Use of Lower Limb Exoskeletons as an Assessment Tool for Human Motor Performance: A Systematic Review.

Exoskeletons are a promising tool to support individuals with a decreased level of motor performance. Due to their built-in sensors, exoskeletons offer the possibility of continuously recording and assessing user data, for example, related to motor performance. The aim of this article is to provide an overview of studies that rely on using exoskeletons to measure motor performance. Therefore, we conducted a systematic literature review, following the PRISMA Statement guidelines. A total of 49 studies using lower limb exoskeletons for the assessment of human motor performance were included. Of these, 19 studies were validity studies, and six were reliability studies. We found 33 different exoskeletons; seven can be considered stationary, and 26 were mobile exoskeletons. The majority of the studies measured parameters such as range of motion, muscle strength, gait parameters, spasticity, and proprioception. We conclude that exoskeletons can be used to measure a wide range of motor performance parameters through built-in sensors, and seem to be more objective and specific than manual test procedures. However, since these parameters are usually estimated from built-in sensor data, the quality and specificity of an exoskeleton to assess certain motor performance parameters must be examined before an exoskeleton can be used, for example, in a research or clinical setting.

Self-aligning exoskeleton hip joint: Kinematic design with five revolute, three prismatic and one ball joint.

Kinematic compatibility is of paramount importance in wearable robotic and exoskeleton design. Misalignments between exoskeletons and anatomical joints of the human body result in interaction forces which make wearing the exoskeleton uncomfortable and even dangerous for the human. In this paper we present a kinematically compatible design of an exoskeleton hip to reduce kinematic incompatibilities, so called macro- and micro-misalignments, between the human's and exoskeleton's joint axes, which are caused by inter-subject variability and articulation. The resulting design consists of five revolute, three prismatic and one ball joint. Design parameters such as range of motion and joint velocities are calculated based on the analysis of human motion data acquired by motion capture systems. We show that the resulting design is capable of self-aligning to the human hip joint in all three anatomical planes during operation and can be adapted along the dorsoventral and mediolateral axis prior to operation. Calculation of the forward kinematics and FEM-simulation considering kinematic and musculoskeletal constraints proved sufficient mobility and stiffness of the system regarding the range of motion, angular velocity and torque admissibility needed to provide 50 % assistance for an 80 kg person.