presented. This actuation centers on an active mechanical element to modulate the assistance generated by a traditional passive component, in this case an elastic belt. This study assesses the feasibility of this type of assistive device by evaluating the energetic outcomes on a healthy subject during a walking task. Human-exoskeleton interaction in relation to task-based biological power assistance and kinematics variations of the gait are evaluated. The resultant assistance, in terms of overall power ratio (Λ) between the exoskeleton and the assisted joint, was 26.6% for hip actuation, 9.3% for the knee and 12.6% for the ankle. The released maximum power supplied on each articulation, was 113.6% for the hip, 93.2% for the knee, and 150.8% for the ankle.

SmartProbe: a bioimpedance sensing system for head and neck cancer tissue detection.

OBJECTIVES: This study presents SmartProbe, an electrical bioimpedance (EBI) sensing system based on a concentric needle electrode (CNE). The system allows the use of commercial CNEs for accurate EBI measurement, and was specially developed for in-vivo real-time cancer detection. APPROACH: Considering the uncertainties in EBI measurements due to the CNE manufacturing tolerances, we propose a calibration method based on statistical learning. This is done by extracting the correlation between the measured impedance value |Z|, and the material conductivity σ, for a group of reference materials. By utilizing this correlation, the relationship of σ and |Z| can be described as a function and reconstructed using a single measurement on a reference material of known conductivity. MAIN RESULTS: This method simplifies the calibration process, and is verified experimentally. Its effectiveness is demonstrate by results that show less than 6% relative error. An additional experiment is conducted for evaluating the system's capability to detect cancerous tissue. Four types of ex-vivo human tissue from the head and neck region, including mucosa, muscle, cartilage and salivary gland, are characterized using SmartProbe. The measurements include both cancer and surrounding healthy tissue excised from 10 different patients operated on for head and neck cancer. The measured data is then processed using dimension reduction and analyzed for tissue classification. The final results show significant differences between pathologic and healthy tissues in muscle, mucosa and cartilage specimens. SIGNIFICANCE: These results are highly promising and indicate a great potential for SmartProbe to be used in various cancer detection tasks.

Applicability of an Active Back-Support Exoskeleton to Carrying Activities.

Occupational back-support exoskeletons are becoming a more and more common solution to mitigate work-related lower-back pain associated with lifting activities. In addition to lifting, there are many other tasks performed by workers, such as carrying, pushing, and pulling, that might benefit from the use of an exoskeleton. In this work, the impact that carrying has on lower-back loading compared to lifting and the need to select different assistive strategies based on the performed task are presented. This latter need is studied by using a control strategy that commands for constant torques. The results of the experimental campaign conducted on 9 subjects suggest that such a control strategy is beneficial for the back muscles (up to 12% reduction in overall lumbar activity), but constrains the legs (around 10% reduction in hip and knee ranges of motion). Task recognition and the design of specific controllers can be exploited by active and, partially, passive exoskeletons to enhance their versatility, i.e., the ability to adapt to different requirements.

Acceleration-based Assistive Strategy to Control a Back-support Exoskeleton for Load Handling: Preliminary Evaluation.

Industrial active exoskeletons have recently achieved considerable interest, due to their intrinsic versatility compared to passive devices. To achieve this versatility, an important open challenge is the design of appropriate control strategies to automatically modulate the physical assistance according to the activity the user is performing.This work focuses on active back-support exoskeletons. To improve the assistance provided in dynamic situations with respect to state-of-the-art methods, a new strategy making use of the angular acceleration of the user's trunk is presented.The feasibility and effectiveness of the proposed strategy were tested experimentally on a prototype in a load handling task. The main advantages in terms of assistive torque profiles emerge during the transition phases of the movement (i.e. beginning and end of lowering and lifting) indicating an appropriate adaptation to the dynamics of the execution.In this preliminary evaluation, the data on peak muscular activity at the spine show promising trends, encouraging further developments and a more detailed evaluation.

Design and Integration of Electrical Bio-impedance Sensing in Surgical Robotic Tools for Tissue Identification and Display.

The integration of intra-operative sensors into surgical robots is a hot research topic since this can significantly facilitate complex surgical procedures by enhancing surgical awareness with real-time tissue information. However, currently available intra-operative sensing technologies are mainly based on image processing and force feedback, which normally require heavy computation or complicated hardware modifications of existing surgical tools. This paper presents the design and integration of electrical bio-impedance sensing into a commercial surgical robot tool, leading to the creation of a novel smart instrument that allows the identification of tissues by simply touching them. In addition, an advanced user interface is designed to provide guidance during the use of the system and to allow augmented-reality visualization of the tissue identification results. The proposed system imposes minor hardware modifications to an existing surgical tool, but adds the capability to provide a wealth of data about the tissue being manipulated. This has great potential to allow the surgeon (or an autonomous robotic system) to better understand the surgical environment. To evaluate the system, a series of ex-vivo experiments were conducted. The experimental results demonstrate that the proposed sensing system can successfully identify different tissue types with 100% classification accuracy. In addition, the user interface was shown to effectively and intuitively guide the user to measure the electrical impedance of the target tissue, presenting the identification results as augmented-reality markers for simple and immediate recognition.

A robotic microsurgical forceps for transoral laser microsurgery.

PURPOSE: In transoral laser microsurgery (TLM), the close curved cylindrical structure of the laryngeal region offers functional challenges to surgeons who operate on its malignancies with rigid, single degree-of-freedom (DOF) forceps. These challenges include surgeon hand tremors, poor reachability, poor tissue surface perception, and reduced ergonomy in design. The integrated robotic microsurgical forceps presented here is capable of addressing the above challenges through tele-operated tissue manipulation in TLM. METHODS: The proposed device is designed in compliance with the spatial constraints in TLM. It incorporates a novel 2-DOF motorized microsurgical forceps end-effector, which is integrated with a commercial 6-DOF serial robotic manipulator. The integrated device is tele-operated through the haptic master interface, Omega.7. The device is augmented with a force sensor to measure tissue gripping force. The device is called RMF-2F, i.e. robotic microsurgical forceps with 2-DOF end-effector and force sensing. RMF-2F is evaluated through validation trials and pick-n-place experiments with subjects. Furthermore, the device is trialled with expert surgeons through preliminary tasks in a simulated surgical scenario. RESULTS: RMF-2F shows a motion tracking error of less than 400 µm. User trials demonstrate the device's accuracy in task completion and ease of manoeuvrability using the Omega.7 through improved trajectory following and execution times. The tissue gripping force shows better regulation with haptic feedback (1.624 N) than without haptic feedback (2.116 N). Surgeons positively evaluated the device with appreciation for improved access in the larynx and gripping force feedback. CONCLUSIONS: RMF-2F offers an ergonomic and intuitive interface for intraoperative tissue manipulation in TLM. The device performance, usability, and haptic feedback capability were positively evaluated by users as well as expert surgeons. RMF-2F introduces the benefits of robotic teleoperation including, (i) overcoming hand tremors and wrist excursions, (ii) improved reachability and accuracy, and (iii) tissue gripping feedback for safe tissue manipulation.