Design and Preliminary

Haohan Zhang
Department of Mechanical Engineering,
Columbia University,
Evaluation of a Passive
New York, NY 10027
e-mail: [email protected] Spine Exoskeleton
Abhijit Kadrolkar This paper presents a design of a passive spine exoskeleton which implements a
Department of Mechanical “push–pull” external assistive strategy. The spine exoskeleton was designed for reducing
and Industrial Engineering, the risk of back injury. It applies a pulling force on thoracic region and a pushing force
University of Massachusetts Amherst, on lumbar region during spine flexion/extension. The design was inspired by previous
160 Governor’s Drive, simulation work, where the results highly supported benefits of the push–pull strategy on
Amherst, MA 01003 reducing the back muscular efforts and bending moment for the sagittal spine flexion/
e-mail: [email protected] extension. A passive physical prototype was designed and constructed to test the
push–pull strategy on human subjects. Three subjects were able to repeat the identical
Frank C. Sup, IV1 dynamic spine flexion and extension tasks with the spine exoskeleton prototype. The sur-
Department of Mechanical face electromyography showed a reduction of up to 24% at lumbar and 54% at thoracic
and Industrial Engineering, level muscle for the human subjects wearing the exoskeleton suit to accomplish the same
University of Massachusetts Amherst, static tasks without any external assistance. The muscle force and intervertebral bending
160 Governor’s Drive, moment were estimated to be reduced by up to 479 N and 36 N  m, respectively.
Amherst, MA 01003 [DOI: 10.1115/1.4031798]
e-mail: [email protected]
Keywords: push–pull, spine flexion/extension, exoskeleton

1 Introduction compliant structure to transfer loads. These designs can extend

load capability of user by adding parallel supporting structures to
Lower back pain is a prevalent health issue that significantly
torso.
impacts one’s quality of life. Causes of lower back pain include
In this paper, the mechanical design of a passive spine exoskel-
muscle strains due to sudden activity or due to lifting heavy
eton for reducing the risk of lower back pain is presented. This
objects, injuries suffered while working labor intensive jobs,
design is a physical realization of previous work by the
decline in muscle mass and function due to aging, and injuries suf-
authors, which proposes a strategy of external assistance for
fered during sports or other similar activities [1–4]. Treatment
flexion/extension of the human spine in the sagittal plane [11].
options for lower back pain include medication, physical therapy,
The strategy is based on pulling back on the thoracic region of the
or in extreme cases surgical intervention, which can be painful
back and pushing forward on the lumbar region during spine
and expensive with only limited promise of recovery [5]. How-
flexion/extension. The approach is inspired by a common postural
ever, rather than having to treat the incidence of back pain, it is
adjustment that people make when faced with lower back pain.
possible to mitigate the effects of strain-inducing loads on
When lower back pain occurs, individuals can mitigate it by using
muscles, by providing external assistance to human efforts during
their palms to push their lumbar region to support their lower
physical activity [1,4]. A wearable exoskeleton suit is a candidate
back. This extends their shoulders backward which allows for an
solution to provide such external assistance to human efforts so
extensor moment to be applied on their upper back. The concept
that the risks of back injuries can be reduced.
was simulated in OPENSIM, an open source biomechanics simula-
Exoskeletons have been realized to extend human power by
tion software, and demonstrated substantial decrease in forces and
aligning external actuators to human limb joints. Kazerooni et al.
moments in the lumbar region using the push–pull strategy of
initiated research into a series of lower extremity exoskeletons for
external assistance [11]. Based on this work, a physical prototype
military, such as BLEEX, ExoHiker, and HULC [6–8], which
was developed and experimental evaluation of the passive exo-
transmit payload from the user’s back to the ground through exo-
skeleton is presented.
skeleton so that the soldier can carry more load during missions.
The paper is organized into five sections. Section 2 outlines the
Sankai et al. developed a full-body exoskeleton HAL [1,9], which
push–pull strategy of external assistance and the mechanical
assists health care workers to carry and move patients. However,
design of the exoskeleton, Sec. 3 details the experimental methods
these designs used rigid spine supports that do not address the sig-
and data analysis employed to evaluate the exoskeleton, Sec. 4
nificance of spine flexibility to mobility. In recent years, support
presents the experimental results, and Sec. 5 concludes with
to the torso has been more emphasized in the design of exoskele-
discussion.
tons. Taal and Sankai proposed a flexible “Exo-Spine” [4] to
replace the rigid corset of HAL-5. The Exo-Spine pushes on the
torso during flexion and pulls on it during extension through a
cable-tension mechanism actuated by one hip joint motor. 2 Approach
Agrawal and coworkers developed a “second spine” [10], which A schematic illustration of the push–pull external assistance
provides a parallel load bearing structure to the natural spine. It strategy is shown in Fig. 1. The human body is modeled as an
passively connects the user’s shoulder with pelvis through a inverted pendulum and the action of the two external assistive
forces (F1 and F2) are applied to the thoracic and lumbar regions
1
Corresponding author.
of the back, during flexion/extension in the sagittal plane. During
Manuscript received March 23, 2015; final manuscript received September 14, flexion, the back muscles, specifically the erector spinae, stretch
2015; published online November 16, 2015. Assoc. Editor: Carl Nelson. and provide pulling forces on the torso. To assist the erector

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 Fig. 2 (Left) Customized OPENSIM full-body musculoskeletal
model with markers locations and (right) implementation of
push–pull in OPENSIM. The thorax part and pelvic part are welded
on the torso and pelvis, respectively, and the cam is pin jointed
Fig. 1 Inverted pendulum model with the push–pull external on the pelvis where the joint locates at the geometric center of
assistive strategy. The blocks denote the segments of human the bottom cylinder. The pin joint rotation is coupled with the
body; the ellipse connecting pelvis to the thorax represents the hip flexion.
erector spinae; F1 and F2 represent the external assistances
proposed by the push–pull strategy; and the gravitational force
and the ground reaction force are labeled.
prototype design is shown in Figs. 3(a) and 3(b). It consists of a
pelvic cuff, a pair of shoulder harnesses, and two thigh cuffs
with foot straps. Extension springs connect these three sections
spinae, a pulling force F1 is applied at the thoracic level, in paral- to realize the pushing and pulling forces. The pelvic cuff is con-
lel to the natural muscles. This pulling force generates an extensor sidered to be rigidly connected to its wearer’s pelvis. A pair of
moment and a compressive load on lumbar joints, which poten- extension springs (thorax spring) is utilized to link the pelvic
tially compromises lower spine stability. Another pushing force cuff with the shoulder belts to hold back the upper torso during
F2 is applied to the lumbar region to provide support and reduce spine flexion. The pushing force is generated by employing a
such instability issues. cable-tension mechanism connected to an extension spring (lum-
This strategy of external assistance was evaluated in OPENSIM bar spring) that is attached to the thigh cuff, as illustrated in
[12,13] with a customized musculoskeletal model (shown in Fig. 3(c). This actuates a rotating cam that is pinned around a
Fig. 2) that combined two previously published models, lower slight offset on the pelvic cuff, to push the lower back along
limb [14] and lumbar spine [15]. The external assistance was with hip rotations during spine flexion/extension. Both the belt
implemented in simulation by applying spring forces between the connection between shoulder harness and pelvic cuff and cable
added geometric parts and skeletons of this model, as illustrated connection between pelvic cuff and thigh cuffs are length adjust-
in Fig. 2(b). The pulling force is applied between a thorax part able to secure the functionality of the design for different users.
and a pelvic part attached on thoracic spine and pelvis, respec- Finally, foot straps are used to connect the hip and pelvic cuffs
tively, through a spring force, and the pushing force is performed to the feet, whose lengths are also adjustable to fit on different
between a revolute cam (pin jointed on pelvic part and denoted by subjects to contain the thigh cuffs from sliding up on the human
three consecutive cylinders for the sake of geometric adjustment body during torso flexion. The prototype was preliminarily
in simulation) and lumbar vertebrae during spine flexion. An opti- designed based on the kinematics data and dimension from one
mization was performed to determine the optimal external assis- subject while data for comparison were obtained from two more
tances by iteratively calling embedded optimization algorithms in subjects of different sizes to address the performance and the
OPENSIM [12,13] with a random set of parameters (i.e., two virtual
adjustability of the design.
spring constants). The optimization sought to minimize the aver- The prior optimization work [11] searched for the optimal com-
age muscle activation force and maximum intervertebral bending bination of the pushing and pulling forces that equally reduced
moment with an optimal combination of the pushing and pulling both back muscular activations and intervertebral bending
forces. The results from simulations helped validate this strategy moments. This solution is employed and translated to the spring
and suggested that the average muscular forces and the maximum selections in the physical design. The thorax spring selection is
intervertebral bending moment can be reduced during a full spine straightforward due to the alignment of the prototype and simula-
flexion/extension by up to 16% (75 N) and 31% (30 Nm), respec- tion models. The lumbar spring selection is based on the mathe-
tively, with optimal external assistance. matical model provided by the cable-tension mechanism in
Fig. 3(c). The output is the virtual pushing force, FL , given by the
2.1 Mechanical Design. Based on the preliminary simula- corresponding spring force from the simulation, while the input is
tions, the specifications were set for a passive spine exoskeleton, the real cable tension, T. In this mechanical system, the moment
and a mechanically adjustable prototype was designed. The offered by the input and output around the pin joint should be

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 Fig. 3 Solid model of passive spine exoskeleton: (a) dummy user wearing exoskeleton,
(b) zoomed-in detail view, and (c) the cable-tension mechanism of applying the spring pushing
force on the human lumbar region

identical presumably the inertial effects of the cam can be displacements, DlL and Dlh , can be obtained from the model
neglected, which deduces geometry used in the simulation. Therefore, the spring constant of
the spring applying pushing force is determined. Since there are
T  r ¼ FL  rL (1) two extension springs on either side of the spine, the spring con-
stant for each spring should be half of kh . The final springs
where r and rL are the geometric parameters of the cam that can selected for the physical prototype are shown in Table 1.
be measured from the physical model. In addition, both the virtual The components of the physical prototype were 3D printed
spring and the physical spring force obey the Hooke’s Law such using acrylonitrile butadiene styrene plastic (Stratasys, uPrint SE).
that T ¼ kh  Dlh and FL ¼ kL  DlL , where kh is the spring constant The posts for holding rotational joints of the cams (shown in pur-
of the lumbar spring and kL is the spring constant provided by ple in Fig. 3(c)) have a hollow core that allows steel rods to be
the optimization result from OPENSIM, which is the set of spring inserted to strengthen the overall structure. The rotational joints
constants that deliver the best assistance. Additionally, the were supported by ball bearings. Buckles were used to adjust the

Table 1 Specification of the extension springs applied in the prototype

Rest length (m) Spring constant (N/m) Outer diameter (m) Extended Lg. (m)

Thorax spring 0.105 6700 0.015 0.240

Lumbar spring 0.050 2000 0.012 0.120

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 8 0
>
< DFRX ¼ Gðcos h  cos hÞ þ FTS cos a  DFM
0 (4)
DFRZ ¼ Gðsin h  sin hÞ þ FLS  FTS sin a
>
:
0 ¼ FTS dTS þ FLS dLS  DFM d  DsR

The mass of the torso m and weight G of each subject is esti-

mated to be 55% of their total weight according to Adams
et al.[2]. The angle a between the thorax springs and the x axis of
the sensor coordinate can be calculated from the geometry of the
exoskeleton and the spring extension. The moment arms for each
force D; dTS ; dLS , and d can be measured or estimated through
the geometry. The flexion angle h and the linear acceleration at
the attachment point ax and az can be obtained from the output
inertial data from the sensor. The pulling force FTS can be com-
puted by the spring constant and the spring extensions according
to Hooke0 s law. The pushing force FLS can be estimated through
the second equation from Eq. (4). As a result, the reduction of the
muscle force reduction DFM and of the bending moment DsR can
be estimated through the first and last equation from Eq. (4).

3 Evaluation
The performance of the prototype was evaluated experimentally
Fig. 4 Model of static analysis for subject flexion with sEMG and biomechanics data from human subjects performing specific
sensor attached upper body motions were collected. The data included surface
electromyogram (sEMG) readings from selected muscle groups
prototype and to tension the cables. The fabricated prototype and inertial data from wearable accelerometers mounted on the
including all components weighs 3.0 kg which was less than 5% body of the subjects. The control data for the protocol were data
of the total body weight for the subjects tested in this paper. A ma- from the subject performing the same motions while not wearing
jority of the weight is located on the pelvis while the parts carried the exoskeleton prototype. From the experimental data, the reduc-
by the human torso are light weight. Since the prototype was pri- tions of back muscular effort and bending moment were estimated
marily designed to evaluate movement in the sagittal plane, it is for each subject wearing the spine exoskeleton. The study was
passively compliant with the movement of the human body in approved by the Institutional Review Board at the University of
other planes through the flexibility of the prototype structures. Massachusetts Amherst.

2.2 Estimating Muscle Force and Bending Moment. A 3.1 Protocol. The experiment consisted of two tasks:
model for the static test in vivo was applied in the sagittal plane to dynamic and static. Subjects completed both tasks without and
estimate the muscular force and intervertebral bending moment with the exoskeleton for comparison. Control data for each subject
reduction, as shown in Fig. 4. The free body of interest was the were collected without wearing the exoskeleton. Subsequent to
torso above the dashed line indicated the L5–S1 joint. The coordi- this, test data for each subject were collected after donning the
nate frame was constructed according to the accelerometer shown exoskeleton. The goal was to evaluate the effect of the exoskele-
with the green block. The muscle force FM is assumed parallel- ton suit on a person in different situations. It relied on kinematics
ing to the sensor axis at the attaching point [2]. The weight of the data, sEMG magnitudes from the erector spinae muscles, and esti-
exoskeleton suit is negligible since it is much lighter than the torso mates of expected reductions in muscular forces and intervertebral
masses of the subjects. When the participant wore the exoskeleton bending moments. Figures 5(a) and 5(b) show a photograph of a
suit, the two spring forces applied to their torso are the pulling subject wearing the prototype. The subjects were first tested with-
force on thoracic region FTS and the pushing force on lumbar area out the exoskeleton suit and then with in order to not positively
FLS . During the static test, the readings ax and az from the accel- favor the results with the exoskeleton due to fatigue.
eration sensors (without gravity elimination) indicated compo- In the dynamic test, the subjects were asked to perform repeated
nents of the reaction forces FRX and FRZ at the lumbar joint, spine flexion/extension in the sagittal plane (three second flexion
which were decoupled along the frame axes. sR denotes the reac- and three second extension) for 120 s with a constant speed pro-
tion moment about that joint. The equilibrium equations for this vided by an audible tone from a metronome. The subjects started
model are as follows: from standing, flexed their torso approximately 90 deg, and
Without the exoskeleton suit extended it back to the original standing position to finish a com-
8 plete flexion/extension motion. All motion was limited to the sag-
< FRX ¼ max ¼ G cos h þ FM
> ittal plane and lateral or rotational motion was avoided. At all
FRZ ¼ maz ¼ G sin h (2) times during the test, arms were crossed across the chest, and
>
:P hands were placed on opposite shoulders. The subjects fully rested
Mo ¼ 0 ¼ GD  FM d  sR
before approaching into the static tests.
The static tests required the subjects to hold three different flex-
With the exoskeleton suit (denoted with 0 ) ion positions (small, medium, and full-range flexion) for between
8 0 90 and 120 s. The flexion angle in each position was determined
0
0 0
< FRX ¼ max ¼ G cos h þ FM þ FTS cos a
> by a reference height measuring from subject0 s left shoulder to the
0 0 0
FRZ ¼ maz ¼ G sin h þ FLS  FTS sin a (3) ground. These reference heights were measured before the experi-
>
:P ments for each individual subject and varied as anticipated due to
Mo ¼ 0 ¼ GD  F0M d  FTS dTS  FLS dLS  s0R the differences of their total height and lengths of body segments.
The subjects were instructed to maintain their flexion angle by
Subtracting Eq. (2) from Eq. (3) gives the difference equation in aligning their left shoulders with a specific reference height during
two equilibrium situations each trial. The subjects rested between every two trials. After the

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 Fig. 5 (a) and (b) Configurations of the subject wearing the exoskeleton spine prototype and
(c) sEMG sensor distributions on the back of subject

Table 2 sEMG reductions of all subjects. The greatest reductions at each position were bolded among all subjects at lumbar and
thoracic levels, respectively.

Position 1 (%) Position 2 (%) Position 3 (%)

Subject No. 1 Channel 1 (right L3) 0.1 17.2 24.3

Channel 2 (left L3) 3.9 16.7 17.6
Channel 7 (right T11) 0.3 26.9 7.7
Channel 8 (left T11) 8.2 46.0 50.0
Subject No. 2 Channel 2 (left L3) 7.1 8.0 3.2
Channel 4 (left L1) 18.6 11.1 0.8
Channel 7 (right T11) 42.2 54.1 34.6
Channel 8 (left T11) 27.1 44.9 48.5
Subject No. 3 Channel 2 (left L3) 16.3 0.9 39.7
Channel 4 (left L1) 17.8 3.8 34.7
Channel 7 (right T11) 29.0 37.2 21.4
Channel 8 (left T11) 22.9 33.4 30.9

static tests without wearing with exoskeleton suit, the subjects electrode placement. The electrodes that physically interfered
fully rested and then completed the identical tests wearing the with the prototype were removed. In addition, the removed sen-
exoskeleton suit. sors in device tests varied among subjects due to their size differ-
ences. Even with removal of some electrodes, both lumbar and
thoracic level muscular activities on both sides were recorded for
3.2 Participants. Three males participated in this study
each subject and are shown in Table 2.
(height ¼ 172 6 12 cm, weight ¼ 68:3 6 6:7 kg, and age The skin was lightly abraded and swabbed with alcohol prior to
¼ 26:7 6 3:3 years). Subject 1 was the target subject that the affixing the sensors along the muscles with double-sided tape.
spine exoskeleton was designed for. He participated in the biome-
Electrodes were separated by a 10 mm distance and electrically
chanics motion capture experiment where the data were utilized to arranged in a bipolar configuration to obtain sEMG data from
construct the simulation model and perform the computational
each location. The analog sEMG signals were sampled at 2 kHz
evaluations. Subjects 2 and 3 participated for result comparison, and band-pass filtered (20–450 Hz) by the wireless sEMG system.
where subject 2 was similar in size to subject 1 while subject 3 Triaxial accelerometers embedded in the sEMG sensors were used
was about 15 cm taller.
to obtain the inertial data during the evaluations. The inertial data
were sampled at 148.1 Hz and low-pass filtered at 50 Hz. Flexion
3.3 Instrumentation. The sEMG data were captured using a angles were integrated from the acceleration data using the left
commercial measurement system (DelsysTM–TrignoTM Wireless). side accelerometers and linear accelerations were obtained from
Eight electrodes were placed on the torso to capture muscle acti- the right side by assuming the subjects moved symmetrically with
vations during spine flexion/extension and placed as shown in respect to the sagittal plane.
Fig. 5(c). The muscular activities of lumbar erector spinae (LES)
at L3 and L1 levels and thoracic erector spinae (TES) at T11 and
T10 levels were captured on both sides. It needs to be pointed out 3.4 Data Processing. The sEMG signals were processed
that although eight-channel sEMG was collected for all subjects according to Refs. [16–18] prior to result comparison. A second
during control tests, only a subset was used during the device test- order high-pass Butterworth filter with a cut-off frequency of 2 Hz
ing. This is because some components (i.e., springs and cams) of was used to remove DC offsets and motion artifacts. The signals
the wearable device physically interfered with some attached elec- were then normalized by the largest value of the magnitude from
trodes. The control tests were performed first and the sensor loca- each sensing channel for each subject, separately for the control
tion was not adjusted for the exoskeleton tests to avoid altering and test data. Finally, the signals were full-wave rectified and

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 Fig. 6 Representative data comparison with/without exoskeleton suit from a single partici-
pant doing dynamic test: (a) comparison of the average of normalized muscle sEMG signals at
lumbar level during all trials; (b) comparison of the average of normalized muscle sEMG sig-
nals at thorax level during all trials; (c) comparison of angle reading from sensor channel 8;
and (d) comparison of linear accelerations reading from sensor channel 7

Fig. 7 Representative sEMG data comparison from a single participant undertaking static
tests: (a)–(c) comparison of normalized muscle sEMG at lumbar level at positions 1 (barely
flexion) to 3 (full-range flexion) and (d)–(f) comparison of normalized muscle sEMG at thorax
level at positions 1–3

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 Table 3 Estimated reduction of muscular force and interverte- 5 Discussion and Conclusions
bral bending moment of all subjects at positions 1 (minimal
flexion), 2 (medium flexion), and 3 (full flexion) during the static In this paper, a passive spine exoskeleton was developed to
test reduce loading on the lower back during flexion and extension.
The wearable prototype was tested and evaluated on three human
Muscle force Intervertebral reaction subjects. The sEMG and inertial signals collected during the
reduction (N) torque reduction (N  m) experiments showed that the muscle activations reduced markedly
with the exoskeleton as indicated by the magnitudes of the sEMG
Position 1 Subject #1 256 12 signals for the specific subject size. The sEMG was reduced by up
Subject #2 128 7 to 20% at the LES and 50% at the TES in the tested subjects. This
Subject #3 44 4
is because the two extension springs pulling the thorax are respon-
Position 2 Subject #1 397 20 sible for most of the work of the TES, which allows the back
Subject #2 252 22 muscles to be less active. In addition, the flexion–relaxation phe-
Subject #3 104 10
nomenon [19] possibly occurred during the full range of flexion at
Position 3 Subject #1 479 24 the LES during the static tests. This indicates that the muscles
Subject #2 363 36 were stretched and the passive mechanism was providing support-
Subject #3 271 27
ive forces [17,20]. As a result, sEMG cannot be used to evaluate
the performance of the exoskeleton at this position. Furthermore,
the muscle force and intervertebral bending moment were esti-
low-pass filtered by applying a second-order Butterworth filter mated with a simple static analysis model to evaluate the proto-
with a cut-off frequency of 3 Hz to obtain envelopes for the signal type, which decreased by about 479 N and 36 Nm, respectively,
waveforms. with the exoskeleton. The prototype demonstrated in this paper
was specifically designed for the human size like subjects 1 and 2
especially in terms of the passive forces that the springs can pro-
4 Results vide. For this reason, although the prototype can be mechanically
4.1 Data Comparison. The data from dynamic and static adjusted and worn by taller users like subject 3, it cannot provide
tests with and without the exoskeleton suit on each subject were the optimal assistance.
used to evaluate the prototype, as shown in Figs. 6 and 7. The It is observed that the estimated reductions of muscular forces
inertial data show similarity between the tests with and without and bending moment are greater than the ones computed from the
the exoskeleton suit (Figs. 6(c) and 6(d)). This means the subject simulations introduced in Sec. 2. The customized OPENSIM model
was able to successfully repeat the identical dynamic task when was driven by a simplified muscle group, as indicated in Fig. 2.
wearing the exoskeleton suit. The muscle activations are notice- Only 14 erector spinae which provided most of the muscle forces
ably reduced from observation of the sEMG signals, as indicated for this specific movement were involved while the power defi-
in Figs. 6(a) and 6(b). The observed sEMG magnitudes are at a ciencies were compensated by ideal joint actuators. The reason for
relatively low value during the static tests when wearing the exo- using a smaller set of muscles was to reduce the computational
skeleton while it varies more during long-time static position cost of simulations. The simulation model also lacked some other
holding without wearing it. In addition, the sEMG magnitude of features, such as intra-abdominal pressure and facet joints com-
the TES is reduced more than the sEMG magnitude of the LES. paring to reality. The reductions of forces and moment computed
Table 2 lists the sEMG magnitude reduction of all three sub- from simulations were therefore probably underestimated.
jects wearing the exoskeleton during the static tests. The magni- Although deviations exist in the simulation results, the simulations
tudes listed in the table are the average values (with/without provided valuable insights into the biomechanics that helped guide
exoskeleton) of the sEMG amplitude over the static flexion time the design and prototyping of the exoskeleton in an economical
intervals. It is observed that the magnitudes are reduced at both and time-bound manner. On the other hand, the static estimation
the TES and LES of subjects 1 and 2, who are in the similar size. of muscle force and bending moment in vivo treated the torso as a
Whereas, it reduces at the TES but increases at the LES for sub- single mass and neglected the additional mass from the device,
ject 3 who is much taller. This is attributed to the fact that the exo- thus the estimated reductions may be overestimated. Despite the
skeleton, especially the spring constants, was designed for the estimation errors in simulation and tests in vivo, the two estima-
body size of subject 1. Although the exoskeleton has the length tions provide the reasonable range of assistance in terms of reduc-
adjustment mechanism to fit for different sizes of human being, ing muscular efforts and bending moment during spine flexion/
the spring constants and resulting forces may not have been extension. Other factors like fabrication deviations, measurement
optimal. errors, and mechanical efficiency can also be attributed to the
Overall, reductions in sEMG magnitude of up to about 24% at result differences from simulations to prototype tests in vivo.
the LES and about 54% at the TES, respectively, among all three Future work on this topic will be guided in three primary direc-
subjects were observed. It is noticed that the sEMG reductions of tions. First, a limitation of this study is the number of subjects
subjects vary with positions and are rather variable. For instance, included. In a broader experimental evaluation of the exoskeleton,
the design favored subject 2 in position 1 (reduction of 18.6% at we will evaluate the device on more subjects (both males and
lumbar level and of 42.2% at thoracic level) while it did not make females) and focus on both healthy and individuals with impair-
much difference for subject 1 (less than 8% difference). It was ments to study its efficacy. Second, the functionality of the design
very effective for subject 1 in position 3 (reduction of 24.3% at can be further improved, by making the exoskeleton lighter, more
lumbar level and 50.0% at thoracic level). compliant, and able to assist rotation and lateral movements of
the torso. Third, the pursuit of an active, electrically powered exo-
skeleton will help fully realize the idea of external assistance and
4.2 Muscular Force and Intervertebral Bending Moment minimization of human effort.
Estimation. Applying Eqs. (2)–(4), the reductions of total muscu-
lar force and intervertebral bending moment were estimated.
Table 3 lists the estimation results for all three subjects during the
References
static tests at the three different flexion positions. The reductions
[1] Hara, H., and Sankai, Y., 2012, “HAL Equipped With Passive Mechanism,”
of both the total muscular force and the intervertebral bending 2012 IEEE/SICE International Symposium on System Integration, Fukuoka,
moments increase with the flexion angle of all three subjects. In Japan, Dec. 16–18, pp. 1–6.
addition, the reductions for subjects 1 and 2 who are in the size [2] Adams, M. A., Bogduk, N., Kim, B., Dolan, P., and Freeman, B. J. C., 2013,
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