A Survey in the Different Designs of Passive Exoskeletons for Lower Extremities

Document Type : Review Article

Authors

1 Department of mechanical Engineering, Faculty of Technology and Engineering, Tehran central Branch, Islamic Azad university, Tehran, Iran.

2 Department of Biomedical Engineering, Faculty of Technology and Engineering, Islamshahr Branch, Islamic Azad University, Islamshahr, Iran.

Abstract

Assistance exoskeletons are among the requirements for those suffering from strokes, post-polio complications, injuries, osteoarthritis and multiple other health issues. These exoskeletons could also be beneficial for individuals who exert heavy physical activities on a regular basis. Consequently, various academic as well as commercial projects are available in the market in the field of lower limb exoskeletons. The purpose of this article is to investigate passive and quasi-passive lower limb exoskeletons with a focus on knees and categorize these exoskeletons and moreover introduce their basic structures. It is concluded that ppassive exoskeletons are among the most essential subjects of this field due to their simplicity and cost efficiency. The basis of these types of exoskeletons is grounded on energy storage while the knee is in flexion (stored energy to be released in the extension phase). Furthermore, passive exoskeleton designs endeavor to sustain/endure some of the weight force with the aim of reducing pressure on the knee joint. One of the important parameters in choosing an exoskeleton is the user's comfort when using the exoskeleton, which depends on two factors, the first is how the exoskeleton connects to the body and the second is the changes in metabolic energy consumption as a result of using this exoskeleton.

Keywords

Main Subjects


  1. Chen B, Zi B, Wang Z, Qin L, Liao W-H. Knee exoskeletons for gait rehabilitation and human performance augmentation: A state-of-the-art. Mechanism and Machine Theory. 2019;134:499-511.
  2. Yu H, Cruz MS, Chen G, Huang S, Zhu C, Chew E, et al. Mechanical design of a portable knee-ankle-foot robot. 2013 IEEE International Conference on Robotics and Automation; 2013: IEEE.
  3. Baldovino RG, Jamisola RS. A survey in the different designs and control systems of powered exoskeleton for lower extremities. 2017; 1 (4): 103-115.
  4. Nacy SM, Ghaeb NH, Abdallh M. A review of lower limb exoskeletons. Innovative Syst Des Eng. 2016;7(1); 95, 102-116.
  5. McGibbon CA, Brandon SC, Brookshaw M, Sexton A. Effects of an over-ground exoskeleton on external knee moments during stance phase of gait in healthy adults. The Knee. 2017;24(5):977-93.
  6. Cherry MS, Kota S, Young A, Ferris DP. Running with an elastic lower limb exoskeleton. Journal of applied biomechanics. 2016;32(3):269-77.
  7. Van Dijk W, Van der Kooij H, Hekman E. A passive exoskeleton with artificial tendons: Design and experimental evaluation. 2011 IEEE International Conference on Rehabilitation Robotics; 2011: IEEE.
  8. van Dijk W, Van der Kooij H. XPED2: A passive exoskeleton with artificial tendons. IEEE robotics & automation magazine. 2014;21(4):56-61.
  9. Van den Bogert AJ. Exotendons for assistance of human locomotion. Biomedical engineering online. 2003;2(1):1-8.
  10. Lee K-M, Wang D, editors. Design analysis of a passive weight-support lower-extremity-exoskeleton with compliant knee-joint. 2015 IEEE International Conference on Robotics and Automation (ICRA); 2015: IEEE.
  11. Lovrenovic Z, Doumit M. Development and testing of a passive walking assist exoskeleton. Biocybernetics and Biomedical Engineering. 2019;39(4):992-1004.
  12. Xie L, Li X, Cai S, Huang G, Huang L. Knee-braced energy harvester: Reclaim energy and assist walking. Mechanical Systems and Signal Processing. 2019;127:172-89.
  13. Budarick AR, MacKeil BE, Fitzgerald S, Cowper-Smith CD. Design evaluation of a novel Multicompartment unloader knee brace. Journal of Biomechanical Engineering. 2020;142(1): 014502.
  14. Bishop E, Kuntze G, Ronsky J. Effect of a tri compartment unloader knee brace on knee moments and quadriceps activity during a chair rise and lower and stair descent in individuals with knee osteoarthritis. Osteoarthritis and Cartilage. 2020;28:S243-S4.
  15. https://springloadedtechnology.com/.
  16. Kapadia BH, Cherian JJ, Starr R, Chughtai M, Mont MA, Harwin SF, et al. Gait using pneumatic brace for end-stage knee osteoarthritis. The journal of knee surgery. 2016;29(03):218-23.
  17. Actiscience. Power Knee Stabilizer Pads 2020 [Available from: www.flexicomfort.co.uk.
  18. De Looze MP, Bosch T, Krause F, Stadler KS, O’Sullivan LW. Exoskeletons for industrial application and their potential effects on physical work load. Ergonomics. 2016;59(5):671-81.
  19. noonee. chairless: https://www.noonee.com/en/; 2019 [Available from: https://www.noonee.com/en/.
  20. https://exoskeletonreport.com/product/fortis/.
  21. Wilmart R, Garone E, Innocenti BJM. The use of robotics devices in knee rehabilitation; a critical review. Muscles, Ligaments & Tendons Journal. 2019;9(1): 21-48.
  22. Krut S, Benoit M, Dombre E, Pierrot F, editors. Moonwalker, a lower limb exoskeleton able to sustain bodyweight using a passive force balancer. 2010 IEEE International Conference on Robotics and Automation; 2010: IEEE.
  23. Fedorov D, Birglen L. Design of a Compliant Mechanical Device for Upper Leg Rehabilitation. IEEE Robotics and Automation Letters. 2019;4(2):870-7.
  24. Agrawal SK, Banala SK, Fattah A, Scholz JP, Krishnamoorthy V, Hsu W-L. A Gravity Balancing Passive Exoskeleton for the Human Leg. Robotics: Science and Systems; 2006.
  25. Geonea ID, Tarnita D. Design and evaluation of a new exoskeleton for gait rehabilitation. Mechanical Sciences. 2017;8(2):307.
  26. Auberger R, Breuer-Ruesch C, Fuchs F, Wismer N, Riener R, editors. Smart passive exoskeleton for everyday use with lower limb paralysis: Design and first results of knee joint kinetics. 2018 7th IEEE International Conference on Biomedical Robotics and Biomechatronics (Biorob); 2018: IEEE.
  27. Alamdari A, Krovi V. Design and analysis of a cable-driven articulated rehabilitation system for gait training. Journal of Mechanisms and Robotics. 2016;8(5):051018.
  28. www.alterg.com.
  29. Tian F, Hefzy MS, Elahinia M. State of the art review of Knee–Ankle–Foot orthoses. Annals of biomedical engineering. 2015;43(2):427-41.
  30. Winter DA. Biomechanics and motor control of human movement: John Wiley & Sons; 2009.
  31. Prodromos C. The Anterior Cruciate Ligament: Reconstruction and Basic Science E-Book: Elsevier Health Sciences; 2017.
  32. MASc TY, Jonathan Kofman PhD P. Engineering design review of stance-control knee-ankle-foot orthoses. Journal of rehabilitation research and development. 2009;46(2):257.
  33. https://www.donjoyperformance.com.
  34. Hangalur G, Bakker R, Tomescu S, Chandrashekar N. New Adjustable Unloader Knee Brace and Its Effectiveness. Journal of Medical Devices. 2018;12(1):015001.
  35. Greenfield JR, Hwang HF, Davies C, McDaid AJ, editors. Soft-stop knee brace for rehabilitation from ligament injuries: Design and pilot trial. 2017 International Conference on Rehabilitation Robotics (ICORR); 2017: IEEE.
  36. ossur. Formfit® OA Wraparound 2020 [Available from: www.ossur.com/en-ca/bracing-and-supports/knee.
  37. He C, Pan L, Li Q, editors. Structural Design of Wearable Lower Extremity Exoskeleton Based on the Human Body Engineering. 2015 3rd International Conference on Mechanical Engineering and Intelligent Systems; 2015: Atlantis Press.