The effects of exoskeleton use on human response to simulated overhead tasks with vibration.

The use of occupational exoskeletons has grown fast in manufacturing industries in recent years. One major scenario of exoskeleton use in manufacturing is to assist overhead, power hand tool operations. This preliminary work aimed to determine the effects of arm-supporting exoskeletons on shoulder muscle activity and human-hand tool coupling in simulated overhead tasks with axially applied vibration. An electromagnetic shaker capable of producing the random vibration spectrum specified in ISO 10819 was hung overhead to deliver vibrations. Two passive, arm-supporting exoskeletons, with one (ExoVest) transferring load to both the shoulder and pelvic region while the second one (ExoStrap) transferring load primarily to the pelvic region, were used in testing. Testing was also done with the shaker placed in front of the body to better understand the posture and exoskeleton engagement effects. The results collected from 6 healthy male subjects demonstrate the dominating effects of the overhead working posture on increased shoulder muscle activities. Vibration led to higher muscle activities in both agonist and antagonist shoulder muscles to a less extent. Exoskeleton use reduced the anterior deltoid and serratus anterior activities by 27% to 43%. However, wearing the ExoStrap increased the upper trapezius activities by 23% to 38% in the overhead posture. Furthermore, an increased human-shaker handle coupling was observed in the OH posture when wearing the ExoVest, indicating a more demanding neuromuscular control.

The current work sought to understand exoskeleton use in overhead tasks with power hand tools. The study findings demonstrate that vibration didn't alter the effects of arm-supporting exoskeletons on shoulder muscle activities in overhead tasks with vibration, though exoskeleton use may complicate human-hand tool coupling and corresponding neuromuscular control.

Pediatric laryngeal simulator using 3D printed models: A novel technique.

OBJECTIVE: Simulation to acquire and test technical skills is an essential component of medical education and residency training in both surgical and nonsurgical specialties. High-quality simulation education relies on the availability, accessibility, and reliability of models. The objective of this work was to describe a practical pediatric laryngeal model for use in otolaryngology residency training. Ideally, this model would be low-cost, have tactile properties resembling human tissue, and be reliably reproducible. STUDY DESIGN: Pediatric laryngeal models were developed using two manufacturing methods: direct three-dimensional (3D) printing of anatomical models and casted anatomical models using 3D-printed molds. Polylactic acid, acrylonitrile butadiene styrene, and high-impact polystyrene (HIPS) were used for the directly printed models, whereas a silicone elastomer (SE) was used for the casted models. METHODS: The models were evaluated for anatomic quality, ease of manipulation, hardness, and cost of production. A tissue likeness scale was created to validate the simulation model. Fleiss' Kappa rating was performed to evaluate interrater agreement, and analysis of variance was performed to evaluate differences among the materials. RESULTS: The SE provided the most anatomically accurate models, with the tactile properties allowing for surgical manipulation of the larynx. Direct 3D printing was more cost-effective than the SE casting method but did not possess the material properties and tissue likeness necessary for surgical simulation. CONCLUSION: The SE models of the pediatric larynx created from a casting method demonstrated high quality anatomy, tactile properties comparable to human tissue, and easy manipulation with standard surgical instruments. Their use in a reliable, low-cost, accessible, modular simulation system provides a valuable training resource for otolaryngology residents. LEVEL OF EVIDENCE: N/A. Laryngoscope, 127:E132-E137, 2017.

Tool-specific performance of vibration-reducing gloves for attenuating palm-transmitted vibrations in three orthogonal directions.

Vibration-reducing (VR) gloves have been increasingly used to help reduce vibration exposure, but it remains unclear how effective these gloves are. The purpose of this study was to estimate tool-specific performances of VR gloves for reducing the vibrations transmitted to the palm of the hand in three orthogonal directions (3-D) in an attempt to assess glove effectiveness and aid in the appropriate selection of these gloves. Four typical VR gloves were considered in this study, two of which can be classified as anti-vibration (AV) gloves according to the current AV glove test standard. The average transmissibility spectrum of each glove in each direction was synthesized based on spectra measured in this study and other spectra collected from reported studies. More than seventy vibration spectra of various tools or machines were considered in the estimations, which were also measured in this study or collected from reported studies. The glove performance assessments were based on the percent reduction of frequency-weighted acceleration as is required in the current standard for assessing the risk of vibration exposures. The estimated tool-specific vibration reductions of the gloves indicate that the VR gloves could slightly reduce (<5%) or marginally amplify (<10%) the vibrations generated from low-frequency (<25 Hz) tools or those vibrating primarily along the axis of the tool handle. With other tools, the VR gloves could reduce palm-transmitted vibrations in the range of 5%-58%, primarily depending on the specific tool and its vibration spectra in the three directions. The two AV gloves were not more effective than the other gloves with some of the tools considered in this study. The implications of the results are discussed. RELEVANCE TO INDUSTRY: Hand-transmitted vibration exposure may cause hand-arm vibration syndrome. Vibration-reducing gloves are considered as an alternative approach to reduce the vibration exposure. This study provides useful information on the effectiveness of the gloves when used with many tools for reducing the vibration transmitted to the palm in three directions. The results can aid in the appropriate selection and use of these gloves.