Effects of a lower-body exoskeleton device on metabolic cost and gait biomechanics during load carriage.

This study investigated the effects on metabolic cost and gait biomechanics of using a prototype lower-body exoskeleton (EXO) to carry loads. Nine US Army participants walked at 1.34 m/s on a 0% grade for 8 min carrying military loads of 20 kg, 40 kg and 55 kg with and without the EXO. Mean oxygen consumption (VO(2)) scaled to body mass and scaled to total mass were significantly higher, by 60% and 41% respectively, when the EXO was worn, compared with the control condition. Mean VO(2) and mean VO(2) scaled to body mass significantly increased with load. The kinematic and kinetic data revealed significant differences between EXO and control conditions, such as walking with a more flexed posture and braking with higher ground reaction force at heel strike when wearing the EXO. Study findings demonstrate that the EXO increased users' metabolic cost while carrying various loads and altered their gait biomechanics compared with conventional load carriage. STATEMENT OF RELEVANCE: An EXO designed to assist in load bearing was found to raise energy expenditure substantially when tested by soldiers carrying military loads. EXO weight, weight distribution and design elements that altered users' walking biomechanics contributed to the high energy cost. To realise the potential of EXOs, focus on the user must accompany engineering advances.

Comparison of body fat estimates using 3D digital laser scans, direct manual anthropometry, and DXA in men.

OBJECTIVES: The purpose of this study was to assess the feasibility of utilizing three dimensional whole body laser surface scanning (3DS) to obtain specific anthropometric measurements to estimate percent body fat (BF). METHODS: Percent BF estimates from 37 male volunteers, of age 18-62 yr, were determined by inputting manual anthropometric (MA) and 3DS anthropometric measurements into the current Army BF prediction equation for males. The results were compared with each other and to BF values from Dual Energy X-ray Absorptiometry (DXA), employed as a reference method. RESULTS: Mean percent BF estimates (+/-SD) derived from MA, 3DS and from DXA were 18.4(+/-3.8), 18.8(+/-3.9), and 18.9(+/-4.7), respectively. Analysis of Variance tests revealed no statistical difference between the mean values. Correlation analysis comparing MA and 3DS derived percent BF estimates to each other and to those measured by DXA revealed moderate to strong Pearson correlation coefficients (r), small to moderate standard errors of the estimate (SEE), and were statistically significant (p < 0.05). CONCLUSIONS: Correlation coefficients and SEE results for this sample were: (1) DXA vs 3DS; r = 0.74, SEE = 3.2, (2) MA vs DXA; r = 0.82, SEE = 2.8, and (3) MA vs 3DS; r = 0.96, SEE = 1.0. Lin's concordance analysis, including Bland-Altman limits of agreement (LOA), revealed statistically significant measurement agreement among the three measurement modalities (p < 0.05). The application of 3DS scanning to estimate percent BF from commonly used anthropometric measurements are in close agreement with BF estimates derived from analogous MA measurements and from DXA scanning.

The effects of a lower body exoskeleton load carriage assistive device on limits of stability and postural sway.

The study investigated the effects of using a lower body prototype exoskeleton (EXO) on static limits of stability and postural sway. Measurements were taken with participants, 10 US Army enlisted men, standing on a force platform. The men were tested with and without the EXO (15 kg) while carrying military loads of 20, 40 and 55 kg. Body lean to the left and right was significantly less and postural sway excursions and maximal range of movement were significantly reduced when the EXO was used. Hurst values indicated that body sway was less random over short-term time intervals and more random over long-term intervals with the EXO than without it. Feedback to the user's balance control mechanisms most likely was changed with the EXO. The reduced sway and relatively small changes in sway with increasing load weights suggest that the EXO structure may have functioned to provide a bracing effect on the body.

Modulation of force transmission to the head while carrying a backpack load at different walking speeds.

This study was designed to investigate the capability of the joints and segments to reduce transmission of forces during load carriage. Eleven subjects were required to carry a backpack loaded with 40% of their body weight and to walk at 6 speeds increasing from 0.6 to 1.6 ms(-1) in increments of 0.2 ms(-1), and then decreasing in the same manner. Subjects were filmed in 3-dimensions, but analysis of shock transmission ratio (TR) was limited to the sagittal plane. Shock transmission was measured as the ratio of peak vertical accelerations (ankle:head, ankle:knee, and knee:head) measured immediately following foot strike. TR for all ratios increased significantly as a function of increasing speed. TR from the ankle to the head showed no significant increase as a function of load carriage, but did increase as a function of load in transmission from knee to head. A significant interaction effect revealed that during load carriage at the higher speeds the acceleration of the ankle and knee decreased below that for the unloaded conditions. These findings suggest that the potentially injurious effects of previously observed increased ground reaction forces and increased joint stiffness while walking with loads are offset by adaptations in the gait pattern that maintain force transmission at acceptable levels. Increased variability in the acceleration of the head and in the transmission ratios suggest a potentially destabilizing effect of load carriage on the head trajectory.

Increased musculoskeletal stiffness during load carriage at increasing walking speeds maintains constant vertical excursion of the body center of mass.

The primary objective of this research was to determine changes in body and joint stiffness parameters and kinematics of the knee and body center of mass (COM), that result from wearing a backpack (BP) with a 40% body weight load at increasing speeds of walking. It was hypothesized that there would be speed and load-related increases in stiffness that would prevent significant deviations in the COM trajectory and in lower-extremity joint angles. Three independent biomechanical models employing kinematic data were used to estimate global lower-extremity stiffness, vertical stiffness and knee joint rotational stiffness in the sagittal plane during walking on a treadmill at speeds of 0.6-1.6 ms(-1) in 0.2 ms(-1) increments in BP and no backpack conditions. Kinematic data were collected using an Optotrak, three-dimensional motion analysis system. Knee angles and vertical excursion of the COM during the compression (loading phase) increased as a function of speed but not load. All three estimates of stiffness showed significant increases as a function of both speed and load. Significant interaction effects indicated a convergence of load-related stiffness values at lower speeds. Results suggested that increases in muscle-mediated stiffness are used to maintain a constant vertical excursion of the COM under load across the speeds tested, and thereby limit increases in metabolic cost that would occur if the COM would travel through greater vertical range of motion.