Outsmarting the Laws of (Mother) Nature

There seems to be no limit to device intelligence these days.

Better brainpower has permeated practically every aspect of modern life, easing such mundane tasks as vacuuming, cooking, dieting, home surveillance, and indoor climate control, among others. Even Garbage Day has become a bit more tolerable, thanks to a self-alerting trash can that doubles as a vacuum cleaner.

Indeed, “smart” products are everywhere, but they’re becoming particularly prevalent in healthcare as patients seek improved outcomes through mobile apps and wearables.
There are devices that act as medication reminders for the sick; gadgets that provide point-of-care diagnostic capabilities for the poor; sensors for virtually every part of the human body; and fitness trackers for Jack LaLanne wannabes.

“Watches and bands are and always will be popular,” Jitesh Ubrani, senior research analyst for IDC Mobile Device Trackers, said in March, “but the market will clearly benefit from the emergence of additional form factors like clothing and eyewear, that will deliver new capabilities and experiences.”

Some of these new form factors are spawning truly mind-boggling creations. Consider, for instance, the “soft” exoskeleton under development through the European Union’s Horizon 2020 Research and Innovation Programme. Designed specifically for people with mobility impairments, the lower-limb XoSoft exoskeleton is worn like leggings and comprised of soft materials that stiffen depending on use. Built-in sensors communicate the wearer’s motions and intentions to a controlling unit for analysis to determine and provide, by way of actuators, the appropriate level of assistance: Depending on the user’s need at any given moment, the device will provide support, release, or freedom of movement.

“XoSoft is a modular system and consists of three different modules, which can be selected based on the patient’s need,” Professor Markus Wirz, director of R&D at the Institute of Physiotherapy, Zurich University of Applied Sciences, told MEDICA Magazine in June. “There is a module that supports the ankles and reaches just below the knee. Then there is a module for knee joint and another one for hip joint support. The idea behind it is that users put XoSoft on in the mornings like a piece of clothing and wear it discreetly under their clothes. This ensures support when they walk.”

The XoSoft design targets three primary patient populations: stroke victims, spinal cord injury convalescents, and the elderly. “Our objective with the XoSoft system is to help these people regain independent walking ability and provide intelligent assistance,” Wirz said. “The goal is to avoid secondary problems stemming from immobility.”

Another goal is preventative care. Engineers plan to add a connected health module to the XoSoft system to review activity data and detect users’ deteriorating physical conditions at the earliest possible stage. The module would also monitor the exoskeleton itself for malfunctioning parts so they can be replaced before they fail.

XoSoft researchers are building three generations of prototypes (dubbed Alpha, Beta, and Gamma), with the first two models intended to ensure both accurate sensor measurements and top-notch performance in various real-life settings (straight walking, sitting down, standing up, walking around corners, etc.). The project will culminate with a fully-functional Gamma prototype by 2019 and be followed by home testing.

“…new technologies can be roughly distinguished between devices that compensate for the loss of functions, like a prosthesis, and those devices that facilitate rehabilitation training, for example,” Wirz noted in the MEDICA interview. “XoSoft is actually a hybrid. On the one hand, it compensates for the loss of functions, while it also enables movement at the same time. Our goal is to get people to keep moving in everyday life. Systems like XoSoft help patients to move on their own and don’t enforce actions that add to inactivity.”

Certainly, the health benefits of regular exercise are hard to ignore: weight control, stroke prevention, increased energy, better sleep. But physical activity—particularly repeated motions—can also lead to injury. Karl Zelik is living proof of this conundrum, having hurt his back lifting his toddler son.

The injury inspired Zelik to devise a we- arable tech device for his back pain. He and a Vanderbilt University engineering team have developed a smart, mechanized undergarment that offloads lower back stress. 
       
The device consists of two fabric sections, made of nylon canvas, Lycra, polyester and other materials, for the chest and legs. The sections are connected by sturdy straps across the middle back, with natural rubber pieces at the lower back and glutes.

The device is designed to be engaged only when needed. A double tap to the shirt engages the straps. When the task is done, another double tap releases the straps so the user can sit down, and the device feels and behaves like normal clothes. The device can also be controlled by an app the team created—users tap their phones to engage the smart clothing wirelessly via Bluetooth.

Eight subjects tested the device leaning forward and lifting 25-pound and 55-pound weights while holding their position at 30, 60, and 90 degrees. Using motion capture, force plates, and electromyography, the testing demonstrated the device reduced activity in lower back extensor muscles by an average of 15 to 45 percent for each task.

“I’m sick of Tony Stark and Bruce Wayne being the only ones with performance-boosting supersuits,” said Zelik, an assistant professor of mechanical engineering at Vanderbilt. “We, the masses, want our own. The difference is that I’m not fighting crime. I’m fighting the odds that I’ll strain my back this week trying to lift my 2-year-old.”

Take note, Iron Man.