As we age, humans see natural decreases in muscle force and power which leads to a slower, less efficient gait. Improving mobility for both healthy individuals and those with muscle impairments/weakness has been a goal for exoskeleton designers for decades. In this work, we discover that significant reductions in the energy cost required for walking can be achieved with almost 50% less mechanical power compared to the state of the art. This was achieved by leveraging human-in-the-loop optimization to understand the importance of individualized assistance for hip flexion, a relatively unexplored joint motion. Specifically, we show that a tethered hip flexion exosuit can reduce the metabolic rate of walking by up to 15.2 ± 2.6%, compared to locomotion with assistance turned off (equivalent to 14.8% reduction compared to not wearing the exosuit). This large metabolic reduction was achieved with surprisingly low assistance magnitudes (average of 89 N, ~ 24% of normal hip flexion torque). Furthermore, the ratio of metabolic reduction to the positive exosuit power delivered was 1.8 times higher than ratios previously found for hip extension and ankle plantarflexion. These findings motivated the design of a lightweight (2.31 kg) and portable hip flexion assisting exosuit, that demonstrated a 7.2 ± 2.9% metabolic reduction compared to walking without the exosuit. The high ratio of metabolic reduction to exosuit power measured in this study supports previous simulation findings and provides compelling evidence that hip flexion may be an efficient joint motion to target when considering how to create practical and lightweight wearable robots to support improved mobility.
The knee joint experiences significant torques in the frontal plane to keep the body upright during walking. Excessive loading over time can lead to knee osteoarthritis (OA), the progression of which is correlated with external knee adduction moment (KAM). In this paper, we present a wearable soft robotic exosuit that applies a hip abduction torque and evaluate its ability to reduce KAM. The exosuit uses a portable cable actuation system to generate torque when desired while remaining unrestrictive when unpowered. We explored five different force profiles on healthy participants (N=8) walking on an instrumented treadmill at 1.25 m/s. For each force profile, we tested two peak force levels: 15% and 20% of bodyweight. We observed KAM reductions with two of the five profiles. With Force Profile 2 (FP2), peak KAM was reduced by 9.61% and impulse KAM by 12.76%. With Force Profile 5 (FP5), we saw reductions of peak KAM by 6.14% and impulse KAM by 21.09%. These initial findings show that the device has the ability to change walking biomechanics in a consistent and potentially beneficial way.