Occupational exoskeletons have the potential to prevent work-related musculoskeletal disorders. Their widespread adoption should be promoted by investigating their long-term innocuity, sustained effectiveness, and practicability. This article presents a six-months longitudinal study exploring effects of an arm support exoskeleton (ASE) on six male workers, examining potential side effects, ASE's effectiveness, and its integration into daily work practices. Monthly clinical visits were scheduled to monitor workers’ health. Effectiveness, usability and acceptance metrics were collected at the beginning of the study and after six months. No side effects were found in clinical metrics during the study. Significant reductions, consistent overtime, were observed in shoulder muscle activity (up to 30%) and in effort perception-related metrics (up to 2.4 out of 10 points). Usage time settled around 10% of the monthly work-shift and gradually decreased possibly due to external factors (e.g., social, motivational, and seasonal factors) beyond researchers' control. Results encourage the continuation of similar investigations to strengthen these findings and promote the use of occupational exoskeletons.

Most individuals who experience a stroke exhibit several sensorimotor impairments that limit their independence in everyday activities. Hemiparetic gait is frequently characterized by reduced knee flexion in swing due to knee stiffness or muscle weakness and knee hyperextension or knee buckling in the stance phase. Recently, unilateral-powered orthoses have been designed to overcome the limitations of the passive knee-ankle-foot orthoses. This study presents a unilateral Active Knee Orthosis Exoskeleton, AKO-$\beta$, endowed with a series elastic actuator and designed to assist the knee in flexion and extension movements. The paper describes the system mechatronic design and its characterization on the bench, the control system, and pilot experiments with three post-stroke participants. The device has a weight of 1.78 kg on the user's leg, with a lateral encumbrance of 76 mm. The pilot experiments aimed to verify the effects of the exoskeleton assistance in hemiparetic gait patterns. When walking with the device, participants on average increased the knee flexion on the paretic side by 18.70 deg (+44.9%) during swing and decreased knee hyperextension in stance by 4.50 deg, compared to walking without it. Overall, when walking with the exoskeleton, subjects showed improved Gait Variable Score of the paretic knee profile by 37.5% compared to walking without it. The temporal and spatial gait symmetry indexes did not show clear changes, although an improvement in symmetry was observed in two of the three participants. These preliminary results suggest the potential benefits of the unilateral Active Knee Orthosis exoskeleton to enhance and restore mobility in individuals with hemiparetic gait.

Robotic lower limb prostheses have the power to revolutionize mobility by enhancing gait efficiency and facilitating movement. While several design approaches have been explored to create lightweight and energy-efficient devices, the potential of underactuation remains largely untapped in lower limb prosthetics. Taking inspiration from the natural harmony of walking, in this article, we have developed an innovative active transfemoral prosthesis. By incorporating underactuation, our design uses a single power actuator placed near the knee joint and connected to a differential mechanism to drive both the knee and ankle joints. We conduct comprehensive benchtop tests and evaluate the prosthesis with three individuals who have above-knee amputations, assessing its performance in walking, stair climbing, and transitions between sitting and standing. Our evaluation focuses on gathering position and torque data recorded from sensors integrated into the prosthesis and comparing these measurements to biomechanical data of able-bodied locomotion. Our findings highlight the promise of underactuation in advancing lower limb prosthetics and demonstrate the feasibility of our knee–ankle underactuated design in various tasks, showcasing its ability to replicate natural movement.

Lower-limb exoskeletons are wearable devices whose main purposes are human rehabilitation and bilateral locomotion assistance. In particular, there is a growing interest for their use to symmetrize the gait of hemiparetic patients. This often consists in using the kinematics of the less affected side as a reference for the most affected one. In this work, we followed this approach to design a symmetrization algorithm using the formalism of motor primitives, i.e. a low-dimensional set of signals that provide the desired assistance through their combination. The amount of variables to be stored in memory is thus intrinsically limited, and this framework is particularly adapted to include other modes of assistance and/or transitions between locomotion tasks. In this paper, we report the preliminary validation of this newly developed algorithm with a hip exoskeleton and a single participant replicating hemiparetic walking. Results show that the algorithm effectively managed to reduce both temporal and spatial gait asymmetry.

Lower-limb exoskeletons are robotic devices that can provide assistance to human locomotion. Since they are expected to be used in ecological environments, their control strategy should handle different kinds of daily-life situations. Taking inspiration from the human neuromuscular system - and particularly from the socalled motor primitives - may help in adapting the type of delivered assistance to different locomotion tasks. In this work, we validated the combination of simplified primitives and a musculoskeletal model for assisting healthy subjects with a hip exoskeleton. This framework showed adaptation to the user's gait for different slope inclinations, although its effects on the subject's speed and their perceived effort showed no significant improvement compared to wearing the device in transparent mode.

For a lower limb exoskeleton, accurate and continuous estimation of the gait phase in real time is a fundamental requirement to provide a well-tailored assistive action at the proper time in the gait cycle (GC). This article presents a new gait phase estimator for a portable hip exoskeleton based on discrete wavelet transform (DWT) and adaptive oscillators. The algorithm is capable of continuously tracking the gait phase and identifying the relevant biomechanical gait events online, i.e., heel strike (HS) and toe-off (TO). The proposed method exploits only the hip joint angle signals measured by hip encoders, avoiding the need to use additional sensors to those already built in the exoskeleton. The novel phase estimator has been benchmarked against a state-of-the-art method, based on the maximum flexion angle (MFA), with pressure-sensitive insoles used as the reference ground truth for the event detection. To validate the method, two experimental activities were carried out. Experiments conducted with eight healthy subjects walking on a treadmill at different speeds, with and without hip assistance, demonstrated that the DWT-based method outperformed the MFA method in all operative conditions, reducing the rms of the phase reset error by 64.0% in assistive mode, and identifying the HS and TO events with low delay (0.4% and 1.1% GC, respectively, for HS and TO). Experiments carried out with three transfemoral amputees showed similar performance, paving the way for clinical applications of the method.

Dynamic control of robotic exoskeletons is paramount to ensuring safe, synergistic assistive action of functional benefit to users. To date, exoskeleton controllers have excelled in rhythmic and quasi-rhythmic tasks, whereas control methods for assisting discrete movements remain limited by their task-specificity. Inspired by neurophysiological dynamic movement primitives (DMPs), we formulated a novel controller that facilitated a variety of lifting movements using a singleadaptiveDMP (aDMP), for wearable robotic assistance of discrete movements. For a variety of load lifting tasks, we first benchmarked our method's trajectory prediction accuracy against the state-of-the-art DMP using passively recorded exoskeleton sensor data (offline), followed by a functional validation of online aDMP trajectory estimates. Finally, we assessed the functional effects of aDMP-based exoskeletal assistance on joint kinematics and muscular activity during repetitive lifting. The new aDMP method accurately predicted and smoothly synchronized robotic assistance with variable movement trajectories, resulting in reduced muscular activation of the erector spinae muscles (up to 47.6%) while preserving lower-limb joint kinematics and reducing the extension time by 15.5% compared to unassisted conditions. This method holds promise for use in a wide range of wearable robotic applications, including both clinical rehabilitation and user assistance in activities of daily living and/or manual labor.

The soft exosuit is a new approach for applying assistive forces over the wearer's body through load paths configured by the textile architecture. In this paper, we present a body-worn lower-extremity soft exosuit and a new control approach that can independently control the level of assistance that is provided during negative- and positive-power periods at the ankle. The exosuit was designed to create load paths assisting ankle plantarflexion and hip flexion, and the actuation system transmits forces from the motors to the suit via Bowden cables. A load cell and two gyro sensors per leg are used to measure real-time data, and the controller performs position control of the cable on a step-by-step basis with respect to the power delivered to the wearer's ankle by controlling two force parameters, the pretension and the active force. Human subjects testing results demonstrate that the controller is capable of modulating the amount of power delivered to the ankle joint. Also, significant reductions in metabolic rate (11%-15%) were observed, which indicates the potential of the proposed control approach to provide benefit to the wearer during walking.