Flexible lower limb exoskeleton systems: A review

Meng, Qiaoling; Zeng, Qingxin; Xie, Qiaolian; Fei, Cuizhi; Kong, Bolei; Lü, Xin; Wang, Haibin; Yu, Hongliu

doi:10.3233/nre-210300

Cited by 22 publications

(5 citation statements)

References 68 publications

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“…The sensors can ascertain changes in task performance, muscle strength and fatigue, and environmental features, which may enable greater support for walking on diverse terrains [39,40]. Research is also expanding into the upper extremity, back, and ankle/foot exosystems [40,41], and more flexible systems with softer components than the traditional hard mechanical components of robotic devices [42]. Flexible systems are lighter and have less bulk, but it is not clear whether these systems can support the full weight of the lower extremities and body posture.…”

Section: Technology Review and Efficacymentioning

confidence: 99%

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Rehabilitation Technologies for Chronic Conditions: Will We Sink or Swim?

LaMarca,

Tse,

Keysor

2023

Healthcare

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Introduction: Chronic conditions such as stroke, Parkinson’s disease, spinal cord injury, multiple sclerosis, vestibular disorders, chronic pain, arthritis, diabetes, chronic obstructive pulmonary disease (COPD), and heart disease are leading causes of disability among middle-aged and older adults. While evidence-based treatment can optimize clinical outcomes, few people with chronic conditions engage in the recommended levels of exercise for clinical improvement and successful management of their condition. Rehabilitation technologies that can augment therapeutic care—i.e., exoskeletons, virtual/augmented reality, and remote monitoring—offer the opportunity to bring evidence-based rehabilitation into homes. Successful integration of rehabilitation techniques at home could help recovery and access and foster long term self-management. However, widespread uptake of technology in rehabilitation is still limited, leaving many technologies developed but not adopted. Methods: In this narrative review, clinical need, efficacy, and obstacles and suggestions for implementation are discussed. The use of three technologies is reviewed in the management of the most prevalent chronic diseases that utilize rehabilitation services, including common neurological, musculoskeletal, metabolic, pulmonary, and cardiac conditions. The technologies are (i) exoskeletons, (ii) virtual and augmented reality, and (iii) remote monitoring. Results: Effectiveness evidence backing the use of technology in rehabilitation is growing but remains limited by high heterogeneity, lack of long-term outcomes, and lack of adoption outcomes. Conclusion: While rehabilitation technologies bring opportunities to bridge the gap between clinics and homes, there are many challenges with adoption. Hybrid effectiveness and implementation trials are a possible path to successful technology development and adoption.

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Section: Technology Review and Efficacymentioning

confidence: 99%

“…Flexible systems are lighter and have less bulk, but it is not clear whether these systems can support the full weight of the lower extremities and body posture. These lighter systems may be useful for alternative options such as upper extremity functions [41,42].…”

Section: Technology Review and Efficacymentioning

confidence: 99%

Rehabilitation Technologies for Chronic Conditions: Will We Sink or Swim?

LaMarca,

Tse,

Keysor

2023

Healthcare

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“…When the collaboration mode is used, the exoskeleton can judge whether the exoskeleton is helpful or not based on the motion state of the patient. Patients actively participate to some extent, which plays a better role in promoting the reconstruction of the nervous system and the recovery of motor function [167]. Through rehabilitation-robot-assisted training, patients' walking ability [168], walking speed [169,170], leg muscle strength [171], stride length [172], and gait symmetry [173] have been improved.…”

Section: Exoskeleton Rehabilitation Robot Regulates Brainmentioning

confidence: 99%

Rehabilitation Training after Spinal Cord Injury Affects Brain Structure and Function: From Mechanisms to Methods

He,

Guo,

Zhao

et al. 2023

Biomedicines

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Spinal cord injury (SCI) is a serious neurological insult that disrupts the ascending and descending neural pathways between the peripheral nerves and the brain, leading to not only functional deficits in the injured area and below the level of the lesion but also morphological, structural, and functional reorganization of the brain. These changes introduce new challenges and uncertainties into the treatment of SCI. Rehabilitation training, a clinical intervention designed to promote functional recovery after spinal cord and brain injuries, has been reported to promote activation and functional reorganization of the cerebral cortex through multiple physiological mechanisms. In this review, we evaluate the potential mechanisms of exercise that affect the brain structure and function, as well as the rehabilitation training process for the brain after SCI. Additionally, we compare and discuss the principles, effects, and future directions of several rehabilitation training methods that facilitate cerebral cortex activation and recovery after SCI. Understanding the regulatory role of rehabilitation training at the supraspinal center is of great significance for clinicians to develop SCI treatment strategies and optimize rehabilitation plans.

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“…The waist and thigh belts consist of open frames and Velcro. The open frames are designed and fitted with the physiological structures of the human body to improve the corresponding twisting resistance (Figure 2c) [32]. Four short nylon belts (width 25 mm) are sewn on the anchor locations denoted by A, B, C and D (Figure 2a).…”

Section: Ergonomic Design Of H-suitmentioning

confidence: 99%

Ergonomic Design and Performance Evaluation of H-Suit for Human Walking

Zhang

Jiao

et al. 2022

Micromachines

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A soft exoskeleton for the hip flexion, named H-Suit, is developed to improve the walking endurance of lower limbs, delay muscle fatigue and reduce the activation level of hip flexors. Based on the kinematics and biomechanics of the hip joints, the ergonomic design of the H-Suit system is clearly presented and the prototype was developed. The profile of the auxiliary forces is planned in the auxiliary range where the forces start at the minimum hip angle, reach the maximum (120 N) and end at 90% of each gait cycle. The desired displacements of the traction unit which consist of the natural and elastic displacements of the steel cables are obtained by the experimental method. An assistance strategy is proposed to track the profile of the auxiliary forces by dynamically adjusting the compensation displacement Lc and the hold time Δt. The influences of the variables Lc and Δt on the natural gaits and auxiliary forces have been revealed and analyzed. The real profile of the auxiliary forces can be obtained and is consistent with the theoretical one by the proposed assistance strategy. The H-Suit without the drive unit has little effect on the EMG signal of the lower limbs. In the powered condition, the H-Suit can delay the muscle fatigue of the lower limbs. The average rectified value (ARV) slope decreases and the median frequency (MNF) slope increases significantly. Wearing the H-Suit resulted in a significant reduction of the vastus lateralis effort, averaged over subjects and walking speeds, of 13.3 ± 2.1% (p = 2 × 10−5).

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Flexible lower limb exoskeleton systems: A review

Cited by 22 publications

References 68 publications

Rehabilitation Technologies for Chronic Conditions: Will We Sink or Swim?

Rehabilitation Technologies for Chronic Conditions: Will We Sink or Swim?

Rehabilitation Training after Spinal Cord Injury Affects Brain Structure and Function: From Mechanisms to Methods

Ergonomic Design and Performance Evaluation of H-Suit for Human Walking

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