Background: In order to reduce the risk of work-related musculoskeletal disorders (WMSDs) several methods have been developed, accepted by the international literature and used in the workplace. The purpose of this systematic review was to describe recent implementations of wearable sensors for quantitative instrumental-based biomechanical risk assessments in prevention of WMSDs. Methods: Articles written until 7 May 2018 were selected from PubMed, Scopus, Google Scholar and Web of Science using specific keywords. Results: Instrumental approaches based on inertial measurement units and sEMG sensors have been used for direct evaluations to classify lifting tasks into low and high risk categories. Wearable sensors have also been used for direct instrumental evaluations in handling of low loads at high frequency activities by using the local myoelectric manifestation of muscle fatigue estimation. In the field of the rating of standard methods, on-body wireless sensors network-based approaches for real-time ergonomic assessment in industrial manufacturing have been proposed. Conclusions: Few studies foresee the use of wearable technologies for biomechanical risk assessment although the requirement to obtain increasingly quantitative evaluations, the recent miniaturization process and the need to follow a constantly evolving manual handling scenario is prompting their use.

We present an avatar system designed to facilitate the embodiment of humanoid robots by human operators, validated through iCub3, a humanoid developed at the Istituto Italiano di Tecnologia. More precisely, the paper makes two contributions: First, we present the humanoid iCub3 as a robotic avatar that integrates the latest significant improvements after about 15 years of development of the iCub series. Second, we present a versatile avatar system enabling humans to embody humanoid robots encompassing aspects such as locomotion, manipulation, voice, and facial expressions with comprehensive sensory feedback including visual, auditory, haptic, weight, and touch modalities. We validated the system by implementing several avatar architecture instances, each tailored to specific requirements. First, we evaluated the optimized architecture for verbal, nonverbal, and physical interactions with a remote recipient. This testing involved the operator in Genoa and the avatar in the Biennale di Venezia, Venice—about 290 kilometers away—thus allowing the operator to visit the Italian art exhibition remotely. Second, we evaluated the optimized architecture for recipient physical collaboration and public engagement on stage, live, at the We Make Future show, a prominent world digital innovation festival. In this instance, the operator was situated in Genoa while the avatar operated in Rimini—about 300 kilometers away—interacting with a recipient who entrusted the avatar with a payload to carry on stage before an audience of approximately 2000 spectators. Third, we present the architecture implemented by the iCub Team for the All Nippon Airways (ANA) Avatar XPrize competition.

Due to the epochal changes introduced by “Industry 4.0”, it is getting harder to apply the varying approaches for biomechanical risk assessment of manual handling tasks used to prevent work-related musculoskeletal disorders (WMDs) considered within the International Standards for ergonomics. In fact, the innovative human–robot collaboration (HRC) systems are widening the number of work motor tasks that cannot be assessed. On the other hand, new sensor-based tools for biomechanical risk assessment could be used for both quantitative “direct instrumental evaluations” and “rating of standard methods”, allowing certain improvements over traditional methods. In this light, this Letter aims at detecting the need for revising the standards for human ergonomics and biomechanical risk assessment by analyzing the WMDs prevalence and incidence; additionally, the strengths and weaknesses of traditional methods listed within the International Standards for manual handling activities and the next challenges needed for their revision are considered. As a representative example, the discussion is referred to the lifting of heavy loads where the revision should include the use of sensor-based tools for biomechanical risk assessment during lifting performed with the use of exoskeletons, by more than one person (team lifting) and when the traditional methods cannot be applied. The wearability of sensing and feedback sensors in addition to human augmentation technologies allows for increasing workers’ awareness about possible risks and enhance the effectiveness and safety during the execution of in many manual handling activities.

Background: Balance impairment is a common disability in post-stroke survivors, leading to reduced mobility and increased fall risk. Robotic gait training (RAGT) is largely used, along with traditional training. There is, however, no strong evidence about RAGT superiority, especially on balance. This study aims to determine RAGT efficacy on balance of post-stroke survivors. Methods: PubMed, Cochrane Library, and PeDRO databases were investigated. Randomized clinical trials evaluating RAGT efficacy on post-stroke survivor balance with Berg Balance Scale (BBS) or Timed Up and Go test (TUG) were searched. Meta-regression analyses were performed, considering weekly sessions, single-session duration, and robotic device used. Results: A total of 18 trials have been included. BBS pre-post treatment mean difference is higher in RAGT-treated patients, with a pMD of 2.17 (95% CI 0.79; 3.55). TUG pre-post mean difference is in favor of RAGT, but not statistically, with a pMD of −0.62 (95%CI − 3.66; 2.43). Meta-regression analyses showed no relevant association, except for TUG and treatment duration (β = −1.019, 95% CI − 1.827; −0.210, p-value = 0.0135). Conclusions: RAGT efficacy is equal to traditional therapy, while the combination of the two seems to lead to better outcomes than each individually performed. Robot-assisted balance training should be the focus of experimentation in the following years, given the great results in the first available trials. Given the massive heterogeneity of included patients, trials with more strict inclusion criteria (especially time from stroke) must be performed to finally define if and when RAGT is superior to traditional therapy.

Occupational exoskeletons are becoming a concrete solution to mitigate work-related musculoskeletal disorders associated with manual material handling activities. The rationale behind this study is to search for common ground for exoskeleton evaluators to engage in dialogue with corporate Health & Safety professionals while integrating exoskeletons with their workers. This study suggests an innovative interpretation of the effect of a lower-back assistive exoskeleton and related performances that are built on the benefit delivered through reduced activation of the erector spinae musculature. We introduce the concept of “equivalent weight” as the weight perceived by the wearer, and use this to explore the apparent reduced effort needed when assisted by the exoskeleton. Therefore, thanks to this assistance, the muscles experience a lower load. The results of the experimental testing on 12 subjects suggest a beneficial effect for the back that corresponds to an apparent reduction of the lifted weight by a factor of $37.5\%$ (the perceived weight of the handled objects is reduced by over a third). Finally, this analytical method introduces an innovative approach to quantify the ergonomic benefit introduced by the exoskeletons’ assistance. This aims to assess the ergonomic risk to support the adoption of exoskeletons in the workplace.