Resonance tuning of rhythmic movements is disrupted at short time scales: A centrifuge study.

The human body exploits its neural mechanisms to optimize actions. Rhythmic movements are optimal when their frequency is close to the natural frequency of the system. In a pendulum, gravity modulates this spontaneous frequency. Participants unconsciously adjust their natural pace when cyclically moving the arm in altered gravity. However, the timescale of this adaptation is unexplored. Participants performed cyclic movements before, during, and after fast transitions between hypergravity levels (1g-3g and 3g-1g) induced by a human centrifuge. Movement periods were modulated with the average value of gravity during transitions. However, while participants increased movement pace on a cycle basis when gravity increased (1g-3g), they did not decrease pace when gravity decreased (3g-1g). We highlight asymmetric effects in the spontaneous adjustment of movement dynamics on short timescales, suggesting the involvement of cognitive factors, beyond standard dynamical models.

The Effects of Different Motor Teaching Strategies on Learning a Complex Motor Task.

During the learning of a new sensorimotor task, individuals are usually provided with instructional stimuli and relevant information about the target task. The inclusion of haptic devices in the study of this kind of learning has greatly helped in the understanding of how an individual can improve or acquire new skills. However, the way in which the information and stimuli are delivered has not been extensively explored. We have designed a challenging task with nonintuitive visuomotor perturbation that allows us to apply and compare different motor strategies to study the teaching process and to avoid the interference of previous knowledge present in the naïve subjects. Three subject groups participated in our experiment, where the learning by repetition without assistance, learning by repetition with assistance, and task Segmentation Learning techniques were performed with a haptic robot. Our results show that all the groups were able to successfully complete the task and that the subjects' performance during training and evaluation was not affected by modifying the teaching strategy. Nevertheless, our results indicate that the presented task design is useful for the study of sensorimotor teaching and that the presented metrics are suitable for exploring the evolution of the accuracy and precision during learning.

Explicit learning based on reward prediction error facilitates agile motor adaptations.

Error based motor learning can be driven by both sensory prediction error and reward prediction error. Learning based on sensory prediction error is termed sensorimotor adaptation, while learning based on reward prediction error is termed reward learning. To investigate the characteristics and differences between sensorimotor adaptation and reward learning, we adapted a visuomotor paradigm where subjects performed arm movements while presented with either the sensory prediction error, signed end-point error, or binary reward. Before each trial, perturbation indicators in the form of visual cues were presented to inform the subjects of the presence and direction of the perturbation. To analyse the interconnection between sensorimotor adaptation and reward learning, we designed a computational model that distinguishes between the two prediction errors. Our results indicate that subjects adapted to novel perturbations irrespective of the type of prediction error they received during learning, and they converged towards the same movement patterns. Sensorimotor adaptations led to a pronounced aftereffect, while adaptation based on reward consequences produced smaller aftereffects suggesting that reward learning does not alter the internal model to the same degree as sensorimotor adaptation. Even though all subjects had learned to counteract two different perturbations separately, only those who relied on explicit learning using reward prediction error could timely adapt to the randomly changing perturbation. The results from the computational model suggest that sensorimotor and reward learning operate through distinct adaptation processes and that only sensorimotor adaptation changes the internal model, whereas reward learning employs explicit strategies that do not result in aftereffects. Additionally, we demonstrate that when humans learn motor tasks, they utilize both learning processes to successfully adapt to the new environments.

An EMG-Based Objective Function for Human-in-the-Loop Optimization.

Advancements in wearable robots aim to improve the users' motion, performance, and comfort by optimizing, mainly, energetic cost (EC). However, EC is a noisy measurement with a physiological delayed response that requires long evaluation periods and wearing an uncomfortable mask. This study aims to estimate and minimize an EMG-based objective function that describes the natural energetic expenditure of individuals walking. This objective is assessed by combining multiple electromyography (EMG) variables from the EMG intensity and muscle synergies. To evaluate this objective function simply and repeatedly, we prescribed step frequency (SF) via a metronome and optimized this frequency to minimize muscle activity demands. Further, a linear mixed-effects model was fitted for EC, with the EMG variables as fixed-effects and a random intercept that varies by participant. After the model was fitted to the data, a cubic polynomial was used to identify the optimal SF that reduces the overall EMG-based objective function. Our analysis outlines that the proposed objective function is comparable to the EC during walking, the primary objective function used in human-in-the-loop optimization. Thus, this EMG-based objective function could be potentially used to optimize wearable robots and improve human-robot interaction.

Relevance of hazards in exoskeleton applications: a survey-based enquiry.

Exoskeletons are becoming the reference technology for assistance and augmentation of human motor functions in a wide range of application domains. Unfortunately, the exponential growth of this sector has not been accompanied by a rigorous risk assessment (RA) process, which is necessary to identify the major aspects concerning the safety and impact of this new technology on humans. This situation may seriously hamper the market uptake of new products. This paper presents the results of a survey that was circulated to understand how hazards are considered by exoskeleton users, from research and industry perspectives. Our analysis aimed to identify the perceived occurrence and the impact of a sample of generic hazards, as well as to collect suggestions and general opinions from the respondents that can serve as a reference for more targeted RA. Our results identified a list of relevant hazards for exoskeletons. Among them, misalignments and unintended device motion were perceived as key aspects for exoskeletons' safety. This survey aims to represent a first attempt in recording overall feedback from the community and contribute to future RAs and the identification of better mitigation strategies in the field.

A mechatronic leg replica to benchmark human-exoskeleton physical interactions.

Evaluating human-exoskeleton interaction typically requires experiments with human subjects, which raises safety issues and entails time-consuming testing procedures. This paper presents a mechatronic replica of a human leg, which was designed to quantify physical interaction dynamics between exoskeletons and human limbs without the need for human testing. In the first part of this work, we present the mechanical, electronic, sensory system and software solutions integrated in our leg replica prototype. In the second part, we used the leg replica to test its interaction with two types of commercially available wearable devices, i.e. an active full leg exoskeleton and a passive knee orthosis. We ran basic test examples to demonstrate the functioning and benchmarking potential of the leg replica to assess the effects of joint misalignments on force transmission. The integrated force sensors embedded in the leg replica detected higher interaction forces in the misaligned scenario in comparison to the aligned one, in both active and passive modalities. The small standard deviation of force measurements across cycles demonstrates the potential of the leg replica as a standard test method for reproducible studies of human-exoskeleton physical interaction.

Human-in-the-Loop Optimization of Wearable Robotic Devices to Improve Human-Robot Interaction: A Systematic Review.

This article presents a systematic review on wearable robotic devices that use human-in-the-loop optimization (HILO) strategies to improve human-robot interaction. A total of 46 HILO studies were identified and divided into upper and lower limb robotic devices. The main aspects from HILO were identified, reviewed, and classified in four areas: 1) human-machine systems; 2) optimization methods; 3) control strategies; and 4) experimental protocols. A variety of objective functions (physiological, biomechanical, and subjective), optimization strategies, and optimized control parameters configurations used in different control strategies are presented and analyzed. An overview of experimental protocols is provided, including metrics, tasks, and conditions tested. Moreover, the relevance given to training or adaptation periods was explored. We outline an HILO framework that includes current wearable robots, optimization strategies, objective functions, control strategies, and experimental protocols. We conclude by highlighting current research gaps and defining future directions to improve the development of advanced HILO strategies in upper and lower limb wearable robots.

Human Stiffness Perception and Learning in Interacting With Compliant Environments.

Humans are capable of adjusting their posture stably when interacting with a compliant surface. Their whole-body motion can be modulated in order to respond to the environment and reach to a stable state. In perceiving an uncertain external force, humans repetitively push it and learn how to produce a stable state. Research in human motor control has led to the hypothesis that the central nervous system integrates an internal model with sensory feedback in order to generate accurate movements. However, how the brain understands external force through exploration movements, and how humans accurately estimate a force from their experience of the force, is yet to be fully understood. To address these questions, we tested human behaviour in different stiffness profiles even though the force at the goal was the same. We generated one linear and two non-linear stiffness profiles, which required the same force at the target but different forces half-way to the target; we then measured the differences in the learning performance at the target and the differences in perception at the half-way point. Human subjects learned the stiffness profile through repetitive movements in reaching the target, and then indicated their estimation of half of the target value (position and force separately). This experimental design enabled us to probe how perception of the force experienced in different profiles affects the participants' estimations. We observed that the early parts of the learning curves were different for the three stiffness profiles. Secondly, the position estimates were accurate independent of the stiffness profile. The estimation in position was most likely influenced by the external environment rather than the profile itself. Interestingly, although visual information about the target had a large influence, we observed significant differences in accuracy of force estimation according to the stiffness profile.

Effects of vision on energy expenditure and kinematics during level walking.

PURPOSE: We have previously observed substantially higher oxygen uptake in soldiers walking on terrain at night than when performing the same walk in bright daylight. The aims of the present study were to investigate the influence of vision on mechanical efficiency during slow, horizontal, constant-speed walking, and to determine whether any vision influence is modified by load carriage. METHODS: Each subject (n = 15) walked (3.3 km/h) for 10 min on a treadmill in four different conditions: (1) full vision, no carried load, (2) no vision, no carried load, (3) full vision with a 25.5-kg rucksack, (4) no vision with a 25.5-kg rucksack. RESULTS: Oxygen uptake was 0.94 ± 0.12 l/min in condition (1), 1.15 ± 0.20 l/min in (2), 1.15 ± 0.12 l/min in (3) and 1.35 ± 0.19 l/min in (4). Thus, lack of vision increased oxygen uptake by about 19%. Analyses of movement pattern, by use of optical markers attached to the limbs and torso, revealed considerably shorter step length (12 and 10%) in the no vision (2 and 4) than full vision conditions (1 and 3). No vision conditions (2 and 4) increased step width by 6 and 6%, and increased vertical foot clearance by 20 and 16% compared to full vision conditions (1 and 3). CONCLUSION: The results suggest that vision has a marked influence on mechanical efficiency even during entrained, repetitive movements performed on an obstacle-free horizontal surface under highly predictable conditions.

Effects of Simulated Microgravity and Hypergravity Conditions on Arm Movements in Normogravity.

The human sensorimotor control has evolved in the Earth's environment where all movement is influenced by the gravitational force. Changes in this environmental force can severely impact the performance of arm movements which can be detrimental in completing certain tasks such as piloting or controlling complex vehicles. For this reason, subjects that are required to perform such tasks undergo extensive training procedures in order to minimize the chances of failure. We investigated whether local gravity simulation of altered gravitational conditions on the arm would lead to changes in kinematic parameters comparable to the full-body experience of microgravity and hypergravity onboard a parabolic flight. To see if this would be a feasible approach for on-ground training of arm reaching movements in altered gravity conditions we developed a robotic device that was able to apply forces at the wrist in order to simulate micro- or hypergravity conditions for the arm while subjects performed pointing movements on a touch screen. We analyzed and compared the results of several kinematic parameters along with muscle activity using this system with data of the same subjects being fully exposed to microgravity and hypergravity conditions on a parabolic flight. Both in our simulation and in-flight, we observed a significant increase in movement durations in microgravity conditions and increased velocities in hypergravity for upward movements. Additionally, we noted a reduced accuracy of pointing both in-flight and in our simulation. These promising results suggest, that locally simulated altered gravity can elicit similar changes in some movement characteristics for arm reaching movements. This could potentially be exploited as a means of developing devices such as exoskeletons to aid in training individuals prior to undertaking tasks in changed gravitational conditions.

Effects of Local Gravity Compensation on Motor Control During Altered Environmental Gravity.

Our sensorimotor control is well adapted to normogravity environment encountered on Earth and any change in gravity significantly disturbs our movement. In order to produce appropriate motor commands for aimed arm movements such as pointing or reaching, environmental changes have to be taken into account. This adaptation is crucial when performing successful movements during microgravity and hypergravity conditions. To mitigate the effects of changing gravitational levels, such as the changed movement duration and decreased accuracy, we explored the possible beneficial effects of gravity compensation on movement. Local gravity compensation was achieved using a motorized robotic device capable of applying precise forces to the subject's wrist that generated a normogravity equivalent torque at the shoulder joint during periods of microgravity and hypergravity. The efficiency of the local gravity compensation was assessed with an experiment in which participants performed a series of pointing movements toward the target on a screen during a parabolic flight. We compared movement duration, accuracy, movement trajectory, and muscle activations of movements during periods of microgravity and hypergravity with conditions when local gravity compensation was provided. The use of local gravity compensation at the arm mitigated the changes in movement duration, accuracy, and muscle activity. Our results suggest that the use of such an assistive device helps with movements during unfamiliar environmental gravity.

Erratum: Jamsek et al. Gaussian Mixture Models for Control of Quasi-Passive Spinal Exoskeletons. Sensors 2020, 20, 2705.

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Postural Responses to Sudden Horizontal Perturbations in Tai Chi Practitioners.

Tai Chi has been shown to elicit numerous positive effects on health and well-being. In this study, we examined reactive postural control after sudden unloading horizontal perturbations, which resembled situations encountered during Tai Chi. The study involved 20 participants, 10 in the Tai Chi group (age: 37.4 ± 7.8 years), who had been regularly training the push-hand technique for at least 7 years, and 10 in the control group, consisting of healthy adults (age: 28.8 ± 5.0). Perturbations were applied at three different positions (hips, shoulders, and arms) via the load-release paradigm. Twenty measurements were carried out for each perturbation position. We measured peak vertical and horizontal forces on the ground (expressed percentage of body mass (%BM)), peak center of pressure displacement and peak horizontal and vertical velocities at the knee, hip and shoulder joints. The Tai Chi group exhibited smaller increases in vertical ground reaction forces when perturbations were applied at the hips (11.5 ± 2.1 vs. 19.6 ± 5.5 %BW; p = 0.002) and the arms (14.1 ± 4.2 vs. 23.2 ± 8.4 %BW; p = 0.005). They also responded with higher horizontal force increase after hip perturbation (16.2 ± 3.2 vs. 13.1 ± 2.5 %BW; p < 0.001). Similar findings were found when observing various outcomes related to velocities of vertical movement. The Tai Chi group also showed lower speeds of backward movement of the knee (p = 0.005-0.009) after hip (0.49 ± 0.13 vs. 0.85 ± 0.14 m/s; p = 0.005) and arm perturbations (0.97 ± 0.18 vs. 1.71 ± 0.29 m/s; p = 0.005). Center of pressure displacements were similar between groups. Our study demonstrated that engaging in Tai Chi could be beneficial to reactive postural responses after sudden perturbations in a horizontal direction; however, future interventional studies are needed to directly confirm this. Moreover, because of the age difference between the groups, some confounding effects of age cannot be ruled out.

Induced stabilization of center of mass decreases variability of center of pressure regardless of visual or tactile information.

Traditional theories claim that center of pressure (COP) is oscillating to minimize the center of mass (COM) movements, contrary to exploratory theories which propose that COP oscillates to increase sensory information flow from the environment. The aim of this work was to better understand the underlying postural control mechanisms, specifically the interplay of COP oscillations and sensory information flow on keeping the COM stable. Eighteen volunteers took part of the experiment divided into three parts based on sensory conditions: eyes opened, eyes closed and eyes closed with lightly touching a fixed object with one finger. Throughout each part the participants had to quietly stand for 335 s. In the middle of each part, we stabilized their COM for 105 s using a robotized waist-pull system. We recorded whole-body kinematics, COP oscillations, electromyographic activity of soleus and tibialis anterior muscles and the force applied by the finger during light touch conditions. The variability of COP significantly decreased when the COM was stabilized in all sensory conditions. The interaction between sensory condition and stabilization was also significant with different decline of COP variability between quiet standing and stabilization part in all three different sensory conditions. Ankle and knee angle variability decreased significantly while the hip angle variability did not. Our findings suggest that COP is not moving to explore the environment, but to attenuate oscillations of the COM. However, possible functional aspect of movement variability to keep the COM stable still remains.

Human pressure tolerance and effects of different padding materials with implications for development of exoskeletons and similar devices.

In this study, we assessed pressure tolerance in 16 healthy participants at the thigh, chest, and pelvic area, using different surfaces (1 cm2, 20 cm2 and different components, used in exoskeleton design), and the effects of different padding materials. Our results showed substantial variability in pressure tolerance among the participants, as well as lower pressure tolerance in females. Regarding the force applied with the exoskeleton components, male participants had higher discomfort threshold (230.3 ± 44.9 N compared to females (116.1 ± 24.6 N) in the chest area. For the applications with 20 cm2 surface, the males also showed higher pain threshold at the thigh (89.3 ± 41.8 N vs. 34.6 ± 27.2 N) and the pelvis (97.6 ± 37.0 N vs. 56.1 ± 29.5 N). All padding materials increased pressure tolerance for 10-38% (p < 0.001), but little differences between materials were observed.

Inter-Individual Variability in Postural Control During External Center of Mass Stabilization.

Understanding the relation between the motion of the center of mass (COM) and the center of pressure (COP) is important to understand the underlying mechanisms of maintaining body equilibrium. One way to investigate this is to stabilize COM by fixing the joints of the human and looking at the corresponding COP reactions. However, this approach constrains the natural motion of the human. To avoid this shortcoming, we stabilized COM without constraining the joint movements by using an external stabilization method based on inverted cart-pendulum system. Interestingly, this method only stabilized COM of a subgroup of participants and had a destabilizing effect for others which implies significant variability in inter-individual postural control. The aim of this work was to investigate the underlying causes of inter-individual variability by studying the postural parameters of quiet standing before the external stabilization. Eighteen volunteers took part in the experiment where they were standing on an actuated cart for 335 s. In the middle of this period we stabilized their COM in anteroposterior direction for 105 s. To stabilize the COM, we controlled the position of the cart using a double proportional-integral-derivative controller. We recorded COM position throughout the experiment, calculated its velocity, amplitude, and frequency during the quiet standing before the stabilization, and used these parameters as features in hierarchical clustering method. Clustering solution revealed that postural parameters of quiet standing before the stabilization cannot explain the inter-individual variability of postural responses during the external COM stabilization. COM was successfully stabilized for a group of participants but had a destabilizing effect on the others, showing a variability in individual postural control which cannot be explained by postural parameters of quiet-stance.

Assessing the efficiency of exoskeletons in physical strain reduction by biomechanical simulation with AnyBody Modeling System.

Introduction: Recently, many industrial exoskeletons for supporting workers in heavy physical tasks have been developed. However, the efficiency of exoskeletons with regard to physical strain reduction has not been fully proved, yet. Several laboratory and field studies have been conducted, but still more data, that cannot be obtained solely by behavioral experiments, are needed to investigate effects on the human body. Methods: This paper presents an approach to extend laboratory and field research with biomechanical simulations using the AnyBody Modeling System. Based on a dataset recorded in a laboratory experiment with 12 participants using the exoskeleton Paexo Shoulder in an overhead task, the same situation was reproduced in a virtual environment and analyzed with biomechanical simulation. Results: Simulation results indicate that the exoskeleton substantially reduces muscle activity and joint reaction forces in relevant body areas. Deltoid muscle activity and glenohumeral joint forces in the shoulder were decreased between 54 and 87%. Simultanously, no increases of muscle activity and forces in other body areas were observed. Discussion: This study demonstrates how a simulation framework could be used to evaluate changes in internal body loads as a result of wearing exoskeletons. Biomechanical simulation results widely agree with experimental measurements in the previous laboratory experiment and supplement such by providing an insight into effects on the human musculoskeletal system. They confirm that Paexo Shoulder is an effective device to reduce physical strain in overhead tasks. The framework can be extended with further parameters, allowing investigations for product design and evaluation.

Challenges and solutions for application and wider adoption of wearable robots.

The science and technology of wearable robots are steadily advancing, and the use of such robots in our everyday life appears to be within reach. Nevertheless, widespread adoption of wearable robots should not be taken for granted, especially since many recent attempts to bring them to real-life applications resulted in mixed outcomes. The aim of this article is to address the current challenges that are limiting the application and wider adoption of wearable robots that are typically worn over the human body. We categorized the challenges into mechanical layout, actuation, sensing, body interface, control, human-robot interfacing and coadaptation, and benchmarking. For each category, we discuss specific challenges and the rationale for why solving them is important, followed by an overview of relevant recent works. We conclude with an opinion that summarizes possible solutions that could contribute to the wider adoption of wearable robots.

Comparison of Subjective Responses of Low Back Pain Patients and Asymptomatic Controls to Use of Spinal Exoskeleton during Simple Load Lifting Tasks: A Pilot Study.

Spinal exoskeletons have been suggested as an approach for the prevention and rehabilitation of occupational low back pain (LBP). While the state-of-the-art exoskeletons were shown to substantially unload the back, user acceptance is still limited. Perceived discomfort and restriction of freedom of movement are commonly reported. In this pilot study, we explored the differences in subjective responses and user impressions to using passive spinal exoskeleton during a set of simple lifting tasks between LBP patients (n = 12) and asymptomatic individuals (n = 10). Visual analog scales (0-10) were used for all assessments. Overall, the results showed mostly similar responses or slightly more positive responses to the exoskeleton from LBP patients. Most notably, the LBP patients reported a statistically significant (p = 0.048) higher willingness to use the device daily (5.36 ± 4.05) compared to the control group (2.00 ± 1.85) and also gave the device a higher overall grade (6.58 ± 1.98 vs. 4.30 ± 2.26; p = 0.021). This study has demonstrated that individuals with current LBP responded more favorably to the use of the spinal exoskeleton for simple lifting tasks. This implies that current exoskeletons could be appropriate for LBP rehabilitation, but not preventions, as pain-free individuals are less willing to use such devices. Future studies should explore whether different exoskeleton designs could be more appropriate for people with no LBP issues.