Lower Limb Exoskeleton Research Articles

Human–exoskeleton interaction portrait

Human–robot physical interaction contains crucial information for optimizing user experience, enhancing robot performance, and objectively assessing user adaptation. This study introduces a new method to evaluate human–robot interaction and co-adaptation in lower limb exoskeletons by analyzing muscle activity and interaction torque as a two-dimensional random variable. We introduce the interaction portrait (IP), which visualizes this variable’s distribution in polar coordinates. We applied IP to compare a recently developed hybrid torque controller (HTC) based on kinematic state feedback and a novel adaptive model-based torque controller (AMTC) with online learning, proposed herein, against a time-based controller (TBC) during treadmill walking at varying speeds. Compared to TBC, both HTC and AMTC significantly lower users’ normalized oxygen uptake, suggesting enhanced user-exoskeleton coordination. IP analysis reveals that this improvement stems from two distinct co-adaptation strategies, unidentifiable by traditional muscle activity or interaction torque analyses alone. HTC encourages users to yield control to the exoskeleton, decreasing overall muscular effort but increasing interaction torque, as the exoskeleton compensates for user dynamics. Conversely, AMTC promotes user engagement through increased muscular effort and reduces interaction torques, aligning it more closely with rehabilitation and gait training applications. IP phase evolution provides insight into each user’s interaction strategy formation, showcasing IP analysis’s potential in comparing and designing novel controllers to optimize human–robot interaction in wearable robots.

Adaptive Modular Neural Control for Online Gait Synchronization and Adaptation of an Assistive Lower-Limb Exoskeleton.

Gait synchronization has attracted significant attention in research on assistive lower-limb exoskeletons because it can circumvent conflicting movements and improve the assistance performance. This study proposes an adaptive modular neural control (AMNC) for online gait synchronization and the adaptation of a lower-limb exoskeleton. The AMNC comprises several distributed and interpretable neural modules that interact with each other to effectively exploit neural dynamics and adopt feedback signals to quickly reduce the tracking error, thereby smoothly synchronizing the exoskeleton movement with the user's movement on the fly. Taking state-of-the-art control as the benchmark, the proposed AMNC provides further improvements in the locomotion phase, frequency, and shape adaptation. Accordingly, under the physical interaction between the user and the exoskeleton, the control can reduce the optimized tracking error and unseen interaction torque by up to 80% and 30%, respectively. Accordingly, this study contributes to the advancement of exoskeleton and wearable robotics research in gait assistance for the next generation of personalized healthcare.

A review on the implementation of lower-limb exoskeletons to improve the intrinsic capacity and functional ability of older adults

A review on the implementation of lower-limb exoskeletons to improve the intrinsic capacity and functional ability of older adults

Human-in-the-Loop Trajectory Optimization Based on sEMG Biofeedback for Lower-Limb Exoskeleton.

Lower-limb exoskeletons (LLEs) can provide rehabilitation training and walking assistance for individuals with lower-limb dysfunction or those in need of functionality enhancement. Adapting and personalizing the LLEs is crucial for them to form an intelligent human-machine system (HMS). However, numerous LLEs lack thorough consideration of individual differences in motion planning, leading to subpar human performance. Prioritizing human physiological response is a critical objective of trajectory optimization for the HMS. This paper proposes a human-in-the-loop (HITL) motion planning method that utilizes surface electromyography signals as biofeedback for the HITL optimization. The proposed method combines offline trajectory optimization with HITL trajectory selection. Based on the derived hybrid dynamical model of the HMS, the offline trajectory is optimized using a direct collocation method, while HITL trajectory selection is based on Thompson sampling. The direct collocation method optimizes various gait trajectories and constructs a gait library according to the energy optimality law, taking into consideration dynamics and walking constraints. Subsequently, an optimal gait trajectory is selected for the wearer using Thompson sampling. The selected gait trajectory is then implemented on the LLE under a hybrid zero dynamics control strategy. Through the HITL optimization and control experiments, the effectiveness and superiority of the proposed method are verified.

Development of an individualized stable and force-reducing lower-limb exoskeleton

In this study, an individualized and stable passive-control lower-limb exoskeleton robot was developed. Users’ joint angles and the center of pressure (CoP) of one of their soles were input into a convolutional neural network (CNN)–long short-term memory (LSTM) model to evaluate and adjust the exoskeleton control scheme. The CNN–LSTM model predicted the fitness of the control scheme and output the results to the exoskeleton robot, which modified its control parameters accordingly to enhance walking stability. The sole’s CoP had similar trends during normal walking and passive walking with the developed exoskeleton; the y-coordinates of the CoPs with and without the exoskeleton had a correlation of 91%. Moreover, electromyography signals from the rectus femoris muscle revealed that it exerted 40% less force when walking with a stable stride length in the developed system than when walking with an unstable stride length. Therefore, the developed lower-limb exoskeleton can be used to assist users in achieving balanced and stable walking with reduced force application. In the future, this exoskeleton can be used by patients with stroke and lower-limb weakness to achieve stable walking.

Research status of lower limb exoskeleton rehabilitation robot

Lower limb exoskeleton rehabilitation robots are used to improve or restore the walking and movement ability of people with lower limb movement disorders. However, the required functions for patients differ based on various diseases. For example, patients with weak muscle strength require power assistance, patients with spinal cord injuries require motion compensation, patients with gait abnormalities require gait correction, and patients with strokes require neural rehabilitation. To design a more targeted lower limb exoskeleton rehabilitation robot for different diseases, this article summarised and compared existing lower limb exoskeleton rehabilitation robots according to their main functions and the characteristics and rehabilitation needs of various lower limb movement disorders. The correlations between the functions of existing devices and diseases were summarised to provide certain references for the development of new lower limb exoskeleton rehabilitation robots.

Optimization of Joint Space Trajectories for Assistive Lower Limb Exoskeleton Robots: Real-Time and Flexible Gait Patterns

This research focuses on designing a real-time, flexible gait planner for lower limb exoskeleton robots to assist patients with lower limb disabilities. Given the dynamic nature of gait parameters, which vary according to ground conditions and user intent, the challenge lies in developing a gait planner capable of adapting to these changes in real-time. To avoid planning complications in the cartesian space and to comply with the speed constraints of joint motors, this paper proposes planning in joint space. Furthermore, the approach also considers the maximum speed capabilities of the joint motors, aiming to generate an executable gait pattern and simultaneously enhance the robot’s walking speed by determining the minimum time required for implementation. The introduced gait planner optimizes joint trajectories for minimal angular acceleration. To provide flexibility, generalized boundary conditions suitable for different scenarios are defined. The effectiveness of the proposed planner is validated through comprehensive performance analysis, simulations, and successful implementation trials on the Exoped® robot in various scenarios.

User-Centered Evaluation of the Wearable Walker Lower Limb Exoskeleton; Preliminary Assessment Based on the Experience Protocol.

Using lower limb exoskeletons provides potential advantages in terms of productivity and safety associated with reduced stress. However, complex issues in human-robot interactions are still open, such as the physiological effects of exoskeletons and the impact on the user's subjective experience. In this work, an innovative exoskeleton, the Wearable Walker, is assessed using the EXPERIENCE benchmarking protocol from the EUROBENCH project. The Wearable Walker is a lower-limb exoskeleton that enhances human abilities, such as carrying loads. The device uses a unique control approach called Blend Control that provides smooth assistance torques. It operates two models simultaneously, one in the case in which the left foot is grounded and another for the grounded right foot. These models generate assistive torques combined to provide continuous and smooth overall assistance, preventing any abrupt changes in torque due to model switching. The EXPERIENCE protocol consists of walking on flat ground while gathering physiological signals, such as heart rate, its variability, respiration rate, and galvanic skin response, and completing a questionnaire. The test was performed with five healthy subjects. The scope of the present study is twofold: to evaluate the specific exoskeleton and its current control system to gain insight into possible improvements and to present a case study for a formal and replicable benchmarking of wearable robots.

Lower-Limb Exoskeletons for Gait Training in Parkinson's Disease: The State of the Art and Future Perspectives.

Gait dysfunction (GD) is a common impairment of Parkinson's disease (PD), which negatively impacts patients' quality of life. Among the most recent rehabilitation technologies, a lower-limb powered exoskeleton (LLEXO) arises as a useful instrument for gait training in several neurological conditions, including PD. However, some questions relating to methods of use, achievable results, and usefulness compared to traditional rehabilitation methodologies still require clear answers. Therefore, in this review, we aim to summarise and analyse all the studies that have applied an LLEXO to train gait in PD patients. Literature research on PubMed and Scopus retrieved five articles, comprising 46 PD participants stable on medications (age: 71.7 ± 3.7 years, 24 males, Hoehn and Yahr: 2.1 ± 0.6). Compared to traditional rehabilitation, low-profile lower-limb exoskeleton (lp-LLEXO) training brought major improvements towards walking capacity and gait speed, while there are no clear major benefits regarding the dual-task gait cost index and freezing of gait symptoms. Importantly, the results suggest that lp-LLEXO training is more beneficial for patients with an intermediate-to-severe level of disease severity (Hoehn and Yahr > 2.5). This review could provide a novel framework for implementing LLEXO in clinical practise, highlighting its benefits and limitations towards gait training.

Integrating musculoskeletal simulation and machine learning: a hybrid approach for personalized ankle-foot exoskeleton assistance strategies.

Introduction: Lower limb exoskeletons have shown considerable potential in assisting human walking, particularly by reducing metabolic cost (MC), leading to a surge of interest in this field in recent years. However, owing to significant individual differences and the uncertainty of movements, challenges still exist in the personalized design and control of exoskeletons in human-robot interactions. Methods: In this study, we propose a hybrid data-driven approach that integrates musculoskeletal simulation with machine learning technology to customize personalized assistance strategies efficiently and adaptively for ankle-foot exoskeletons. First, optimal assistance strategies that can theoretically minimize MC, were derived from forward muscle-driven simulations on an open-source dataset. Then, a neural network was utilized to explore the relationships among different individuals, movements, and optimal strategies, thus developing a predictive model. Results: With respect to transfer learning, our approach exhibited effectiveness and adaptability when faced with new individuals and movements. The simulation results further indicated that our approach successfully reduced the MC of calf muscles by approximately 20% compared to normal walking conditions. Discussion: This hybrid approach offers an alternative for personalizing assistance strategy that may further guide exoskeleton design.

Conceptualization of Cloud-Based Motion Analysis and Navigation for Wearable Robotic Applications.

The behavior of pedestrians in a non-constrained environment is difficult to predict. In wearable robotics, this poses a challenge, since devices like lower-limb exoskeletons and active orthoses need to support different walking activities, including level walking and climbing stairs. While a fixed movement trajectory can be easily supported, switches between these activities are difficult to predict. Moreover, the demand for these devices is expected to rise in the years ahead. In this work, we propose a cloud software system for use in wearable robotics, based on geographical mapping techniques and Human Activity Recognition (HAR). The system aims to give context to the surrounding pedestrians by providing hindsight information. The system was partially implemented and tested. The results indicate a viable concept with great extensibility prospects.

Physiotherapy-assisted overground exoskeleton use: mixed methods feasibility study protocol quantifying the user experience, as well as functional, neural, and muscular outcomes in children with mobility impairments.

Early phase research suggests that physiotherapy paired with use of robotic walking aids provides a novel opportunity for children with severe mobility challenges to experience active walking. The Trexo Plus is a pediatric lower limb exoskeleton mounted on a wheeled walker frame, and is adjustable to fit a child's positional and gait requirements. It guides and powers the child's leg movements in a way that is individualized to their movement potential and upright support needs, and can provide progressive challenges for walking within a physiotherapy-based motor learning treatment paradigm. This protocol outlines a single group mixed-methods study that assesses the feasibility of physiotherapy-assisted overground Trexo use in school and outpatient settings during a 6-week physiotherapy block. Children ages 3-6 years (n = 10; cerebral palsy or related disorder, Gross Motor Function Classification System level IV) will be recruited by circle of care invitations to participate. Study indicators/outcomes will focus on evaluation of: (i) clinical feasibility, safety, and acceptability of intervention; (ii) pre-post intervention motor/functional outcomes; (iii) pre-post intervention brain structure characterization and resting state brain connectivity; (iv) muscle activity characterization during Trexo-assisted gait and natural assisted gait; (v) heart rate during Trexo-assisted gait and natural assisted gait; and (vi) user experience and perceptions of physiotherapists, children, and parents. This will be the first study to investigate feasibility indicators, outcomes, and experiences of Trexo-based physiotherapy in a school and outpatient context with children who have mobility challenges. It will explore the possibility of experience-dependent neuroplasticity in the context of gait rehabilitation, as well as associated functional and muscular outcomes. Finally, the study will address important questions about clinical utility and future adoption of the device from the physiotherapists' perspective, comfort and engagement from the children's perspective, and the impressions of parents about the value of introducing this technology as an early intervention. https://clinicaltrials.gov, identifier NCT05463211.

Advancing healthy aging in times of sustainability: The role of lower-limb exoskeletons in gerontechnology

Advancing healthy aging in times of sustainability: The role of lower-limb exoskeletons in gerontechnology

Predicting sit-to-stand motions with a deep reinforcement learning based controller under idealized exoskeleton assistance

AbstractMaintaining the capacity for sit-to-stand transitions is paramount for preserving functional independence and overall mobility in older adults and individuals with musculoskeletal conditions. Lower limb exoskeletons have the potential to play a significant role in supporting this crucial ability. In this investigation, a deep reinforcement learning (DRL) based sit-to-stand (STS) controller is developed to study the biomechanics of STS under both exoskeleton assisted and unassisted scenarios. Three distinct conditions are explored: 1) Hip joint assistance (H-Exo), 2) Knee joint assistance (K-Exo), and 3) Hip-knee joint assistance (H+K-Exo). By utilizing a generic musculoskeletal model, the STS joint trajectories generated under these scenarios align with unassisted experimental observations. We observe substantial reductions in muscle activations during the STS cycle, with an average decrease of 68.63% and 73.23% in the primary hip extensor (gluteus maximus) and primary knee extensor (vasti) muscle activations, respectively, under H+K-Exo assistance compared to the unassisted STS scenario. However, the H-Exo and K-Exo scenarios reveal unexpected increases in muscle activations in the hamstring and gastrocnemius muscles, potentially indicating a compensatory mechanism for stability. In contrast, the combined H+K-Exo assistance demonstrates a noticeable reduction in the activation of these muscles. These findings underscore the potential of sit-to-stand assistance, particularly in the combined hip-knee exoskeleton scenario, and contribute valuable insights for the development of robust DRL-based controllers for assistive devices to improve functional outcomes.

Design of a brain-machine interface for reducing false activations of a lower-limb exoskeleton based on error related potential

Background and objectiveBrain-Machine Interfaces (BMIs) based on a motor imagination paradigm provide an intuitive approach for the exoskeleton control during gait. However, their clinical applicability remains difficulted by accuracy limitations and sensitivity to false activations. A proposed improvement involves integrating the BMI with methods based on detecting Error Related Potentials (ErrP) to self-tune erroneous commands and enhance not only the system accuracy, but also its usability. The aim of the current research is to characterize the ErrP at the beginning of the gait with a lower limb exoskeleton to reduce the false starts in the BMI system. Furthermore, this study is valuable for determining which type of feedback, Tactile, Visual, or Visuo-Tactile, achieves the best performance in evoking and detecting the ErrP. MethodsThe initial phase of the research concentrates on detecting ErrP at the beginning of gait to improve the efficiency of an asynchronous BMI based on motor imagery (BMI-MI) to control a lower limb exoskeleton. Initially, an experimental protocol is designed to evoke ErrP at the start of gait, employing three different stimuli: Tactile, Visual, and Visuo-Tactile. An iterative selection process is then utilized to characterize ErrP in both time and frequency domains and fine-tune various parameters, including electrode distribution, feature combinations, and classifiers. A generic classifier with 6 subjects is employed to configure an ensemble classification system for detecting ErrP and reducing the false starts. ResultsThe ensembled system configured with the selected parameters yields an average correction of false starts of 72.60 % ± 10.23, highlighting its corrective efficacy. Tactile feedback emerges as the most effective stimulus, outperforming Visual and Visuo-Tactile feedback in both training types. ConclusionsThe results suggest promising prospects for reducing the false starts when integrating ErrP with BMI-MI, employing Tactile feedback. Consequently, the security of the system is enhanced. Subsequent, further research efforts will focus on detecting error potential during movement for gait stop, in order to limit undesired stops.

Modeling and Strength Calculations of Parts Made Using 3D Printing Technology and Mounted in a Custom-Made Lower Limb Exoskeleton.

This study is focused on the application of 3D-printed elements and conventional elements to create a prototype of a custom-made exoskeleton for lower limb rehabilitation. The 3D-printed elements were produced by using Fused Deposition Modeling technology and acrylonitrile butadiene styrene (ABS) material. The scope of this work involved the design and construction of an exoskeleton, experimental testing of the ABS material and numerical research by using the finite element method. On the basis of the obtained results, it was possible to deduce whether the load-bearing 3D-printed elements can be used in the proposed mechanical construction. The work contains full data of the material models used in FEM modeling, taking into account the orthotropic properties of the ABS material. Various types of finite elements were used in the presented FE models. The work is a comprehensive combination of material testing issues with the possibility of implementing the obtained results in numerical strength models of machine parts.

Enhanced Euler–Lagrange Formulation for Analyzing Human Gait With Moving Base Reference

Abstract Euler–Lagrange's formulation is known for its systematic and simplified approach to deriving dynamics of complex systems. In order to apply the existing formulation to human gait dynamics, the base reference frame must be assumed as an inertial reference frame. Conventionally, the ankle joints or the hip joints are regarded as base reference frames during the stance and swing phases of human walking. As these joints are non-inertial in nature during actual locomotion, this assumption could result in inaccurate calculation of lower-limb joint torques and forces. Therefore, in this paper, an existing Euler–Lagrange-based formulation originally developed for fixed-base robotic manipulators is considered and modified to accommodate the movement of the base reference frame with respect to an inertial frame of reference defined outside the human body. The applicability of the modified formulation is studied, implemented, and validated using three standard and publicly available gait datasets covering the phases of walking and running. The joint torques obtained using the proposed dynamic model are compared with reference torques by calculating the mean absolute error values and visually through Bland–Altman plots. The obtained joint torque values and plots indicate a close agreement with published torques, thereby validating the accuracy of the proposed dynamic model. The robust formulation implementation makes it a valuable resource for researchers in this field, offering a reliable framework for gait analysis and the design of lower-limb prosthetics or exoskeletons.

Convolution‐enhanced vision transformer method for lower limb exoskeleton locomotion mode recognition

AbstractProviding the human body with smooth and natural assistance through lower limb exoskeletons is crucial. However, a significant challenge is identifying various locomotion modes to enable the exoskeleton to offer seamless support. In this study, we propose a method for locomotion mode recognition named Convolution‐enhanced Vision Transformer (Conv‐ViT). This method maximizes the benefits of convolution for feature extraction and fusion, as well as the self‐attention mechanism of the Transformer, to efficiently capture and handle long‐term dependencies among different positions within the input sequence. By equipping the exoskeleton with inertial measurement units, we collected motion data from 27 healthy subjects, using it as input to train the Conv‐ViT model. To ensure the exoskeleton's stability and safety during transitions between various locomotion modes, we not only examined the typical five steady modes (involving walking on level ground [WL], stair ascent [SA], stair descent [SD], ramp ascent [RA], and ramp descent [RD]) but also extensively explored eight locomotion transitions (including WL‐SA, WL‐SD, WL‐RA, WL‐RD, SA‐WL, SD‐WL, RA‐WL, RD‐WL). In tasks involving the recognition of five steady locomotions and eight transitions, the recognition accuracy reached 98.87% and 96.74%, respectively. Compared with three popular algorithms, ViT, convolutional neural networks, and support vector machine, the results show that the proposed method has the best recognition performance, and there are highly significant differences in accuracy and F1 score compared to other methods. Finally, we also demonstrated the excellent performance of Conv‐ViT in terms of generalization performance.

Exploration of deep learning-driven multimodal information fusion frameworks and their application in lower limb motion recognition

Research on Lower Limb Motion Recognition (LLMR) based on various wearable sensors has been widely applied in exoskeleton robots, exercise rehabilitation, etc. Typically, employing multimodal information tends to yield higher accuracy and stronger robustness compared to using unimodal information. Due to the inevitable reliance on feature engineering in shallow machine learning-based LLMR methods, this study leverages the powerful non-linear feature mapping capability of deep learning (DL) to construct several end-to-end LLMR frameworks, including: Convolutional Neural Networks (CNNs), CNN-Recurrent Neural Networks (RNNs) and CNN-Graph Neural Networks (GNNs). The effectiveness of the proposed frameworks is verified in distinct tasks, including the recognition of seven types of lower limb motions in healthy subjects and three types of motions in patients with stroke, as well as the phase recognition task during the sit-to-stand (SitTS) process in patients with stroke, achieving the highest mean accuracy of 95.198 %, 99.784 %, and 99.845 %, respectively. Further research and integration of two transfer learning techniques, adaptive Batch Normalization (BN) and model fine-tuning, significantly enhance the applicability of the proposed frameworks in inter-subject prediction. Additionally, systematic analyses are conducted to assess the strengths and weaknesses of different models in terms of recognition performance, complexity, and adaptability to variations in the number of modalities and sensor channels. Experimental results indicate that the proposed frameworks hold promise in providing potential support for the development of human-robot collaborative lower limb exoskeletons or rehabilitation robots.

Active Power Assist with Equivalent Force on Connection for Lower Limb Exoskeleton Robots

Active power-assist lower limb exoskeleton robots aim to enhance wearer assistance while ensuring wearer comfort and simplifying the exoskeleton’s design and control. This study proposes an active assistance method known as Equivalent Force on Connection (EFOC). The EFOC method effectively addresses the limitations encountered in conventional Joint Torque Proportional Compensation (JTPC) approaches. These limitations include the necessity for exoskeleton robot configurations to align with human limb structures for parallel assistance at each lower limb joint, as well as the exoskeleton’s inability to contribute a greater proportion of assistance due to the excessive load on specific skeletal and muscular structures, resulting in wearer discomfort. Furthermore, the effectiveness of the EFOC method is evaluated and validated for assistance during both the stance and swing phases of single-leg movements. Finally, the proposed EFOC method is implemented on a hydraulic-driven lower limb exoskeleton robot to assist wearers in squatting, stepping, and jumping locomotion. The experimental results demonstrate that the proposed EFOC method can effectively achieve the desired assistance effect.