Evidence map›Paper›PMID 39811476›Full record

ArticleWearable technologies2024

The effect of active exoskeleton support with different lumbar-to-hip support ratios on spinal musculoskeletal loading and lumbar kinematics during lifting.

Niels P Brouwer, Ali Tabasi, Feng Hu, Idsart Kingma, Wietse van Dijk, Mohamed Irfan Mohamed Refai, Herman van der Kooij, Jaap H van Dieën

Abstract read
In one paragraph

Article in Wearable technologies, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Niels P BrouwerDepartment of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.ORCID https://orcid.org/0000-0001-7613-9947
Ali TabasiDepartment of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.
Feng HuDepartment of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.
Idsart KingmaDepartment of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.
Wietse van DijkTNO, Leiden, The Netherlands.ORCID https://orcid.org/0000-0002-5735-4446
Mohamed Irfan Mohamed RefaiDepartment of Biomechanical Engineering, University of Twente, Enschede, The Netherlands.ORCID https://orcid.org/0000-0002-3617-5131
Herman van der KooijDepartment of Biomechanical Engineering, University of Twente, Enschede, The Netherlands.
Jaap H van DieënDepartment of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

While active back-support exoskeletons can reduce mechanical loading of the spine, current designs include only one pair of actuated hip joints combined with a rigid structure between the pelvis and trunk attachments, restricting lumbar flexion and consequently intended lifting behavior. This study presents a novel active exoskeleton including actuated lumbar and hip joints as well as subject-specific exoskeleton control based on a real-time active low-back moment estimation. We evaluated the effect of exoskeleton support with different lumbar-to-hip (L/H) support ratios on spine loading, lumbar kinematics, and back muscle electromyography (EMG). Eight healthy males lifted 15 kg loads using three techniques without exoskeleton (NOEXO) and with exoskeleton: minimal impedance mode (MINIMP), L/H support ratio in line with a typical L/H net moment ratio (R0.8), lower (R0.5) and higher (R2.0) L/H support ratio than R0.8, and a mechanically fixed lumbar joint (LF; simulating hip joint-only exoskeleton designs). EMG-driven musculoskeletal model results indicated that R0.8 and R0.5 yielded significant reductions in spinal loading (4-11%, p < .004) across techniques when compared to MINIMP, through reducing active moments (14-30%) while not affecting lumbar flexion and passive moments. R2.0 and LF significantly reduced spinal loading (8-17%, p < .001; 22-26%, p < .001, respectively), however significantly restricted lumbar flexion (3-18%, 24-27%, respectively) and the associated passive moments. An L/H support ratio in line with a typical L/H net moment ratio reduces spinal loading, while allowing normal lifting behavior. High L/H support ratios (e.g., in hip joint-only exoskeleton designs) yield reductions in spinal loading, however, restrict lifting behavior, typically perceived as hindrance.

Indexed as

lumbo-pelvic rhythmmanual material handlingmusculoskeletal disordersOccupational exoskeletontrunk-support exoskeleton

Identifiers

PMID39811476
PMCPMC11729479

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.