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Article ; Online: Experimental Study of Fully Passive, Fully Active, and Active-Passive Upper-Limb Exoskeleton Efficiency: An Assessment of Lifting Tasks.

Nasr, Ali / Dickerson, Clark R / McPhee, John

2023 Volume 24, Issue 1

Abstract: Recently, robotic exoskeletons are gaining attention for assisting industrial workers. The exoskeleton power source ranges from fully passive (FP) to fully active (FA), or a mixture of both. The objective of this experimental study was to assess the ... ...

Abstract	Recently, robotic exoskeletons are gaining attention for assisting industrial workers. The exoskeleton power source ranges from fully passive (FP) to fully active (FA), or a mixture of both. The objective of this experimental study was to assess the efficiency of a new active-passive (AP) shoulder exoskeleton using statistical analyses of 11 quantitative measures from surface electromyography (sEMG) and kinematic data and a user survey for weight lifting tasks. Two groups of females and males lifted heavy kettlebells, while a shoulder exoskeleton helped them in modes of fully passive (FP), fully active (FA), and active-passive (AP). The AP exoskeleton outperformed the FP and FA exoskeletons because the participants could hold the weighted object for nearly twice as long before fatigue occurred. Future developments should concentrate on developing sex-specific controllers as well as on better-fitting wearable devices for women.
MeSH term(s)	Male ; Humans ; Female ; Exoskeleton Device ; Lifting ; Upper Extremity ; Electric Power Supplies ; Electromyography
Language	English
Publishing date	2023-12-22
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2052857-7
ISSN	1424-8220 ; 1424-8220
ISSN (online)	1424-8220
ISSN	1424-8220
DOI	10.3390/s24010063
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Article ; Online: Examining the Effect of Time-From-Treatment on Activities of Daily Living Kinematics in Breast Cancer Survivors.

Wills, Rebecca A M / Maciukiewicz, Jacquelyn M / Mourtzakis, Marina / Dickerson, Clark R

Journal of applied biomechanics

2023 Volume 39, Issue 4, Page(s) 217–222

Abstract: Breast cancer affects one in 8 females with a 5-year survival rate of 89%. Up to 72% of breast cancer survivors have trouble with activities of daily living (ADL) following treatment. Increased time-from-treatment improves some measures of function, yet ... ...

Abstract	Breast cancer affects one in 8 females with a 5-year survival rate of 89%. Up to 72% of breast cancer survivors have trouble with activities of daily living (ADL) following treatment. Increased time-from-treatment improves some measures of function, yet ADL limitations persist. Therefore, this study assessed the effect of time-from-treatment on upper extremity kinematics during ADLs in breast cancer survivors. Twenty-nine female breast cancer survivors were divided into 2 groups: <1 year (n = 12) and 1-2 years (n = 17) from treatment. Kinematics were collected during 6 ADL tasks, and humerothoracic joint angles were quantified. A 2-way mixed analysis of variance assessed the effects of time-from-treatment and arm on maximum angles for each ADL. Decreased maximum angle existed for breast cancer survivors with increased time-from-treatment during all ADLs. Breast cancer survivors in the 1-2 years group used ∼28° to 32° lower elevation, ∼14° to 28° lower axial rotation, and ∼10° to 14° lower plane of elevation range across tasks. Decreased ranges of arm movement during ADLs with increased time-from-treatment may reflect compensatory movement strategies. Recognizing this shift in strategies and accompanying underlying disease progression can help inform responses to functional performance limitations in breast cancer survivors as delayed effects are present posttreatment.
MeSH term(s)	Humans ; Female ; Activities of Daily Living ; Breast Neoplasms ; Biomechanical Phenomena ; Cancer Survivors ; Upper Extremity ; Range of Motion, Articular
Language	English
Publishing date	2023-05-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	1145288-2
ISSN	1543-2688 ; 1065-8483
ISSN (online)	1543-2688
ISSN	1065-8483
DOI	10.1123/jab.2022-0245
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Article ; Online: Evaluation of a machine-learning-driven active-passive upper-limb exoskeleton robot: Experimental human-in-the-loop study.

Nasr, Ali / Hunter, Jason / Dickerson, Clark R / McPhee, John

Wearable technologies

2023 Volume 4, Page(s) e13

Abstract: Evaluating exoskeleton actuation methods and designing an effective controller for these exoskeletons are both challenging and time-consuming tasks. This is largely due to the complicated human-robot interactions, the selection of sensors and actuators, ... ...

Abstract	Evaluating exoskeleton actuation methods and designing an effective controller for these exoskeletons are both challenging and time-consuming tasks. This is largely due to the complicated human-robot interactions, the selection of sensors and actuators, electrical/command connection issues, and communication delays. In this research, a test framework for evaluating a new active-passive shoulder exoskeleton was developed, and a surface electromyography (sEMG)-based human-robot cooperative control method was created to execute the wearer's movement intentions. The hierarchical control used sEMG-based intention estimation, mid-level strength regulation, and low-level actuator control. It was then applied to shoulder joint elevation experiments to verify the exoskeleton controller's effectiveness. The active-passive assistance was compared with fully passive and fully active exoskeleton control using the following criteria: (1) post-test survey, (2) load tolerance duration, and (3) computed human torque, power, and metabolic energy expenditure using sEMG signals and inverse dynamic simulation. The experimental outcomes showed that active-passive exoskeletons required less muscular activation torque (50%) from the user and reduced fatigue duration indicators by a factor of 3, compared to fully passive ones.
Language	English
Publishing date	2023-05-15
Publishing country	England
Document type	Journal Article
ISSN	2631-7176
ISSN (online)	2631-7176
DOI	10.1017/wtc.2023.9
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Article ; Online: A comparative probabilistic analysis of human and chimpanzee rotator cuff functional capacity.

MacLean, Kathleen F E / Langenderfer, Joseph E / Dickerson, Clark R

Journal of anatomy

2023 Volume 243, Issue 3, Page(s) 431–447

Abstract: Computational musculoskeletal modeling represents a valuable approach to examining biological systems in physical anthropology. Probabilistic modeling builds on computational musculoskeletal models by associating mathematical distributions of specific ... ...

Abstract	Computational musculoskeletal modeling represents a valuable approach to examining biological systems in physical anthropology. Probabilistic modeling builds on computational musculoskeletal models by associating mathematical distributions of specific musculoskeletal features within known ranges of biological variability with functional outcomes. The purpose of this study was to determine if overlap in rotator cuff muscle force predictions would occur between species during the performance of an evolutionarily relevant horizontal bimanual arm suspension task. This necessitated creating novel probabilistic models of the human and chimpanzee glenohumeral joint through augmentation of previously published deterministic models. Glenohumeral musculoskeletal features of anthropological interest were probabilistically modeled to produce distributions of predicted human and chimpanzee rotator cuff muscle force that were representative of the specific anatomical manipulations. Musculoskeletal features modeled probabilistically included rotator cuff origins and deltoid insertion, glenoid inclination, and joint stability. Predicted human rotator cuff muscle force distributions were mostly limited to alternating between infraspinatus and teres minor, with both 100% and 0% muscle force predicted for both muscles. The chimpanzee model predicted low-to-moderate muscle force across all rotator cuff muscles. Rotator cuff muscle force predictions were most sensitive to changes of muscle origins and insertions. Results indicate that functional rotator cuff overlap is unlikely between chimpanzees and humans without greater modifications of the glenohumeral musculoskeletal phenotypes. The results also highlight the low efficacy of the human upper extremity in overhead, weight-bearing tasks, and propensity for rotator cuff injury.
MeSH term(s)	Humans ; Animals ; Rotator Cuff/physiology ; Pan troglodytes ; Shoulder Joint/physiology ; Rotator Cuff Injuries ; Scapula ; Biomechanical Phenomena
Language	English
Publishing date	2023-04-25
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2955-5
ISSN	1469-7580 ; 0021-8782
ISSN (online)	1469-7580
ISSN	0021-8782
DOI	10.1111/joa.13882
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Article ; Online: Upper extremity muscle activity and joint loading changes between the standard and powerlifting bench press techniques.

Cudlip, Alan C / Maciukiewicz, Jacquelyn M / Pinto, Brendan L / Dickerson, Clark R

Journal of sports sciences

2022 Volume 40, Issue 9, Page(s) 1055–1063

Abstract: The bench press is a common activity found in many exercise regimens. Powerlifters often adopt non-standard techniques to potentially enhance maximal capability. The purpose of this research was to examine muscle activation and joint loading differences ... ...

Abstract	The bench press is a common activity found in many exercise regimens. Powerlifters often adopt non-standard techniques to potentially enhance maximal capability. The purpose of this research was to examine muscle activation and joint loading differences between the powerlifting (Arch) and standardised techniques. Twenty experienced male lifters completed lifts at an instructed cadence in the arch and the National Strength and Conditioning Association standard techniques at 25%, 50% and 75% of their self-reported one rep maximum. The arch technique increased latissimus dorsi mean and peak activation (p < 0.0001), generating activation of approximately 13% maximal voluntary contraction, regardless of percentage of the one rep maximum lifted. The standardised technique resulted in integrated shoulder moments that were 8% larger (p < 0.0001). This latissimus dorsi activation paired with decreased shoulder loading in the arch technique likely acts to minimise the amount of time spent in the "sticking region", where most lift efforts fail. It is possible to use this technique to increase latissimus dorsi activation, without increasing overall shoulder loading. The technique-specific differences can be used in performance or rehabilitation-based programmes to increase muscular output of some muscles without increasing overall loading.
MeSH term(s)	Electromyography/methods ; Humans ; Isometric Contraction/physiology ; Male ; Muscle, Skeletal/physiology ; Superficial Back Muscles/physiology ; Upper Extremity/physiology ; Weight Lifting/physiology
Language	English
Publishing date	2022-03-02
Publishing country	England
Document type	Journal Article
ZDB-ID	995528-8
ISSN	1466-447X ; 0264-0414
ISSN (online)	1466-447X
ISSN	0264-0414
DOI	10.1080/02640414.2022.2046937
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Article ; Online: A comparison of isometric and isokinetic normalization methods for electromyographic data from sub-regions of supraspinatus and infraspinatus during dynamic tasks.

Calver, Ronelle / Cudlip, Alan / Dickerson, Clark R / Mondal, Prosanta / Butcher, Scotty / Kim, Soo Y

International biomechanics

2023 Volume 10, Issue 1, Page(s) 1–9

Abstract: This study explored effects of using isometric versus isokinetic maximal voluntary contractions (MVCs) to normalize EMG data from supraspinatus and infraspinatus subregions during isokinetic tasks. Participants performed submaximal isokinetic external ... ...

Abstract	This study explored effects of using isometric versus isokinetic maximal voluntary contractions (MVCs) to normalize EMG data from supraspinatus and infraspinatus subregions during isokinetic tasks. Participants performed submaximal isokinetic external rotation (ER) and scaption tasks at two speeds. Three isometric MVCs were used: seated ER; side-lying scaption; side-lying abduction. Isokinetic MVCs were performed in the same position and speeds as the experimental tasks. Data were normalized using peak EMG from reference tasks: MVC which produced the greatest amplitude overall (MEA), isometric MVC with greatest amplitude (isometric best), isokinetic MVC with greatest amplitude (isokinetic best), and the greatest amplitude from the isokinetic MVC that matched the experimental task (isokinetic matched). Mean %MVC from each experimental task/ sub-region were compared by normalization method. The isokinetic matched method versus the MEA method was significantly different in all comparisons with isokinetic matched resulting in relative normalized task values up to 162% greater. The isometric best method resulted in significantly greater %MVC 37% of the time compared to the MEA method, whereas there were no differences when using isokinetic best compared to MEA. Isokinetic MVCs are less likely to overestimate %MVC than isometric and their use should be considered when normalizing data from dynamic tasks.
MeSH term(s)	Humans ; Rotator Cuff ; Electromyography/methods ; Isometric Contraction ; Movement ; Exercise Therapy
Language	English
Publishing date	2023-05-14
Publishing country	England
Document type	Journal Article
ZDB-ID	2819173-0
ISSN	2333-5432 ; 2333-5432
ISSN (online)	2333-5432
ISSN	2333-5432
DOI	10.1080/23335432.2023.2210634
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Article ; Online: Differential regional pectoralis major activation indicates functional diversity in healthy females.

Lulic-Kuryllo, Tea / Negro, Francesco / Jiang, Ning / Dickerson, Clark R

Journal of biomechanics

2022 Volume 133, Page(s) 110966

Abstract: Pectoralis major activation enables the performance of several upper extremity movements. Its regional activation, however, is not documented in healthy females. This work used high-density surface electromyography to investigate regional pectoralis ... ...

Abstract	Pectoralis major activation enables the performance of several upper extremity movements. Its regional activation, however, is not documented in healthy females. This work used high-density surface electromyography to investigate regional pectoralis major activation in twenty-nine healthy young females across two independent experiments in several ramp and hold isometric tasks and force levels. Regional mean root mean square amplitudes (normalized to the task-specific maxima) were quantified for the clavicular, superior, and middle sternocostal regions. Two-way ANOVAs were used to determine if differences in normalized regional activation exist within each task and force level. The middle sternocostal region activated 12-108% more than the clavicular and the superior sternocostal region in extension, adduction with external rotation, and high elevation internal rotation. In high elevation adduction, the middle sternocostal region activated more (7-22%) than the superior sternocostal region. In low elevation, internal rotation (60°), the clavicular and middle sternocostal regions activated more (9-13%) than the superior sternocostal region, while in adduction 60°, the clavicular region activated 9-19% more than the superior sternocostal region. Lastly, in forward and horizontal flexion, all three regions activated similarly irrespective of the force level, except at 25% MVF in forward flexion, where the clavicular region activated 21% more than the superior sternocostal region. This work provides a first comprehensive evaluation of the normalized regional pectoralis major activation in healthy females. The present findings indicate that the performance of isometric tasks in different directions activates different pectoralis major regions in healthy females, suggesting regional specificity to functional actions.
MeSH term(s)	Clavicle/physiology ; Electromyography ; Female ; Humans ; Pectoralis Muscles/physiology ; Shoulder/physiology ; Shoulder Joint/physiology
Language	English
Publishing date	2022-01-22
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	218076-5
ISSN	1873-2380 ; 0021-9290
ISSN (online)	1873-2380
ISSN	0021-9290
DOI	10.1016/j.jbiomech.2022.110966
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Article ; Online: Hybrid Soft-Rigid Active Prosthetics Laboratory Exercise for Hands-On Biomechanical and Biomedical Engineering Education.

Gao, Run Ze / Lee, Peter S / Ravi, Aravind / Ren, Carolyn L / Dickerson, Clark R / Tung, James Y

Journal of biomechanical engineering

2024 Volume 146, Issue 5

Abstract: This paper introduces a hands-on laboratory exercise focused on assembling and testing a hybrid soft-rigid active finger prosthetic for biomechanical and biomedical engineering (BME) education. This hands-on laboratory activity focuses on the design of a ...

Abstract	This paper introduces a hands-on laboratory exercise focused on assembling and testing a hybrid soft-rigid active finger prosthetic for biomechanical and biomedical engineering (BME) education. This hands-on laboratory activity focuses on the design of a myoelectric finger prosthesis, integrating mechanical, electrical, sensor (i.e., inertial measurement units (IMUs), electromyography (EMG)), pneumatics, and embedded software concepts. We expose students to a hybrid soft-rigid robotic system, offering a flexible, modifiable lab activity that can be tailored to instructors' needs and curriculum requirements. All necessary files are made available in an open-access format for implementation. Off-the-shelf components are all purchasable through global vendors (e.g., DigiKey Electronics, McMaster-Carr, Amazon), costing approximately USD 100 per kit, largely with reusable elements. We piloted this lab with 40 undergraduate engineering students in a neural and rehabilitation engineering upper year elective course, receiving excellent positive feedback. Rooted in real-world applications, the lab is an engaging pedagogical platform, as students are eager to learn about systems with tangible impacts. Extensions to the lab, such as follow-up clinical (e.g., prosthetist) and/or technical (e.g., user-device interface design) discussion, are a natural means to deepen and promote interdisciplinary hands-on learning experiences. In conclusion, the lab session provides an engaging journey through the lifecycle of the prosthetic finger research and design process, spanning conceptualization and creation to the final assembly and testing phases.
MeSH term(s)	Humans ; Biomedical Engineering/education ; Upper Extremity ; Hand ; Curriculum ; Artificial Limbs
Language	English
Publishing date	2024-03-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	243094-0
ISSN	1528-8951 ; 0148-0731
ISSN (online)	1528-8951
ISSN	0148-0731
DOI	10.1115/1.4065008
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Article ; Online: Activation patterns of shoulder internal and external rotators during pure axial moment generation across a postural range.

Lang, Angelica E / Lin, Jia-Hua / Dickerson, Clark R

Journal of biomechanics

2021 Volume 123, Page(s) 110503

Abstract: Musculoskeletal risk is mediated by body posture, especially for static tasks. Workstations that require non-neutral postures can lead to increased load, muscular fatigue and injury risk. However, demands during simple axial rotation tasks are not well- ... ...

Abstract	Musculoskeletal risk is mediated by body posture, especially for static tasks. Workstations that require non-neutral postures can lead to increased load, muscular fatigue and injury risk. However, demands during simple axial rotation tasks are not well-defined. The purpose of this study is to quantify the muscular activity of during static axial rotation in a range of postures. Eighteen participants performed 76 axial rotation exertions in varying combinations of humeral elevation angles (30°-60°-90°-120°-150°), plane of elevation (30°-60°-90°-120°) and exertion intensity (20-40%). Six unilateral (right) muscles (pectoralis major (clavicular and sternal), posterior deltoid, teres major, infraspinatus, latissiumus dorsi) were monitored using surface electromyography (EMG). EMG was normalized and integrated over 2 s. The influences of elevation, plane, and intensity on activity levels were then tested with a 3-way ANOVAs (p < .05). During internal rotation, activity was highest at low elevation/high plane combinations for the internal rotators, but at high elevation/low plane combinations for the external rotators. During the 40% intensity exertions, activity levels were highest at lower elevations for internal rotator but at high elevations for the external rotators. During external rotation, as the degree of elevation increased, the activity of the external rotator muscles also increased while internal rotators were unaffected. Humeral muscles responsible for axial rotation are influenced by arm posture during axial rotation exertions. High elevation and plane combinations resulted in high demands for external rotator muscles and this should be considered for job design and injury risk.
MeSH term(s)	Electromyography ; Humans ; Humerus ; Rotation ; Rotator Cuff ; Shoulder ; Shoulder Joint
Language	English
Publishing date	2021-05-07
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	218076-5
ISSN	1873-2380 ; 0021-9290
ISSN (online)	1873-2380
ISSN	0021-9290
DOI	10.1016/j.jbiomech.2021.110503
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Article ; Online: An evaluation of upper limb strength and range of motion of breast cancer survivors immediately following treatment.

Maciukiewicz, Jacquelyn M / Hussein, Ayah T S / Mourtzakis, Marina / Dickerson, Clark R

Clinical biomechanics (Bristol, Avon)

2022 Volume 96, Page(s) 105666

Abstract: Background: There is a growing number of breast cancer survivors from improved cancer treatments. However, treatments often impair upper limb function, specifically range of motion and strength, reducing quality of life and function. The primary purpose ...

Abstract	Background: There is a growing number of breast cancer survivors from improved cancer treatments. However, treatments often impair upper limb function, specifically range of motion and strength, reducing quality of life and function. The primary purpose of this study was to quantify differences in strength and range of motion following treatment. The secondary purpose aimed to measure the activation of each upper limb muscle in the completion of tasks. Methods: 29 breast cancer survivors were categorized into two groups based on time-since-treatment: 1) up to 1-year post-treatment, and 2) 1 to 2 years post-treatment. Participants completed maximal strength and range of motion tasks. During trials eight muscles were monitored bilaterally. Maximal force output was taken during strength trials, and kinematics were monitored during range of motion trials. A 2 by 2 mixed ANOVA (limb (affected, unaffected) x time-since-treatment) examined interaction and main effects of these factors on task peak force, angle and mean activation. Findings: Time-since-treatment influenced strength (flexion, extension, internal and external rotation) and range of motion (flexion, scapular abduction), wherein the group further from treatment had 11.5-15.5° less range of motion and 27.7-43.6 N less force production. A main effect of time-since-treatment influenced muscular behaviours during both tasks, where activation was higher in the group 1-2 years from treatment. Interpretation: Effects of treatment may manifest in a delayed manner whereby strength and range of motion are reduced in breast cancer survivors to a greater extent in those who are past 1 year of treatment cessation.
MeSH term(s)	Breast Neoplasms/therapy ; Cancer Survivors ; Female ; Humans ; Quality of Life ; Range of Motion, Articular/physiology ; Shoulder Joint ; Upper Extremity
Language	English
Publishing date	2022-05-15
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632747-3
ISSN	1879-1271 ; 0268-0033
ISSN (online)	1879-1271
ISSN	0268-0033
DOI	10.1016/j.clinbiomech.2022.105666
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