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      Towards a Functional Performance Validation Standard for Industrial Low-Back Exoskeletons: State of the Art Review

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          Abstract

          While the research interest for exoskeletons has been rising in the last decades, missing standards for their rigorous evaluation are potentially limiting their adoption in the industrial field. In this context, exoskeletons for worker support have the aim to reduce the physical effort required by humans, with dramatic social and economic impact. Indeed, exoskeletons can reduce the occurrence and the entity of work-related musculoskeletal disorders that often cause absence from work, resulting in an eventual productivity loss. This very urgent and multifaceted issue is starting to be acknowledged by researchers. This article provides a systematic review of the state of the art for functional performance evaluation of low-back exoskeletons for industrial workers. We report the state-of-the-art evaluation criteria and metrics used for such a purpose, highlighting the lack of a standard for this practice. Very few studies carried out a rigorous evaluation of the assistance provided by the device. To address also this topic, the article ends with a proposed framework for the functional validation of low-back exoskeletons for the industry, with the aim to pave the way for the definition of rigorous industrial standards.

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          Exoskeletons for industrial application and their potential effects on physical work load.

          The aim of this review was to provide an overview of assistive exoskeletons that have specifically been developed for industrial purposes and to assess the potential effect of these exoskeletons on reduction of physical loading on the body. The search resulted in 40 papers describing 26 different industrial exoskeletons, of which 19 were active (actuated) and 7 were passive (non-actuated). For 13 exoskeletons, the effect on physical loading has been evaluated, mainly in terms of muscle activity. All passive exoskeletons retrieved were aimed to support the low back. Ten-forty per cent reductions in back muscle activity during dynamic lifting and static holding have been reported. Both lower body, trunk and upper body regions could benefit from active exoskeletons. Muscle activity reductions up to 80% have been reported as an effect of active exoskeletons. Exoskeletons have the potential to considerably reduce the underlying factors associated with work-related musculoskeletal injury. Practitioner Summary: Worldwide, a significant interest in industrial exoskeletons does exist, but a lack of specific safety standards and several technical issues hinder mainstay practical use of exoskeletons in industry. Specific issues include discomfort (for passive and active exoskeletons), weight of device, alignment with human anatomy and kinematics, and detection of human intention to enable smooth movement (for active exoskeletons).
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            State of the Art and Future Directions for Lower Limb Robotic Exoskeletons.

            Research on robotic exoskeletons has rapidly expanded over the previous decade. Advances in robotic hardware and energy supplies have enabled viable prototypes for human testing. This review paper describes current lower limb robotic exoskeletons, with specific regard to common trends in the field. The preponderance of published literature lacks rigorous quantitative evaluations of exoskeleton performance, making it difficult to determine the disadvantages and drawbacks of many of the devices. We analyzed common approaches in exoskeleton design and the convergence, or lack thereof, with certain technologies. We focused on actuators, sensors, energy sources, materials, and control strategies. One of the largest hurdles to be overcome in exoskeleton research is the user interface and control. More intuitive and flexible user interfaces are needed to increase the success of robotic exoskeletons. In the last section, we discuss promising future solutions to the major hurdles in exoskeleton control. A number of emerging technologies could deliver substantial advantages to existing and future exoskeleton designs. We conclude with a listing of the advantages and disadvantages of the emerging technologies and discuss possible futures for the field.
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              Robotic orthosis lokomat: a rehabilitation and research tool.

              The aim of this article is to introduce the robotic orthosis Lokomat, developed to automate treadmill training rehabilitation of locomotion for spinal cord injured and stroke patients, to the Functional Electrical Stimulation (FES) and Neuromodulation research communities, and to report on our newly conducted research. We first illustrate the primary use of Lokomat in rehabilitation and focus on control aspects and algorithms associated with robotic rehabilitation of locomotion. Then we describe two applications where the Lokomat was used as a research tool. The first application is closed-loop control of the FES-induced shank movement and the second is the development of a neural network model of the spinal locomotor centers. This model was used to derive a neural locomotion controller for the Lokomat.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Sensors (Basel)
                Sensors (Basel)
                sensors
                Sensors (Basel, Switzerland)
                MDPI
                1424-8220
                26 January 2021
                February 2021
                : 21
                : 3
                : 808
                Affiliations
                [1 ]Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy; alberto.antonietti@ 123456polimi.it (A.A.); alessandra.pedrocchi@ 123456polimi.it (A.P.)
                [2 ]Department of Mechanical Engineering, Politecnico di Milano, 20156 Milan, Italy; marta.gandolla@ 123456polimi.it
                Author notes
                Author information
                https://orcid.org/0000-0002-0505-4361
                https://orcid.org/0000-0003-0388-6321
                Article
                sensors-21-00808
                10.3390/s21030808
                7865790
                33530377
                a0e926cc-a67c-4679-ad59-8d26b599d209
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 23 December 2020
                : 21 January 2021
                Categories
                Review

                Biomedical engineering
                low back,industrial exoskeleton,assistive device,fatigue relief,worker support,low-back pain

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