Development of Quasi-Passive Back-Support Exoskeleton with Compact Variable Gravity Compensation Module and Bio-Inspired Hip Joint Mechanism.

The back support exoskeletons have garnered significant attention to alleviate musculoskeletal injuries, prevalent in industrial settings. In this paper, we propose AeBS, a quasi-passive back-support exoskeleton developed to provide variable assistive torque across the entire range of hip joint motion, for tasks with frequent load changes. AeBS can adjust the assistive torque levels while minimizing energy for the torque variation without constraining the range of motion of the hip joint. To match the requisite assistance levels for back support, a compact variable gravity compensation module with reinforced elastic elements is applied to AeBS. Additionally, we devised a bio-inspired hip joint mechanism that mimics the configuration of the human hip axis to ensure the free body motion of the wearer, significantly affecting assistive torque transmission and wearing comfort. Benchtop testing showed that AeBS has a variable assistive torque range of 5.81 Nm (ranging from 1.23 to 7.04 Nm) across a targeted hip flexion range of 135°. Furthermore, a questionnaire survey revealed that the bio-inspired hip joint mechanism effectively facilitates the transmission of the intended assistive torque while enhancing wearer comfort.

Effect of hip abduction assistance on metabolic cost and balance during human walking.

The use of wearable robots to provide walking assistance has rapidly grown over the past decade, with notable advances made in robot design and control methods toward reducing physical effort while performing an activity. The reduction in walking effort has mainly been achieved by assisting forward progression in the sagittal plane. Human gait, however, is a complex movement that combines motions in three planes, not only the sagittal but also the transverse and frontal planes. In the frontal plane, the hip joint plays a key role in gait, including balance. However, wearable robots targeting this motion have rarely been investigated. In this study, we developed a hip abduction assistance wearable robot by formulating the hypothesis that assistance that mimics the biological hip abduction moment or power could reduce the metabolic cost of walking and affect the dynamic balance. We found that hip abduction assistance with a biological moment second peak mimic profile reduced the metabolic cost of walking by 11.6% compared with the normal walking condition. The assistance also influenced balance-related parameters, including the margin of stability. Hip abduction assistance influenced the center-of-mass movement in the mediolateral direction. When the robot assistance was applied as the center of mass moved toward the opposite leg, the assistance replaced some of the efforts that would have otherwise been provided by the human. This indicates that hip abduction assistance can reduce physical effort during human walking while influencing balance.

Reducing sprint time with exosuit assistance in the real world.

Hip extension assistance with the aid of exosuits can reduce sprinting time.

Feasibility of mitigating out-toeing gait using compression tights with inward-directing taping lines.

Out-toeing gait may cause alterations in lower limb biomechanics that could lead to an increased risk of overuse injuries. Surgery and physical therapy are conventional methods for mitigating such gait, but they are costly and time-consuming. Wearable devices like braces and orthoses are used as affordable alternatives, but they apply non-negligible stress on the skin. Haptic feedback-delivering shoes were also recently developed, but they require actuators and power sources. The purpose of our study is to develop compression tights with inward directing taping lines that apply compression to lower limb muscles and segments to facilitate inward rotation of the foot, overcoming the drawbacks of previous methods. These compression tights were manufactured to fit the average height, leg length, hip girth, and waist girth of South Korean females in their twenties. The efficacy of these compression tights was evaluated by comparing walking kinematics and user satisfaction of 12 female dancers with an out-toeing gait under three conditions: wearing tights with taping lines, tights without taping lines, and basic bicycle shorts. The foot rotation angles and joint kinematics were recorded using a pressure-pad treadmill and motion capture system, respectively. Multiple pairwise comparisons revealed that the compression tights with inward-directing lines significantly reduced foot rotation angles (up to an average of 20.1%) compared with the bicycle shorts (p = 0.002 and 0.001 for dominant and non-dominant foot, respectively) or the compression tights without taping lines (p = 0.005 and p = 0.001 for dominant and non-dominant foot, respectively). Statistical parametric mapping revealed significant main effects of the tight type on joint kinematics. Also, t-tests revealed that the participants reported significantly higher ratings of perceived functionality and usability on the compression tights with inward-directing taping lines. In conclusion, we developed a comfortable and practical apparel-type wearable and demonstrated its short-term efficacy in mitigating out-toeing gait.

The Effects of a Custom-Designed High-Collar Shoe on Muscular Activity, Dynamic Stability, and Leg Stiffness: A Biomimetic Approach Study.

High-collar shoes are a biomimetic approach to preventing lateral ankle injuries during high-demand activities; however, the influence of collar stiffness (CS) on parameters related to lateral ankle sprain prevention during running remains unclear. In this study, we investigated the effects of a custom-designed shoe CS on muscular activity, dynamic stability, and leg stiffness (Kleg) during running using a biomimetic design approach inspired by the mechanisms of ankle sprain prevention. Sixteen healthy male participants ran on a treadmill while wearing a custom-designed high-collar shoe with low, medium, and high CS conditions, measured using circumferential ankle pressure (CAP). Lower extremity kinematics and electromyography (EMG) data were recorded simultaneously. One-way repeated-measures ANOVA was conducted to compare the CS conditions. Results indicate that high and medium CS conditions significantly reduce sagittal and frontal ankle ranges of motion (ROMs) compared to the low CS condition, providing improved stability and support against lateral ankle sprain; moreover, there was a trend towards higher dynamic stability and Kleg with increasing CS. Our study highlights the importance of considering the CAP in regulating high-collar stiffness properties and how higher CS may provide better support for the ankle during running. Nevertheless, additional research is necessary to validate the efficacy of the current design in preventing ankle sprains during high-demand activities.

Deep Domain Adaptation, Pseudo-Labeling, and Shallow Network for Accurate and Fast Gait Prediction of Unlabeled Datasets.

Developing personalized gait phase prediction models is difficult because acquiring accurate gait phases requires expensive experiments. This problem can be addressed via semi-supervised domain adaptation (DA), which minimizes the discrepancy between the source and target subject features. However, classical DA models have a trade-off between accuracy and inference speed. Whereas deep DA models provide accurate prediction results with a slow inference speed, shallow DA models produce less accurate results with a fast inference speed. To achieve both high accuracy and fast inference, a dual-stage DA framework is proposed in this study. The first stage uses a deep network for precise DA. Then, a pseudo-gait-phase label of the target subject is obtained using the first-stage model. In the second stage, a shallow but fast network is trained using the pseudo-label. Because computation for DA is not conducted in the second stage, an accurate prediction can be accomplished even with the shallow network. Test results show that the proposed DA framework reduces the prediction error by 1.04% compared with a shallow DA model while maintaining its fast inference speed. The proposed DA framework can be used to provide fast personalized gait prediction models for real-time control systems such as wearable robots.

Influence of circumferential ankle pressure of shoe collar on the kinematics, dynamic stability, electromyography, and plantar pressure during normal walking.

BACKGROUND: The shoe's collar plays a significant role in supporting the ankle during walking. Since the protective effect of the collar requires the circular embracing of the ankle and shank, a stiffer collar might be involved with increased circumferential ankle pressure (CAP). It is not clear how collar CAP affects walking performance. Therefore, this study was aimed at examining the influence of the collar CAP on the kinematics, dynamic stability, electromyography (EMG), and plantar pressure during normal walking. METHOD: Sixteen healthy male participants walked on a treadmill while wearing a custom-designed high-collar shoe with 10 (low), 30 (medium), and 60 mmHg (high) CAP conditions, and the joint angles, dynamic stability index, EMG, and plantar pressure were measured. RESULT: While the low CAP condition did not affect the ankle range of motion (ROM), The high CAP condition restricted both the ankle sagittal and frontal ROM, whereas the medium CAP condition limited only the ankle frontal ROM. The knee and hip ROM did not differ between conditions. The dynamic stability for the high and medium CAP cases was comparable but significantly higher than that of the low CAP condition. The ankle muscle activity and corresponding co-contraction increased with increasing CAP for gastrocnemius medialis (GM), soleus (SOL), peroneus longus (PL), tibialis anterior (TA) muscles in the weight acceptance and push-off phases but not in the single limb support. Knee muscle activity, including vastus lateralis (VL) and semitendinosus (SEMI) was similar between all conditions. A higher relative pressure was observed under the lateral aspect of the heel when walking in the high CAP condition. CONCLUSION: The results suggest that a high-collar shoe with a high CAP may not be an appropriate choice for walking owing to the injury risk factors and limited walking efficiency. A medium CAP is associated with certain advantages and, thus, a superior choice for high-collar shoe design.

Influences of Partial Anterior Cruciate Ligament Injury on Anterior Cruciate Ligament Tensional Force and Kinematic Stability During Walking.

Injuries in the anterior cruciate ligament (ACL), including partial tear and lengthening of the ACL, change the dynamic function of the knee. However, there is a lack of information on the effect of ACL partial tear on knee kinematics during walking. This study aimed to investigate the effects of different levels of ACL injuries on knee stability and ACL tensional force to identify the critical injury level. Motion data of five normal subjects were acquired along with the ground reaction force. A knee model with 14 ligaments was developed using cadaveric specimen data. The initial length and stiffness of the ACL were changed to develop ACL-injured knee models. Musculoskeletal simulations of the knee models were performed using the measured gait data. The average tibial anterior translation increased significantly by 2.6 ± 0.7 mm when the ACL stiffness decreased to 25% of its original stiffness. The average tibial anterior translation increased significantly by 2.6 ± 0.3 mm at an increase in initial length of 10%. The knee with partial ACL tear had a nonlinear decrease in ACL forces owing to the increase in the level of ACL injury, while the knee with ACL lengthening had linear decreased ACL forces. The partial tear of the ACL caused translational instability, while the complete tear caused both rotational and translational instabilities during the musculoskeletal walking simulation. This study presents the effects of partial ACL injuries on joint kinematics and ACL tensional force during the dynamic motion of walking.

Lighter and Simpler Design Paradigm for Widespread Use of Ankle Exosuits Based on Bio-Inspired Patterns.

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.

Characterizing force capability and stiffness of hip exosuits under different anchor points.

Exosuits have been broadly researched owing to their benefits from soft and deformable nature. However, compared to exoskeletons, the exosuits have disadvantages in that the deformation of suit and human tissue can cause dissipation, leading to low force transfer efficiency. In this study, we explore the force capability and human-suit stiffness depending on the anchor point positions of the exosuit, introducing a better understanding of exosuit design. We found the relationships between the anchor point position and the force capability, and the anchor point position and the human-suit stiffness by conducting human subject experiments. When the distance between the anchor point of the waist belt and the anchor point of the thigh brace increased, the force capability increased, whereas the human-suit stiffness decreased. Also, statistical analyses are implemented to verify significant differences according to the anchor point position with a 5% significance level. Moreover, we discuss why the capability of force transmission and the human-suit stiffness differ depending on the anchor point positions. The force capability differed with anchor point positions because of the change in the effective cable stroke. Additionally, the force capability changes nonlinearly owing to the body curve as the condition level of the anchor points changes. The human-suit stiffness is affected by the interference of the body when the assistive force is transmitted through the cable. Characteristics of the force capability and human-suit stiffness model can be used to optimize the performance of existing exosuit or to serve a valuable guide of design a new exosuit when the exosuit needs to maximize the force capability or stiffness.

Copper arsenite-complexed Fenton-like nanoparticles as oxidative stress-amplifying anticancer agents.

We report copper(II) arsenite (CuAS)-integrated polymer micelles (CuAS-PMs) as a new class of Fenton-like catalytic nanosystem that can display reactive oxygen species (ROS)-manipulating anticancer therapeutic activity. CuAS-PMs were fabricated through metal-catechol chelation-based formation of the CuAS complex on the core domain of poly (ethylene glycol)-b-poly(3,4-dihydroxy-L-phenylalanine) (PEG-PDOPA) copolymer micelles. CuAS-PMs maintained structural robustness under serum conditions. The insoluble state of the CuAS complex was effectively retained at physiological pH, whereas, at endosomal pH, the CuAS complex was ionized to release arsenite and cuprous Fenton catalysts (Cu+ ions). Upon endocytosis, CuAS-PMs simultaneously released hydrogen peroxide (H2O2)-generating arsenite and Fenton-like reaction-catalyzing Cu+ ions in cancer cells, which synergistically elevated the level of highly cytotoxic hydroxyl radicals (•OH), thereby preferentially killing cancer cells. Animal experiments demonstrated that CuAS-PMs could effectively suppress the growth of solid tumors without systemic in vivo toxicity. The design rationale of CuAS-PMs may provide a promising strategy to develop diverse oxidative stress-amplifying agents with great potential in cancer-specific therapy.

Unsupervised Gait Phase Estimation With Domain-Adversarial Neural Network and Adaptive Window.

The performanceof previous machine learning models for gait phase is only satisfactory under limited conditions. First, they produce accurate estimations only when the ground truth of the gait phase (of the target subject) is known. In contrast, when the ground truth of a target subject is not used to train an algorithm, the estimation error noticeably increases. Expensive equipment is required to precisely measure the ground truth of the gait phase. Thus, previous methods have practical shortcoming when they are optimized for individual users. To address this problem, this study introduces an unsupervised domain adaptation technique for estimation without the true gait phase of the target subject. Specifically, a domain-adversarial neural network was modified to perform regression on continuous gait phases. Second, the accuracy of previous models can be degraded by variations in stride time. To address this problem, this study developed an adaptive window method that actively considers changes in stride time. This model considerably reduces estimation errors for walking and running motions. Finally, this study proposed a new method to select the optimal source subject (among several subjects) by defining the similarity between sequential embedding features.

Reducing the energy cost of running using a lightweight, low-profile elastic exosuit.

BACKGROUND: Human beings can enhance their distance running performance with the help of assistive devices. Although several such devices are available, they are heavy and bulky, which limits their use in everyday activities. In this study, we developed a lightweight running assistive device with a low-profile design. The device applies a flexion moment to the hip according to the hip extension within a specific range of motion to assist running. METHODS: A passive exosuit was fabricated using textile materials and elastic bands. The deformation of the suit was measured and compensated for in the design. The fabricated suit was tested on eight participants (age: 24.4 ± 3.8 y; height: 1.72 ± 0.05 m; weight: 74.5 ± 6.1 kg) who were instructed to run on a treadmill at a speed of 2.5 m/s. Through indirect calorimetry, the metabolic rate was measured for the no-suit condition and three band conditions. Variations in the spatiotemporal parameters were measured using a motion capture system and force-sensing resistors (FSRs). RESULTS: When using the fabricated device, seven out of the eight participants exhibited a reduced metabolic rate in at least one of the three band conditions. An average reduction of - 4.7 ± 1.4% (mean ± standard error of the mean (s.e.m.), two-sided paired t-test, p = 0.017) was achieved when using the best-fitting bands compared to the average of the two no-suit conditions. No statistically significant changes were observed in the spatiotemporal parameters, except for the stance duration in the medium assistance force condition. CONCLUSIONS: The proposed passive exosuit, which has a low weight of 609 g and small extrusion of 2.5 cm from the body in standing posture, can reduce the metabolic rate during running. The proposed device can potentially be used every day owing to its low-profile design and low weight, thereby overcoming the limitations of existing portable devices targeting the hip joints.

Reducing the metabolic rate of walking and running with a versatile, portable exosuit.

Walking and running have fundamentally different biomechanics, which makes developing devices that assist both gaits challenging. We show that a portable exosuit that assists hip extension can reduce the metabolic rate of treadmill walking at 1.5 meters per second by 9.3% and that of running at 2.5 meters per second by 4.0% compared with locomotion without the exosuit. These reduction magnitudes are comparable to the effects of taking off 7.4 and 5.7 kilograms during walking and running, respectively, and are in a range that has shown meaningful athletic performance changes. The exosuit automatically switches between actuation profiles for both gaits, on the basis of estimated potential energy fluctuations of the wearer's center of mass. Single-participant experiments show that it is possible to reduce metabolic rates of different running speeds and uphill walking, further demonstrating the exosuit's versatility.