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Wearable Monitoring and Assistive Devices for the Risk Prevention and Return to Work

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Digital Health".

Deadline for manuscript submissions: closed (31 August 2021) | Viewed by 20545

Special Issue Editors

Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Rome, Italy
Interests: movement analysis; surface electromyography; ergonomics; biomechanical risk; manual handling activities; rehabilitation; neurorehabilitation; wearable monitoring devices; robotics
Special Issues, Collections and Topics in MDPI journals
Istituto Italiano di Tecnologia
Interests: physical human–robot collaboration, humanoid robotics, ergonomy, nonlinear control

Special Issue Information

Dear Colleagues,

In recent years, the epochal changes in Industry 4.0 have driven the development and use of innovative monitoring and assistive devices and technologies for manual handling work activities and return to work. They include:

Miniaturized and wireless wearable sensors, which are increasingly being used for quantitative instrumental-based biomechanical risk assessments in the prevention of work-related musculoskeletal disorders (WMSDs);

Human–robot collaboration (HRC) technologies (i.e. ,wearable trunk and upper-limb exoskeletons, collaborative robots, and humanoids), which are spreading to several ares of work to reduce physical demands and assist the return to work of subjects affected by diseases.

The aim of this Special Issue entitled “Wearable Monitoring and Assistive Devices for Risk Prevention and Return to Work” is to publish studies concerning:

New quantitative wearable devices-based approaches improving biomechanichal risk assessments in manual handling activities. Studies about the adaptation of tools to all work conditions, overcoming some of the limits of the current standardized methods are particularly welcomed;

The use of HRC technologies impacting on the reduction of biomechanical risk;

The use of monitoring and assistive devices for: (1) the evaluation of the efficacy of return to work rehabilitation paths and workplace adaptations, 2) facilitating the return to work of people affected by WMSDs or other pathologies.

Dr. Alberto Ranavolo
Dr. Daniele Pucci
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Wearable Monitoring Devices
  • Work-related Musculoskeletal Disorders Prevention
  • Quantitative Instrumental-based tools for Biomechanical risk assessment
  • Return to Work
  • Human–Robot Collaboration Technologies
  • Exoskeletons
  • Workplace Rehabilitation
  • Bipolar and HD surface Electromyography
  • Kinematics
  • Kinetics

Published Papers (5 papers)

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Research

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25 pages, 2409 KiB  
Article
Equivalent Weight: Connecting Exoskeleton Effectiveness with Ergonomic Risk during Manual Material Handling
by Christian Di Natali, Giorgia Chini, Stefano Toxiri, Luigi Monica, Sara Anastasi, Francesco Draicchio, Darwin G. Caldwell and Jesús Ortiz
Int. J. Environ. Res. Public Health 2021, 18(5), 2677; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18052677 - 07 Mar 2021
Cited by 20 | Viewed by 4343
Abstract
Occupational exoskeletons are becoming a concrete solution to mitigate work-related musculoskeletal disorders associated with manual material handling activities. The rationale behind this study is to search for common ground for exoskeleton evaluators to engage in dialogue with corporate Health & Safety professionals while [...] Read more.
Occupational exoskeletons are becoming a concrete solution to mitigate work-related musculoskeletal disorders associated with manual material handling activities. The rationale behind this study is to search for common ground for exoskeleton evaluators to engage in dialogue with corporate Health & Safety professionals while integrating exoskeletons with their workers. This study suggests an innovative interpretation of the effect of a lower-back assistive exoskeleton and related performances that are built on the benefit delivered through reduced activation of the erector spinae musculature. We introduce the concept of “equivalent weight” as the weight perceived by the wearer, and use this to explore the apparent reduced effort needed when assisted by the exoskeleton. Therefore, thanks to this assistance, the muscles experience a lower load. The results of the experimental testing on 12 subjects suggest a beneficial effect for the back that corresponds to an apparent reduction of the lifted weight by a factor of 37.5% (the perceived weight of the handled objects is reduced by over a third). Finally, this analytical method introduces an innovative approach to quantify the ergonomic benefit introduced by the exoskeletons’ assistance. This aims to assess the ergonomic risk to support the adoption of exoskeletons in the workplace. Full article
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12 pages, 667 KiB  
Article
Return to Work and Quality of Life after Stroke in Italy: A Study on the Efficacy of Technologically Assisted Neurorehabilitation
by Sheyda Ghanbari Ghoshchi, Sara De Angelis, Giovanni Morone, Monica Panigazzi, Benedetta Persechino, Marco Tramontano, Edda Capodaglio, Pierluigi Zoccolotti, Stefano Paolucci and Marco Iosa
Int. J. Environ. Res. Public Health 2020, 17(14), 5233; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17145233 - 20 Jul 2020
Cited by 19 | Viewed by 2847
Abstract
Cerebrovascular diseases, including stroke, are historically considered diseases of old adults so only in a few studies has “return to work” (RTW) been considered as an index of rehabilitative outcome. At the moment, data on RTW in patients with stroke are highly variable: [...] Read more.
Cerebrovascular diseases, including stroke, are historically considered diseases of old adults so only in a few studies has “return to work” (RTW) been considered as an index of rehabilitative outcome. At the moment, data on RTW in patients with stroke are highly variable: four different reviews reported the following ranges: 11–85%, 19–73%, 22–53%, and 40–45%. The absence of re-integration to work after a stroke is shown to be associated with an increase of cardiac disorders and depression, with a higher level of mortality, with social isolation and with insufficient adaptive skills. The aim of this study was to verify the effectiveness of technological treatment, performed with optic (SonicHand) and wearable (Riablo™) systems providing auditory and visual biofeedback, on RTW in patients with stroke. RTW was found to be associated with a higher independence in the activities of daily living (assessed by the Modified Barthel Index). No significant differences were found between technological versus conventional rehabilitation in terms of RTW, despite the former showing a higher odds ratio than the latter (OR = 9 vs. 6). Assistive devices were mainly used in patients who had not returned to work. Finally, quality of life was found higher in those patients who returned to work with the same conditions (work duties and time) as before stroke. Full article
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12 pages, 2636 KiB  
Article
Biomechanical and Metabolic Effectiveness of an Industrial Exoskeleton for Overhead Work
by Thomas Schmalz, Jasmin Schändlinger, Marvin Schuler, Jonas Bornmann, Benjamin Schirrmeister, Andreas Kannenberg and Michael Ernst
Int. J. Environ. Res. Public Health 2019, 16(23), 4792; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16234792 - 29 Nov 2019
Cited by 77 | Viewed by 6653
Abstract
Overhead work activities can lead to shoulder pain and serious musculoskeletal disorders (WMSD), such as rotator cuff injury and degeneration. Recently developed exoskeletons show promising results in supporting workers in such activities. In this study, a novel exoskeleton was investigated for two different [...] Read more.
Overhead work activities can lead to shoulder pain and serious musculoskeletal disorders (WMSD), such as rotator cuff injury and degeneration. Recently developed exoskeletons show promising results in supporting workers in such activities. In this study, a novel exoskeleton was investigated for two different overhead tasks with twelve participants. To investigate the effects of the device, electromyographic (EMG) signals of different shoulder and adjacent muscles as well as kinematic and metabolic parameters were analyzed with and without the exoskeleton. The mean EMG amplitude of all evaluated muscles was significantly reduced when the exoskeleton was used for the overhead tasks. This was accompanied by a reduction in both heart rate and oxygen rate. The kinematic analysis revealed small changes in the joint positions during the tasks. This study demonstrated the biomechanical and metabolic benefits of an exoskeleton designed to support overhead work activities. The results suggest improved physiological conditions and an unloading effect on the shoulder joint and muscles which are promising indicators that the exoskeleton may be a good solution to reduce shoulder WMSD among workers who carry out overhead tasks on a regular basis. Full article
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Review

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25 pages, 1765 KiB  
Review
The Effects of Upper-Body Exoskeletons on Human Metabolic Cost and Thermal Response during Work Tasks—A Systematic Review
by Simona Del Ferraro, Tiziana Falcone, Alberto Ranavolo and Vincenzo Molinaro
Int. J. Environ. Res. Public Health 2020, 17(20), 7374; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17207374 - 09 Oct 2020
Cited by 36 | Viewed by 3722
Abstract
Background: New wearable assistive devices (exoskeletons) have been developed for assisting people during work activity or rehabilitation. Although exoskeletons have been introduced into different occupational fields in an attempt to reduce the risk of work-related musculoskeletal disorders, the effectiveness of their use in [...] Read more.
Background: New wearable assistive devices (exoskeletons) have been developed for assisting people during work activity or rehabilitation. Although exoskeletons have been introduced into different occupational fields in an attempt to reduce the risk of work-related musculoskeletal disorders, the effectiveness of their use in workplaces still needs to be investigated. This systematic review focused on the effects of upper-body exoskeletons (UBEs) on human metabolic cost and thermophysiological response during upper-body work tasks. Methods: articles published until 22 September 2020 were selected from Scopus, Web of Science, and PubMed for eligibility and the potential risk of bias was assessed. Results: Nine articles resulted in being eligible for the metabolic aspects, and none for the thermal analysis. All the studies were based on comparisons between conditions with and without exoskeletons and considered a total of 94 participants (mainly males) performing tasks involving the trunk or overhead work, 7 back-support exoskeletons, and 1 upper-limb support exoskeleton. Eight studies found a significant reduction in the mean values of the metabolic or cardiorespiratory parameters considered and one found no differences. Conclusions: The reduction found represents a preliminary finding that needs to be confirmed in a wider range of conditions, especially in workplaces, where work tasks show different characteristics and durations compared to those simulated in the laboratory. Future developments should investigate the dependence of metabolic cost on specific UBE design approaches during tasks involving the trunk and the possible statistical correlation between the metabolic cost and the surface ElectroMyoGraphy (sEMG) parameters. Finally, it could be interesting to investigate the effect of exoskeletons on the human thermophysiological response. Full article
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Other

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9 pages, 1794 KiB  
Letter
Comparison of Subjective Responses of Low Back Pain Patients and Asymptomatic Controls to Use of Spinal Exoskeleton during Simple Load Lifting Tasks: A Pilot Study
by Žiga Kozinc, Jan Babič and Nejc Šarabon
Int. J. Environ. Res. Public Health 2021, 18(1), 161; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18010161 - 28 Dec 2020
Cited by 6 | Viewed by 2389
Abstract
Spinal exoskeletons have been suggested as an approach for the prevention and rehabilitation of occupational low back pain (LBP). While the state-of-the-art exoskeletons were shown to substantially unload the back, user acceptance is still limited. Perceived discomfort and restriction of freedom of movement [...] Read more.
Spinal exoskeletons have been suggested as an approach for the prevention and rehabilitation of occupational low back pain (LBP). While the state-of-the-art exoskeletons were shown to substantially unload the back, user acceptance is still limited. Perceived discomfort and restriction of freedom of movement are commonly reported. In this pilot study, we explored the differences in subjective responses and user impressions to using passive spinal exoskeleton during a set of simple lifting tasks between LBP patients (n = 12) and asymptomatic individuals (n = 10). Visual analog scales (0–10) were used for all assessments. Overall, the results showed mostly similar responses or slightly more positive responses to the exoskeleton from LBP patients. Most notably, the LBP patients reported a statistically significant (p = 0.048) higher willingness to use the device daily (5.36 ± 4.05) compared to the control group (2.00 ± 1.85) and also gave the device a higher overall grade (6.58 ± 1.98 vs. 4.30 ± 2.26; p = 0.021). This study has demonstrated that individuals with current LBP responded more favorably to the use of the spinal exoskeleton for simple lifting tasks. This implies that current exoskeletons could be appropriate for LBP rehabilitation, but not preventions, as pain-free individuals are less willing to use such devices. Future studies should explore whether different exoskeleton designs could be more appropriate for people with no LBP issues. Full article
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