The mechanical assistance provided by exoskeletons could potentially replace, assist, or rehabilitate upper extremity function in patients with mild to moderate shoulder disability to perform activities of daily living. While many exoskeletons are "active" (e.g. motorized), mechanically passive exoskeletons may be a more practical and affordable solution to meet a growing clinical need for continuous, home-based movement assistance. In the current study, we designed, fabricated, and evaluated the performance of a wearable, passive, cable-driven shoulder exoskeleton (WPCSE) prototype. An innovative feature of the WPCSE is a modular spring-cam-wheel system that can be custom designed to compensate for any proportion of the shoulder elevation moment due to gravity over a large range of shoulder motion. The force produced by the spring-cam-wheel system is transmitted over the superior aspect of the shoulder to an arm cuff through a Bowden cable. The results from mechanical evaluation revealed that the modular spring-cam-wheel system could successfully produce an assistive positive shoulder elevation moment that matched the desired, theoretical moment. However, when measured from the physical WPCSE prototype, the moment was lower (up to 30%) during positive shoulder elevation and higher (up to 120%) during negative shoulder elevation due primarily to friction. Even so, our biomechanical evaluation showed that the WPCSE prototype reduced the root mean square (up to 35%) and peak (up to 33%) muscular activity, as measured by electromyography, of several muscles crossing the shoulder during shoulder elevation and horizontal adduction/abduction movements. These preliminary results suggest that our WPCSE may be suitable for providing movement assistance to people with shoulder disability.

Mechanically passive exoskeletons may be a practical and affordable solution to meet a growing clinical need for continuous, home-based movement assistance. We designed, fabricated, and preliminarily evaluated the performance of a wearable, passive, cam-driven shoulder exoskeleton (WPCSE) prototype. The novel feature of the WPCSE is a modular spring-cam-wheel module, which generates an assistive force that can be customized to compensate for any proportion of the shoulder elevation moment due to gravity. We performed a benchtop experiment to validate the mechanical output of the WPCSE against our theoretical model. We also conducted a pilot biomechanics study (eight able-bodied subjects) to quantify the effect of a WPCSE prototype on muscle activity and shoulder kinematics during three shoulder movements. The shoulder elevation moment produced by the spring-cam-wheel module alone closely matched the desired, theoretical moment. However, when measured from the full WPCSE prototype, the moment was lower (up to 30%) during positive shoulder elevation and higher (up to 120%) during negative shoulder elevation compared to the theoretical moment, due primarily to friction. Even so, a WPCSE prototype, compensating for about 25% of the shoulder elevation moment due to gravity, showed a trend of reducing root mean square electromyogram magnitudes of several muscles crossing the shoulder during shoulder elevation and horizontal adduction/abduction movements. Our results also showed that the WPCSE did not constrain or impede shoulder movements during the tested movements. The results provide proof-of-concept evidence that our WPCSE can potentially assist shoulder movements.

BackgroundMechanically passive (i.e. spring-powered) exoskeletons may be a practical and affordable solution to meet a growing clinical need for continuous, home-based movement assistance. We designed, fabricated, and preliminarily evaluated the performance of a wearable, passive, cam-driven shoulder exoskeleton (WPCSE) prototype. MethodsThe novel feature of the WPCSE is a modular spring-cam-wheel module, which generates an assistive force that can be customized to compensate for any proportion of the shoulder elevation moment due to gravity. We performed a benchtop experiment to validate the mechanical output of the WPCSE against our theoretical model. We also conducted a pilot biomechanics study (four able-bodied subjects) to quantify the effect of a WPCSE prototype on muscle activity and shoulder kinematics during three one-degree-of-freedom shoulder movements. ResultsThe shoulder elevation moment produced by the spring-cam-wheel module alone closely matched the desired, theoretical moment. However, when measured from the full WPCSE prototype, the moment was lower (up to 30%) during positive shoulder elevation and higher (up to 120%) during negative shoulder elevation compared to the theoretical moment, due primarily to friction. Even so, a WPCSE prototype, compensating for about 25% of the shoulder elevation moment due to gravity, showed a trend of reducing root mean square (up to 50%) and peak (up to 53%) electromyogram magnitudes of several muscles crossing the shoulder during shoulder elevation and horizontal adduction/abduction movements. Subjects verbally reported that the WPCSE did not physically constrain them during the tested movements. ConclusionThe results provide proof-of-concept evidence that our WPCSE can potentially assist shoulder movements. The proposed WPCSE, once refined, could provide clinical and home-based rehabilitation for patients with shoulder disability.