INTRODUCTION
State of the art exoskeletons operate in parallel to the human body and are aimed at reducing physical demand, restoring the ability to generate basic movements in daily life and/or amplifying the human abilities of the user [1-3] Improvements in microprocessor capabilities, high-power electronics, multi-axis accelerometers, gyroscopes and advanced power systems has extended the use of these devices from clinical to real-world circumstances [1, 2] Earlier technologies focused on augmenting the abilities of able bodied users for industrial or military purposes. However, the intended use has naturally shifted into the medical realm, with the development of assistive technologies for individuals impaired by disease or neurological conditions such as stroke or spinal cord injuries (SCI) [1]. This paper will discuss the state of the art of exoskeletons with regard to key examples including LOPES (Lower Extremity Powered Exoskeleton), HAL (Hybrid Assistive Limb) and BLEEX (Berkeley Lower Extremity Exoskeleton). Knee joint kinematics and kinetics will also be outlined as well as use of exoskeletons for knee joint augmentation, rehabilitation and assessment.
STATE OF THE ART EXOSKELETONS
Exoskeletons are used in rehabilitation to correct or restore movement patterns, enhance the physical abilities of the user’s limbs or body segments and reduce the physical demand on therapists compared to manually assisted gait training therapy [1]. LOPES, Lokomat and ALEX are all externally grounded devices (fixed to a structure) that have been developed for treadmill gait training [3]. The devices allow flexion and extension of the hips and knees during the swing phase with the assistance of passive elements or programmable drives[4]. Fur...
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...cient knee during activities of daily living, as they have yet to be determined ⁷². In understanding the factors contributing to the mechanism of non-contact ACL injury, investigators should consider whether the kinematics, kinetics and muscle activation strategies observed are the cause of increased ACL strain or compensation for other kinetic chain insufficiencies ²⁹. Further knowledge on how movement patterns and other kinetic chain structures affect ACL loads prove critical in enhancing future prevention strategies ²⁹ ³⁴. As with reconstruction, rehabilitation should aim to aid the knee in attaining its near-normal function ⁵⁵. Through producing rehabilitation programmes built around existing knowledge on the biological and mechanical properties of the ACL, objectives such as reduced pain, greater ROM and improved muscle function can be achieved ⁵⁵.
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