Powered exoskeleton

Powered exoskeletons can improve the quality of life of individuals who have lost the use of their legs by enabling system-assisted walking.[19] Exoskeletons—that may be called "step rehabilitation robots"—may also help with the rehabilitation from stroke, spinal cord injury or during aging.[20] Several prototype exoskeletons are under development.[21][22] The Ekso GT, made by Ekso Bionics, is the first exoskeleton to be approved by the US Food and Drug Administration (FDA) for stroke patients.[23] The German Research Centre for Artificial Intelligence has developed two general purpose powered exoskeletons, CAPIO[24][25] and VI-Bot.[26] These are primarily being used for teleoperation. Exoskeleton technology is also being developed to enhance precision during surgery,[27] and to help nurses move and carry heavy patients.[28]

Developing a full-body suit that meets the needs of soldiers has proven challenging. The Defense Advanced Research Projects Agency (DARPA) launched the Warrior Web program[29] in September 2011[30] and has developed and funded several prototypes, including a "soft exosuit" developed by Harvard University's Wyss Institute.[31] In 2019, the US Army's TALOS exoskeleton project was put on hold.[32] A variety of "slimmed-down" exoskeletons have been developed for use on the battlefield, aimed at decreasing fatigue and increasing productivity.[33] For example, Lockheed Martin's ONYX suit aims to support soldiers in performing tasks that are "knee-intensive", such as crossing difficult terrain.[34] Leia Stirling's group has identified that exoskeletons can reduce a soldier's response times.[35]

Exoskeletons are being developed to help firefighters and other rescue workers to climb stairs carrying heavy equipment.[36]

Passive exoskeleton technology is increasingly being used in the automotive industry, with the goal of reducing worker injury (especially in the shoulders and spine) and reducing errors due to fatigue.[37][38] They are also being examined for use in logistics.[39]

These systems can be divided into two categories:[40]

• exoskeletons for upper-limb for assisting shoulder flexion-extension movements;
• exoskeletons for lumbar support for assisting manual lifting tasks.

For broadest application, industrial exoskeletons must be lightweight, comfortable, safe, and minimally disruptive to the environment.[41] For some applications, single-joint exoskeletons (i.e. intended to assist only the limb involved in specific tasks) are more appropriate than full-body powered suits.[41] Full-body powered exoskeletons have been developed to assist with heavy loads in the industrial setting,[42][43] and for specialized applications such as nuclear power plant maintenance.[44]

The biomechanical efficacy of exoskeletons in industrial applications is however still largely unknown. Companies have to conduct a risk assessment for workplaces at which exoskeletons are to be used. The Institute for Occupational Safety and Health of the German Social Accident Insurance has developed a draft risk assessment for exoskeletons and their use. The safety assessment is based on diverse experience including machine safety, personal protective equipment and risk analysis of physical stresses at work. The exoskeletons available on the market often fail to give adequate consideration to safety aspects, in some cases despite claims to the contrary by their manufacturers.[45]

• Japet Exoskeleton is a powered lower-back exoskeleton for work and industry based on established passive braces. It aims at restoring the capacities of co-workers as it postpones fatigue, relieves pain and follows the user's movements.
• Parker Hannifin's Indego Exoskeleton is an FDA-Cleared, electrically powered support system for legs that helps spinal cord injury patients and stroke patients walk.[46][47]
• ReWalk features powered hip and knee motion to enable those with lower limb disabilities, including paraplegia as a result of spinal cord injury (SCI), to perform self-initiated standing, walking, and stair ascending and descending.[48] ReStore, a simpler system by the same manufacturer, attaches to a single leg to assist with gait retraining, and was approved by the FDA in 2019.[48]
• Ekso Bionics's EskoGT is a hydraulically powered exoskeleton system allowing paraplegics to stand and walk with crutches or a walker.[49] It was approved by the FDA in 2019.[23]
• SuitX's Phoenix is a modular, light and cheap exoskeleton, powered by a battery backpack that allows paraplegics to walk at up to 1.8 kilometres per hour (1.1 mph).[50]
• Cyberdyne's HAL is a wearable robot that comes in multiple configurations.[51] HAL is currently in use in Japanese and US hospitals and was given global safety certification in 2013.[22][52]
• Honda's Walking Assist Device is a partial exoskeleton to help those with difficulties walking unsupported. It was given pre-market notification by the FDA in 2019.[53]
• The European Space Agency has developed a series of ergonomic exoskeletons for robotic teleoperation, including the EXARM, X-Arm-2 and SAM exoskeletons. The target application is telemanipulation of astronaut-like robots, operating in a remote harsh environment.[54]
• Roam Robotics produces a soft exoskeleton for skiers and snowboarders.[55]
• Wandercraft produces Atalante, the first powered exoskeleton to allow users to walk hands-free, unlike most powered medical exoskeleton that require the simultaneous use of crutches.[56]

• SuitX BackxS
• SuitX BackX AC
• SuitX Shoulderx
• Laevo
• SkelEx[57]

• Lockheed Martin's Human Universal Load Carrier (HULC) was abandoned after tests showed that wearing the suit caused users to expend significantly more energy during controlled treadmill walks.[58]
• Sarcos/Raytheon XOS Exoskeleton arms and legs were originally designed for use in the military.[59] In 2019, the project was reported to be on hold.[58]
• The Berkeley Lower Extremity Exoskeleton (BLEEX) consisted of mechanical metal leg braces, a power unit, and a backpack-like frame to carry a heavy load.[60] The technology developed for BLEEX led to SuitX's Phoenix.[61]
• A project from Ghent University, WALL-X was shown in 2013 to reduce the metabolic cost of normal walking. This result was achieved by optimizing the controls based on the study of the biomechanics of the human-exoskeleton interaction.[62]

One of the biggest problems facing engineers and designers of powered exoskeletons is the power supply.[64] This is a particular issue if the exoskeleton is intended to be worn "in the field", i.e. outside a context in which the exoskeleton can be tethered to a power source. Batteries require frequent replacement or recharging,[64] and may risk explosion due to thermal runaway.[65]

Internal combustion engine power supplies offer high energy output, but problems include exhaust fumes, heat and inability to modulate power smoothly.[66] Hydrogen cells have been used in some prototypes[67] but also suffer from several problems.[68]

Early exoskeletons used inexpensive and easy-to-mold materials, such as steel and aluminium. However, steel is heavy and the powered exoskeleton must work harder to overcome its own weight, reducing efficiency. Aluminium alloys are lightweight, but fail through fatigue quickly.[69] Fiberglass, carbon fiber and carbon nanotubes have considerably higher strength per weight.[70] "Soft" exoskeletons that attach motors and control devices to flexible clothing are also under development.[71]

Pneumatic air muscle

Joint actuators also face the challenge of being lightweight, yet powerful. Technologies used include pneumatic activators,[55] hydraulic cylinders,[72] and electronic servomotors.[73] Elastic actuators are being investigated to simulate control of stiffness in human limbs and provide touch perception.[74] The air muscle, a.k.a. braided pneumatic actuator or McKibben air muscle, is also used to enhance tactile feedback.[75]

The flexibility of human anatomy is a design issue for traditional "hard" robots. Several human joints such as the hips and shoulders are ball and socket joints, with the center of rotation inside the body. Since no two individuals are exactly alike, fully mimicking the degrees of freedom of a joint is not possible. Instead, the exoskeleton joint is commonly modeled as a series of hinges with one degree of freedom for each of the dominant rotations.[63]

Spinal flexibility is another challenge since the spine is effectively a stack of limited-motion ball joints. There is no simple combination of external single-axis hinges that can easily match the full range of motion of the human spine. Because accurate alignment is challenging, devices often include the ability to compensate for misalignment with additional degrees of freedom.[76]

Soft exoskeletons bend with the body and address some of these issues.[77]

A successful exoskeleton should assist its user, for example by reducing the energy required to perform a task.[63] Individual variations in the nature, range and force of movements make it difficult for a standardized device to provide the appropriate amount of assistance at the right time. Algorithms to tune control parameters to automatically optimize the energy cost of walking are under development.[78][79] Direct feedback between the human nervous system and motorized prosthetics ("neuro-embodied design") has also been implemented in a few high-profile cases.[80]

Humans exhibit a wide range of physical size differences in both skeletal bone lengths and limb and torso girth, so exoskeletons must either be adaptable or fitted to individual users. In military applications, it may be possible to address this by requiring the user to be of an approved physical size in order to be issued an exoskeleton. Physical body size restrictions already occur in the military for jobs such as aircraft pilots, due to the problems of fitting seats and controls to very large and very small people.[81] For soft exoskeletons, this is less of a problem.[77]