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Effects of back-support exoskeleton use on gait performance and stability during level walking

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dc.contributor.authorPark, Jang-Hoen
dc.contributor.authorKim, Sunwooken
dc.contributor.authorNussbaum, Maury A.en
dc.contributor.authorSrinivasan, Divyaen
dc.date.accessioned2023-01-18T14:22:07Zen
dc.date.available2023-01-18T14:22:07Zen
dc.date.issued2022-02-01en
dc.date.updated2023-01-17T14:43:05Zen
dc.description.abstractBackground: Back-support exoskeletons (BSEs) are a promising intervention to mitigate physical demands at work. Although growing evidence indicates that BSEs can reduce low-back physical demands, there is limited understanding of potential unintended consequences of BSE use, including the risk of falls. Research question: Does using a BSE adversely affect gait performance and stability, and are such effects dependent on specific BSE external torque characteristics? Methods: Twenty participants (10 M, 10 F) completed five level over-ground walking trials and a five-minute treadmill walking trial while wearing a BSE (backX™) with three different levels of external torque (i.e., no torque, low torque, and high torque) and in a control (no-exoskeleton) condition. Spatiotemporal gait patterns, stride-to-stride gait variability measures, required coefficient-of-friction (RCoF), and minimum foot clearance (MFC) were determined, to assess gait performance. Gait stability was quantified using the maximum Lyapunov exponent (MLE) of trunk kinematics and the margin-of-stability (MoS). Results: Using the backX™ with high supportive torque decreased slip risk (7% decrease in RCoF) and slightly improved trunk stability (3% decrease in MLE). However, it also decreased step length (1%), increased step width (10%) and increased gait variability (8–19%). Changes in MoS were complex: while MoS at heel strike decreased in the AP direction, it increased in the ML direction. There was a rather large decrease in MoS (26%) in the ML direction during the swing phase. Significance: This is the first study to quantify the effects of wearing a passive BSE with multiple supportive torque levels on gait performance and stability during level walking. Our results, showing that the external torque of the BSE may adversely affect gait step width, variability, and dynamic stability, can contribute to better design and practice guidelines to facilitate the safe adoption of BSEs in the workplace.en
dc.description.versionAccepted versionen
dc.format.extentPages 181-190en
dc.format.extent10 page(s)en
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.1016/j.gaitpost.2021.11.028en
dc.identifier.eissn1879-2219en
dc.identifier.issn0966-6362en
dc.identifier.orcidNussbaum, Maury [0000-0002-1887-8431]en
dc.identifier.orcidKim, Sun Wook [0000-0003-3624-1781]en
dc.identifier.otherS0966-6362(21)00606-8 (PII)en
dc.identifier.pmid34864386en
dc.identifier.urihttp://hdl.handle.net/10919/113232en
dc.identifier.volume92en
dc.language.isoenen
dc.publisherElsevieren
dc.relation.urihttp://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000788079500015&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=930d57c9ac61a043676db62af60056c1en
dc.rightsIn Copyrighten
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/en
dc.subjectOccupational exoskeletonen
dc.subjectWalking stabilityen
dc.subjectWorkplace fallen
dc.subjectLOCAL DYNAMIC STABILITYen
dc.subjectPASSIVE TRUNK EXOSKELETONen
dc.subjectKINEMATIC VARIABILITYen
dc.subjectOLDER-ADULTSen
dc.subjectSTEP LENGTHen
dc.subjectYOUNGen
dc.subjectHISTORYen
dc.subjectWIDTHen
dc.subjectPreventionen
dc.subjectClinical Researchen
dc.subject.meshHumansen
dc.subject.meshGaiten
dc.subject.meshWalkingen
dc.subject.meshPostural Balanceen
dc.subject.meshBiomechanical Phenomenaen
dc.subject.meshExoskeleton Deviceen
dc.titleEffects of back-support exoskeleton use on gait performance and stability during level walkingen
dc.title.serialGait & Postureen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.otherArticleen
dc.type.otherJournalen
dcterms.dateAccepted2021-11-19en
pubs.organisational-group/Virginia Techen
pubs.organisational-group/Virginia Tech/Engineeringen
pubs.organisational-group/Virginia Tech/Engineering/Industrial and Systems Engineeringen
pubs.organisational-group/Virginia Tech/Faculty of Health Sciencesen
pubs.organisational-group/Virginia Tech/All T&R Facultyen
pubs.organisational-group/Virginia Tech/Engineering/COE T&R Facultyen

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