Abstract
Most wearable robots that assist the gait of workers, soldiers, athletes, and hobbyists are developed towards a vision of outdoor, overground walking. However, so far, these devices have predominantly been tested indoors on laboratory treadmills. It is unclear whether treadmill-based laboratory tests are an accurate representation of overground ambulation outdoors with respect to essential outcomes such as the metabolic benefits of robotic assistance. In this study, we investigated the metabolic benefits of the Myosuit, a wearable robot that assists hip and knee extension during the stance phase of gait, for eight unimpaired participants during uphill walking trials in three settings: outside, on a self-paced treadmill with a virtual reality display, and on a standard treadmill at a fixed gait speed. The relative metabolic reduction with Myosuit assistance was most pronounced in the outside setting at − 10.6% and significantly larger than in the two treadmill settings (− 6.9%, p = 0.015 and − 6.2%, p = 0.008). This indicates that treadmill tests likely result in systematically low estimate for the true metabolic benefits of wearable robots during outside, overground walking. Hence, wearable robots should preferably be tested in an outdoor environment to obtain more representative—and ultimately more favorable—results with respect to the metabolic benefit of robotic gait assistance.
Highlights
Most wearable robots that assist the gait of workers, soldiers, athletes, and hobbyists are developed towards a vision of outdoor, overground walking
The implicit assumption is that fixed speed, treadmill-based laboratory testing is a representative rendition of robot-assisted overground ambulation outdoors with respect to metabolic cost
Relative metabolic benefit of assistance is higher outside. If this had been a typical treadmill-based laboratory study, we would have concluded that Myosuit assistance reduced the metabolic cost of uphill walking by around 6 to 7% compared to wearing the Myosuit in zero-force mode
Summary
Most wearable robots that assist the gait of workers, soldiers, athletes, and hobbyists are developed towards a vision of outdoor, overground walking These devices have predominantly been tested indoors on laboratory treadmills. Thereby, wearable robots could improve the endurance and load carrying capacity of workers, soldiers, athletes, and hobbyists These individuals walk and run overground, often outdoors, and not on laboratory treadmills. The implicit assumption is that fixed speed, treadmill-based laboratory testing is a representative rendition of robot-assisted overground ambulation outdoors with respect to metabolic cost. Perceived balance and surface area of the treadmill might impact the metabolic cost of treadmill ambulation, at higher speeds[10]
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