A pilot study investigating motor adaptations when learning to walk with a whole-body powered exoskeleton

Evidence is emerging on how whole-body powered exoskeleton (EXO) use impacts users in basic occupational work scenarios, yet our understanding of how users learn to use this complex technology is limited. We explored how novice users adapted to using an EXO during gait. Six novices and five experienced users completed the study. Novices completed an initial training/familiarization gait session, followed by three subsequent gait sessions using the EXO, while experienced users completed one gait session with the EXO. Spatiotemporal gait measures, pelvis and lower limb joint kinematics, muscle activities, EXO torques, and human-EXO interaction forces were measured. Adaptations among novices were most pronounced in spatiotemporal gait measures, followed by joint kinematics, with smaller changes evident in muscle activity and EXO joint torques. Compared to the experienced users, novices exhibited a shorter step length and walked with significantly greater anterior pelvic tilt and less hip extension. Novices also used lower joint torques from the EXO at the hip and knee, and they had greater biceps femoris activity. Overall, our results may suggest that novices exhibited clear progress in learning, but they had not yet adopted motor strategies similar to those of experienced users after the three sessions. We suggest potential future directions to enhance motor adaptations to powered EXO in terms of both training protocols and human-EXO interfaces.

Automated summary

This study explores how novice users adapt to using a whole-body powered exoskeleton (EXO) during gait. The results show that novices have the most pronounced changes in spatiotemporal gait measures, followed by joint kinematics, while smaller changes are observed in muscle activity and EXO joint torques. Compared to experienced users, novices exhibit a shorter step length, greater anterior pelvic tilt, less hip extension, lower joint torques from the EXO, and greater biceps femoris activity. Overall, the study suggests that novices make clear progress in learning but have not yet adopted motor strategies similar to experienced users after three training sessions. Future research should focus on enhancing motor adaptations through training protocols and human-EXO interfaces.