In the EU, lower back pain affects more than 40% of the working population. Mechanical loading of the lower back has been shown to be an important risk factor. Peak mechanical load can be reduced by ergonomic interventions, the use of cranes and, more recently, by the use of exoskeletons. Despite recent advances in the development of exoskeletons for industrial applications, they are not widely adopted by industry yet. Some of the challenges, which have to be overcome are a reduced range of motion, misalignment between the human anatomy and kinematics of the exoskeleton as well as discomfort. A body of research exists on how an exoskeleton can be designed to compensate for misalignment and thereby improve comfort. However, how to design an exoskeleton that achieves a similar range of motion as a human lumbar spine of up to 60° in the sagittal plane, has not been extensively investigated. We addressed this need by developing and testing a novel passive back support exoskeleton, including a mechanism comprised of flexible beams, which run in parallel to the spine, providing a large range of motion and lowering the peak torque requirements around the lumbo-sacral (L5/S1) joint. Furthermore, we ran a pilot study to test the biomechanical (N = 2) and functional (N = 3) impact on subjects while wearing the exoskeleton. The biomechanical testing was once performed with flexible beams as a back interface and once with a rigid structure. An increase of more than 25% range of motion of the trunk in the sagittal plane was observed by using the flexible beams. The pilot functional tests, which are compared to results from a previous study with the Laevo device, suggest, that the novel exoskeleton is perceived as less hindering in almost all tested tasks.

The use of exoskeletons by the elderly, disabled people, heavy labor workers, and soldiers can have great social and economic benefit. However, limitations in usability are impeding the widespread adoption of exoskeletal devices. Kinematic compatibility, comfort, volume, mass, simplicity, expandability, and the ability to transmit forces, relative angles between the exoskeleton and the human, and the donning and doffing procedure need to be considered. Over the last decades, a large number of exoskeletons have been developed, to assert kinematic compatibility and compensate for misalignment. To such a degree, that it has become difficult to keep an overview of the different strategies. Therefore, this review article presents an extensive overview of different misalignment compensation strategies existing in the literature. Further, these strategies are organized in nine categories, evaluated and discussed around the exoskeleton's application domain and its specific requirements and needs.

To provide an overview of protocols assessing the effect of occupational exoskeletons on users and to formulate recommendations towards a literature-based assessment framework to benchmark the effect of occupational exoskeletons on the user. PubMed (MEDLINE), Web of Science database and Scopus were searched (March 2, 2021). Studies were included if they investigated the effect of one or more occupational exoskeletons on the user. In total, 139 eligible studies were identified, encompassing 33, 25 and 18 unique back, shoulder and other exoskeletons, respectively. Device validation was most frequently conducted using controlled tasks while collecting muscle activity and biomechanical data. As the exoskeleton concept matures, tasks became more applied and the experimental design more representative. With that change towards realistic testing environments came a trade-off with experimental control, and user experience data became more valuable. This evidence mapping systematic review reveals that the assessment of occupational exoskeletons is a dynamic process, and provides literature-based assessment recommendations. The homogeneity and repeatability of future exoskeleton assessment experiments will increase following these recommendations. The current review recognises the value of variability in evaluation protocols in order to obtain an overall overview of the effect of exoskeletons on the users, but the presented framework strives to facilitate benchmarking the effect of occupational exoskeletons on the users across this variety of assessment protocols.

Sensors and actuators are the core components of all mechatronic systems used in a broad range of diverse applications. A relatively new and rapidly evolving area is the one of rehabilitation and assistive devices that comes to support and improve the quality of human life. Novel exoskeletons have to address many functional and cost-sensitive issues such as safety, adaptability, customization, modularity, scalability, and maintenance. Therefore, a smart variable stiffness actuator was developed. The described approach was to integrate in one modular unit a compliant actuator with all sensors and electronics required for real-time communications and control. This paper also introduces a new method to estimate and control the actuator's torques without using dedicated expensive torque sensors in conditions where the actuator's torsional stiffness can be adjusted by the user. A 6-degrees-of-freedom exoskeleton was assembled and tested using the technology described in this paper, and is introduced as a real-life case study for the mechatronic design, modularity, and integration of the proposed smart actuators, suitable for human-robot interaction. The advantages are discussed together with possible improvements and the possibility of extending the presented technology to other areas of mechatronics.

Objective: This paper assesses the effect of a passive shoulder exoskeleton prototype, Exo4Work, on muscle activity, muscle fatigue and subjective experience during simulated occupational overhead and non-overhead work. Methods: Twenty-two healthy males performed six simulated industrial tasks with and without Exo4Work exoskeleton in a randomized counterbalanced cross-over design. During these tasks electromyography, heart rate, metabolic cost, subjective parameters and performance parameters were acquired. The effect of the exoskeleton and the body side on these parameters was investigated. Results: Anterior deltoid activity and fatigue reduced up to 16% and 41%, respectively, during isometric overhead work, and minimized hindrance of the device during non-overhead tasks. Wearing the exoskeleton increased feelings of frustration and increased discomfort in the areas where the exoskeleton and the body interfaced. The assistive effect of the exoskeleton was less prominent during dynamic tasks. Conclusion: This exoskeleton may reduce muscle activity and delay development of muscle fatigue in an overhead working scenario. For dynamic applications, the exoskeleton’s assistive profile, which mimics the gravitational torque of the arm, is potentially sub-optimal. Significance: This evaluation paper is the first to report reduced muscle fatigue and activity when working with an occupational shoulder exoskeleton providing one third of the gravitational torque of the arm during overhead work. These results stress the potential of occupational shoulder exoskeletons in overhead working situations and may direct towards longitudinal field experiments. Additionally, this experiment may stimulate future work to further investigate the effect of different assistive profiles.

Human–robot interaction sensing is a compulsory feature in modern robotic systems where direct contact or close collaboration is desired. Rehabilitation and assistive robotics are fields where interaction forces are required for both safety and increased control performance of the device with a more comfortable experience for the user. In order to provide an efficient interaction feedback between the user and rehabilitation device, high performance sensing units are demanded. This work introduces a novel design of a multi-axis force sensor dedicated for measuring pelvis interaction forces in a rehabilitation exoskeleton device. The sensor is conceived such that it has different sensitivity characteristics for the three axes of interest having also movable parts in order to allow free rotations and limit crosstalk errors. Integrated sensor electronics make it easy to acquire and process data for a real-time distributed system architecture. Two of the developed sensors are integrated and tested in a complex gait rehabilitation device for safe and compliant control.