Metabolic adaptation and related biomechanics in an ankle-based exoskeleton system during six sessions of steady state walking.

Ankle-based exoskeletons have demonstrated metabolic benefits during steady-state walking; however, variability exists in individual adaptation timelines necessary to achieve those benefits. This study assessed timelines for metabolic and gait-related adaptation while wearing an ankle-based exoskeleton while powered (EXOP) compared to unpowered (EXNP) and no device worn (NOEX). Metabolic (VO2) and biomechanics data were collected while 14 participants walked on a treadmill at 1.3 m/s for six sessions. To better understand variability in responses to wearing exoskeletons, the cohort was divided based on the slope of the VO2 response of the first two sessions in the EXOP condition, and gait parameters were compared between subgroups. Repeated measures analyses of variance revealed a significant (p ≤ 0.001) 10% VO2 reduction for EXOP compared to EXNP and a non-significant 2.5% reduction for EXOP v NOEX. Lack of significant session-based comparisons indicated no additional VO2 adaptation; however, significant session-related results for peak knee flexion (interaction, p = 0.042) and step width (session main effect, p = 0.003) suggest gait-related adaptation continued during the sessions. Subgroup results indicated different response profiles to wearing exoskeletons; and implications of classifying initial responses based on metabolic response are discussed as an approach to understand what drives variation in responses to these devices.

After initial training, VO₂ reductions were observed with an ankle-based exoskeleton during the initial session and those reductions were maintained for the remaining sessions. Some gait-related variables continued to change over the remaining sessions. Exploratory work based on differences between early metabolic responses revealed potential adaptation strategy subgroups.

The intra- and interrater reliability of isometric muscle contractions using a novel fixation system for a hand-held dynamometer.

A novel fixation system for a hand-held dynamometer (HHD) was designed to enable isometric muscle measurements on various muscle groups of strong, healthy individuals in a field setting. The objective of this study was to evaluate the intra- and interrater reliability of the system and determine its suitability for use by multiple researchers within large-scale data collections during field activities. Four researchers tested eight healthy subjects, who each completed eight different maximal isometric muscle strength assessments using the HHD fixation system. Intraclass correlation coefficients (ICC) results were evaluated with a 95% confidence interval. ICC results for interrater reliability demonstrated excellent agreement of all eight measurements tested. ICC results for intrarater reliability demonstrated excellent agreement for six out of eight measurements. This system provides a new opportunity for several different high-quality maximal muscle strength measurements to be collected by multiple data collectors on large numbers of strong, healthy individuals in a field setting.

Effects of Cognitive Over Postural Demands on Upright Standing Among Young Adults.

A growing body of research has shown that static stance control (e.g., body sway) is influenced by cognitive demands (CD), an effect that may be related to competition for limited central resources. Measures of stance control have also been impacted by postural demands (PD) (e.g., stable vs. unstable stances). However, less is known of any possible interactions between PD and CD on static stance control in populations with intact balance control and ample cognitive resources, like young healthy adults. In this study, among the same participants, we factorially compared the impact of PD with and without CD on static stance control. Thirty-four healthy young adults wore inertial measurement units (IMU) while completing static stance tasks for 30 seconds in three different PD positions: feet apart, feet together, and tandem feet. After completing these tasks alone, participants performed these tasks with CD by concurrently completing verbal serial seven subtractions from a randomly selected three-digit number. For two dependent measures, path length and jerk, there were main effects of CD and PD but no interaction effect between these factors. For all other stance control parameters, there was only a PD main effect. Thus, adding a cognitive demand to postural demands, while standing upright, may have an independent impact on stance control, but CD does not seem to interact with PD. These results suggest that young healthy adults may be less sensitive to simple PD and CD due to their greater inherent balance control and available cognitive resources. Future work might explore more complex PD and CD combinations to determine the boundaries under which young adults' resources are taxed.

Body-worn IMU array reveals effects of load on performance in an outdoor obstacle course.

This study introduces a new method to understand how added load affects human performance across a broad range of athletic tasks (ten obstacles) embedded in an outdoor obstacle course. The method employs an array of wearable inertial measurement units (IMUs) to wirelessly record the movements of major body segments to derive obstacle-specific metrics of performance. The effects of load are demonstrated on (N = 22) participants who each complete the obstacle course under four conditions including unloaded (twice) and with loads of 15% and 30% of their body weight (a total of 88 trials across the group of participants). The IMU-derived performance metrics reveal marked degradations in performance with increasing load across eight of the ten obstacles. Overall, this study demonstrates the significant potential in using this wearable technology to evaluate human performance across multiple tasks and, simultaneously, the adverse effects of body-borne loads on performance. The study addresses a major need of military organizations worldwide that frequently employ standardized obstacle courses to understand how added loads influence warfighter performance. Importantly, the findings and conclusions drawn from IMU data would not be possible using traditional timing metrics used to evaluate task performance.

Soldier-relevant body borne loads increase knee joint contact force during a run-to-stop maneuver.

The purpose of this study was to understand the effects of load carriage on human performance, specifically during a run-to-stop (RTS) task. Using OpenSim analysis tools, knee joint contact force, grounds reaction force, leg stiffness and lower extremity joint angles and moments were determined for nine male military personnel performing a RTS under three load configurations (light, ~6kg, medium, ~20kg, and heavy, ~40kg). Subject-based means for each biomechanical variable were submitted to repeated measures ANOVA to test the effects of load. During the RTS, body borne load significantly increased peak knee joint contact force by 1.2 BW (p<0.001) and peak vertical (p<0.001) and anterior-posterior (p=0.002) ground reaction forces by 0.6 BW and 0.3 BW, respectively. Body borne load also had a significant effect on hip (p=0.026) posture with the medium load and knee (p=0.046) posture with the heavy load. With the heavy load, participants exhibited a substantial, albeit non-significant increase in leg stiffness (p=0.073 and d=0.615). Increases in joint contact force exhibited during the RTS were primarily due to greater GRFs that impact the soldier with each incremental addition of body borne load. The stiff leg, extended knee and large braking force the soldiers exhibited with the heavy load suggests their injury risk may be greatest with that specific load configuration. Further work is needed to determine if the biomechanical profile exhibited with the heavy load configuration translates to unsafe shear forces at the knee joint and consequently, a higher likelihood of injury.