Wearable assistive devices are increasingly becoming softer. Modelling their interface with human tissue is necessary to capture transmission of dynamic assistance. However, their nonlinear and compliant nature makes both physical modeling and embedded sensing challenging. In this paper, we develop a image-based, learning-based framework to estimate distributed contact forces for a finger-exosuit system. We used the SoRoSim toolbox to generate a diverse dataset of exosuit geometries and actuation scenarios for training. The method accurately estimated interaction forces across multiple contact locations from low-resolution grayscale images, was able to generalize to unseen shapes and actuation levels, and remained robust under visual noise and contrast variations. We integrated the model into a feedback controller, and found that the vision-based estimator functions as a surrogate force sensor for closed-loop control. This approach could be used as a non-intrusive alternative for real-time force estimation for exosuits.

Anchor point placement is a crucial yet often overlooked aspect of exosuit design since it determines how forces interact with the human body. This work analyzes the impact of different anchor point positions on gait kinematics, muscular activation and energetic consumption. A total of six experiments were conducted with 11 subjects wearing the XoSoft exosuit, which assists hip flexion in five configurations. Subjects were instrumented with an IMU-based motion tracking system, EMG sensors, and a mask to measure metabolic consumption. The results show that positioning the knee anchor point on the posterior side while keeping the hip anchor on the anterior part can reduce muscle activation in the hip flexors by up to 10.21\% and metabolic expenditure by up to 18.45\%. Even if the only assisted joint was the hip, all the configurations introduced changes also in the knee and ankle kinematics. Overall, no single configuration was optimal across all subjects, suggesting that a personalized approach is necessary to transmit the assistance forces optimally. These findings emphasize that anchor point position does indeed have a significant impact on exoskeleton effectiveness and efficiency. However, these optimal positions are subject-specific to the exosuit design, and there is a strong need for future work to tailor musculoskeletal models to individual characteristics and validate these results in clinical populations.

To enhance pediatric exosuit design, it is crucial to assess the actuator-generated forces. This work evaluates the contact forces exerted by soft fabric-based pneumatic actuators in an upper extremity pediatric exosuit. Two actuators were examined: a single-cell bidirectional actuator for shoulder abduction/adduction and a bellow-type actuator for elbow extension/flexion. Experiments assessed the impact of actuator anchoring points and the adjacent joint's angle on exerted forces and actuated joint range of motion (ROM). These were measured via load cells and encoders integrated into a custom infant-scale engineered apparatus with two degrees of freedom (two revolute joints). For the shoulder actuator, results show that anchoring it further from the shoulder joint center while the elbow is flexed at $90^\circ$ yields the highest ROM while minimizing the peak force exerted on the body. For the elbow actuator, anchoring it symmetrically while the shoulder joint is at $0^\circ$ optimizes actuator performance. These findings contribute a key step toward co-optimizing the considered exosuit design for functionality and wearability.

The use of a cable-driven soft exosuit poses challenges with regards to the mechanical design of the actuation system, particularly when used for actuation along multiple degrees of freedom (DoF). The simplest general solution requires the use of two actuators to be capable of inducing movement along one DoF. However, this solution is not practical for the development of multi-joint exosuits. Reducing the number of actuators is a critical need in multi-DoF exosuits. We propose a switch-based mechanism to control an antagonist pair of cables such that it can actuate along any cable path geometry. The results showed that 298.24ms was needed for switching between cables. While this latency is relatively large, it can reduced in the future by a better choice of the motor used for actuation.

Fabric-based pneumatic exosuits have a broad application prospect due to their good human-machine interaction performance, but their structural design paradigm has not yet been finalized and requires in-depth research. This paper proposes the concepts of zone inflation and volume transfer for the design of a fabric-based pneumatic exosuit with both efficiency and wearability. The meaning of zone inflation is to divide the inflation area of pneumatic exosuit into inflation-deflation zone and inflation-holding zone which can reduce the consumption of compressed air and improve efficiency. Volume transfer, a strategic distribution method of inflatable regions inside the garment, can effectively enhance the wearability of the exosuit. Using inexpensive thermoplastic polyurethane film and clothing fabric, the exosuit is made by heat pressing and sewing. The exosuit has a response time of 0.5s, a stress area of 1500mm2, and a profile of only 32mm, which can be hidden inside common clothing. A mathematical model is developed to predict the output torque of the exosuit with an error of 3.6%. Mechanical experiments show that the exosuit outputs a torque of 9.1Nm at a pressure of 100kPa. Surface electromyography experiments show that the exosuit can provide users with a boost from sitting to standing, with an average reduction in electromyography signals of 14.95%. The exosuit designed using these methods synthesizes efficiency and wearability and is expected to be an ideal paradigm for fabric-based pneumatic exosuits.

Movement disorders impact muscle strength and mobility, and despite therapeutic efforts, many people with movement disorders have challenges functioning independently. Soft wearable robots, or exosuits, offer a promising solution for continuous daily support, however, commercially viable devices are not widely available. Here, we introduce a design framework for lower limb exosuits centered on a soft pneumatically driven fabric-based actuator. Our design consists of a novel multi-material textile sleeve that incorporates braided mesh and knit-elastic materials to realize hyper-bending actuators. The actuators incorporate 3D-printed self-sealing end caps that are attached to a semi-rigid human-robot interface to secure them to the body. We will demonstrate the effectiveness of our exosuit in generating enough force to assist during sit-to-stand transitions.

Work related musculoskeletal disorders (WMSDs) are often caused by repetitive lifting, making them a significant concern in occupational health. Although wearable assist devices have become the norm for mitigating the risk of back pain, most spinal assist devices still possess a partially rigid structure that impacts the user comfort and flexibility. This paper addresses this issue by presenting a smart textile actuated spine assistance robotic exosuit (SARE), which can conform to the back seamlessly without impeding the user movement and is incredibly lightweight. The SARE can assist the human erector spinae to complete any action with virtually infinite degrees of freedom. To detect the strain on the spine and to control the smart textile automatically, a soft knitting sensor which utilizes fluid pressure as sensing element is used. The new device is validated experimentally with human subjects where it reduces peak electromyography (EMG) signals of lumbar erector spinae by around 32 percent in loaded and around 22 percent in unloaded conditions. Moreover, the integrated EMG decreased by around 24.2 percent under loaded condition and around 23.6 percent under unloaded condition. In summary, the artificial muscle wearable device represents an anatomical solution to reduce the risk of muscle strain, metabolic energy cost and back pain associated with repetitive lifting tasks.

The fabric-based pneumatic exosuit is now a hot research topic because it is lighter and softer than traditional exoskeletons. Existing research focused more on the mechanical properties of the exosuit (e.g., torque and speed), but less on its wearability (e.g., appearance and comfort). This work presents a new design concept for fabric-based pneumatic exosuits Volume Transfer, which means transferring the volume of pneumatic actuators beyond the garments profile to the inside. This allows for a concealed appearance and a larger stress area while maintaining adequate torques. In order to verify this concept, we develop a fabric-based pneumatic exosuit for knee extension assistance. Its profile is only 26mm and its stress area wraps around almost half of the leg. We use a mathematical model and simulation to determine the parameters of the exosuit, avoiding multiple iterations of the prototype. Experiment results show that the exosuit can generate a torque of 7.6Nm at a pressure of 90kPa and produce a significant reduction in the electromyography activity of the knee extensor muscles. We believe that Volume Transfer could be utilized prevalently in future fabric-based pneumatic exosuit designs to achieve a significant improvement in wearability.

State of the art controllers for back exoskeletons largely rely on body kinematics. This results in control strategies which cannot provide adaptive support under unknown external loads. We developed a neuromechanical model-based controller (NMBC) for a soft back exosuit, wherein assistive forces were proportional to the active component of lumbosacral joint moments, derived from real-time electromyography-driven models. The exosuit provided adaptive assistance forces with no a priori information on the external loading conditions. Across 10 participants, who stoop-lifted 5 and 15 kg boxes, our NMBC was compared to a non-adaptive virtual spring-based control(VSBC), in which exosuit forces were proportional to trunk inclination. Peak cable assistive forces were modulated across weight conditions for NMBC (5kg: 2.13 N/kg; 15kg: 2.82 N/kg) but not for VSBC (5kg: 1.92 N/kg; 15kg: 2.00 N/kg). The proposed NMBC strategy resulted in larger reduction of cumulative compression forces for 5 kg (NMBC: 18.2%; VSBC: 10.7%) and 15 kg conditions (NMBC: 21.3%; VSBC: 10.2%). Our proposed methodology may facilitate the adoption of non-hindering wearable robotics in real-life scenarios.

Recently, soft actuator-based exosuits have gained interest, due to their high strength-to-weight ratio, inherent safety, and low cost. We present a novel wrist exosuit actuated by fabric pneumatic artificial muscles that can move the wrist in flexion/extension and ulnar/radial deviation. We derive a model representing the torque exerted by the exosuit and introduce a model-based optimization methodology for the selection of placement parameters of the exosuit muscles. We evaluate the accuracy of the model by measuring the exosuit torques throughout the full range of wrist flexion/extension. When accounting for the displacement of the mounting points, the model predicts the exosuit torque with a mean absolute error of 0.279 Nm, which is 26.1% of the average measured torque. To explore the capabilities of the exosuit to move the human body, we measure its range of motion on a passive human wrist; the exosuit is able to achieve 55.0% of the active biological range in flexion, 69.1% in extension, 68.6% in ulnar deviation, and 68.4% in radial deviation. Finally, we demonstrate the device controlling the passive human wrist to move to a desired orientation in the flexion/extension plane and along a two-degree-of-freedom trajectory.