Exoskeletons, orthoses, exosuits, assisting robots and such devices referred to as wearable assistive devices are devices designed to augment or protect the human body by applying and transmitting force. Due to the problems concerning cost- and time-consuming user tests, in addition to the possibility to test different configurations of a device, the avoidance of a prototype and many more advantages, digital human models become more and more popular for evaluating the effects of wearable assistive devices on humans. The key indicator for the efficiency of assistance is the interface between device and human, consisting mainly of the soft biological tissue. However, the soft biological tissue is mostly missing in digital human models due to their rigid body dynamics. Therefore, this systematic review aims to identify interaction modelling approaches between wearable assistive devices and digital human models and especially to study how the soft biological tissue is considered in the simulation. The review revealed four interaction modelling approaches, which differ in their accuracy to recreate the occurring interactions in reality. Furthermore, within these approaches there are some incorporating the appearing relative motion between device and human body due to the soft biological tissue in the simulation. The influence of the soft biological tissue on the force transmission due to energy absorption on the other side is not considered in any publication yet. Therefore, the development of an approach to integrate the viscoelastic behaviour of soft biological tissue in the digital human models could improve the design of the wearable assistive devices and thus increase its efficiency and efficacy.

The individualization of patient-specific ankle joint orthoses is becoming increasingly important and can be ideally realized by means of additive manufacturing. However, currently, there are no functional additively manufactured fiber-reinforced products that are used in the field of orthopedic treatment. In this paper, an approach as to how additively manufactured orthopedic products can be designed and produced quickly and flexibly in the future is presented. This is demonstrated using the example of a solid ankle–foot orthosis. For this purpose, test results on PETG-CF15, which were determined in a previous work, were integrated into a material map for an FEA simulation. Therewith, the question can be answered as to whether production parameters that were determined at the test specimen level can also be adapted to real, usable components. Furthermore, gait recordings were used as loading conditions to obtain exact results for the final product. In order to perfectly adapt the design of the splint to the user, a 3D scan of a foot was performed to obtain a perfect design space for topology optimization. This resulted in a patient-specific and stiffness-optimized product. Subsequently, it was demonstrated that the orthosis could be manufactured using fused layer modelling. Finally, a comparison between the conventional design and the consideration of AM-specific properties was made. On this basis, it can be stated that the wearing comfort of the patient-specific design is very good, but the tightening of the splint still needs to be improved.

Biomechanical simulation allows for in silico estimations of biomechanical parameters such as muscle, joint and ligament forces. Experimental kinematic measurements are a prerequisite for musculoskeletal simulations using the inverse kinematics approach. Marker-based optical motion capture systems are frequently used to collect this motion data. As an alternative, IMU-based motion capture systems can be used. These systems allow flexible motion collection without nearly any restriction regarding the environment. However, one limitation with these systems is that there is no universal way to transfer IMU data from arbitrary full-body IMU measurement systems into musculoskeletal simulation software such as OpenSim. Thus, the objective of this study was to enable the transfer of collected motion data, stored as a BVH file, to OpenSim 4.4 to visualize and analyse the motion using musculoskeletal models. By using the concept of virtual markers, the motion saved in the BVH file is transferred to a musculoskeletal model. An experimental study with three participants was conducted to verify our method’s performance. Results show that the present method is capable of (1) transferring body dimensions saved in the BVH file to a generic musculoskeletal model and (2) correctly transferring the motion data saved in the BVH file to a musculoskeletal model in OpenSim 4.4.

Working at and above head height with a power tool represents a common activity in craft and assembly applications. To assist and protect the user from overload and injuries in these situations, the development and use of application-specific support systems, such as exoskeletons and power tools, have greatly increased in recent years. Thus, the integration of aspects of the user-centered product development of support systems in the early phases of product development process has high potentials. A common approach to integrate the user early in the product development process is the use of musculoskeletal human models, which allow the evaluation of effects on the human body. This could also be applicable in the mentioned use case to enable the evaluation of the interactions for the user. Therefore, a co-simulation model for virtual modelling and simulating human–machine interactions is presented. The co-simulation model is made up of a musculoskeletal human model and the models of the technical systems (exoskeleton and power tool). By applying the co-simulation model, the impact of technical systems on the human body can be taken into account to derive design alternatives for the technical system due to the requirements of the user. The paper describes the design of the co-simulation model and particularly, the interaction of the submodels. The evaluation of the co-simulation model is carried out with the help of a subject study for the selected use case working at and above head height. The results show plausible results for the muscle loads considering the support by an exoskeleton. Furthermore, the comparison of simulated results to measured muscle activations via surface electromyography shows a good agreement. Thus, the co-simulation model passes the test for functionality and seems to be applicable for the derivation of design alternatives of technical systems regarding the user needs. In future, the co-simulation model will be further validated with a higher number of subjects and to implement design alterations in the technical systems.

Patients who suffer from foot drop have impaired gait pattern functions and a higher risk of stumbling and falling. Therefore, they are usually treated with an assistive device, a so-called ankle–foot orthosis. The support of the orthosis should be in accordance with the motor requirements of the patient and should only be provided when needed, which is referred to as assistance-as-needed. Thus, in this publication, an approach is presented to determine the assistance-as-needed support using musculoskeletal human models. Based on motion capture recordings of multiple subjects performing gaits at different speeds, a parameter study varying the optimal force of a reserve actuator representing the ankle–foot orthosis added in the musculoskeletal simulation is conducted. The results show the dependency of the simulation results on the selected optimal force of the reserve actuator but with a possible identification of the assistance-as-needed support required from the ankle–foot orthosis. The required increase in support due to the increasing severity of foot drop is especially demonstrated with the approach. With this approach, information for the required support of individual subjects can be gathered, which can further be used to derive the design of an ankle–foot orthosis that optimally assists the subjects.

Simulation models are a valuable tool for exoskeleton development, especially for system optimization and evaluation. It allows an assessment of the performance and effectiveness of exoskeletons even at an early stage of their development without physical realization. Due to the closed physical interaction between the exoskeleton and the user, accurate modeling of the human–exoskeleton interaction in defined scenarios is essential for exoskeleton simulations. This paper presents a novel approach to simulate exoskeleton motion in response to human motion and the interaction forces at the physical interfaces between the human and the exoskeleton. Our approach uses a multibody model of a shoulder exoskeleton in MATLAB R2021b and imports human motion via virtual markers from a digital human model to simulate human–exoskeleton interaction. To validate the human-motion-based approach, simulated exoskeleton motion and interaction forces are compared with experimental data from a previous lab study. The results demonstrate the feasibility of our approach to simulate human–exoskeleton interaction based on human motion. In addition, the approach is used to optimize the support profile of an exoskeleton, indicating its potential to assist exoskeleton development prior to physical prototyping.