Muscular, temporal, and spatial responses to shoulder exosuit assistance during functional tasks

Shoulder exosuits are a promising new technology that could enable individuals with neuromuscular impairments to independently perform activities of daily living, however, scarce evidence exists to evaluate their ability to support such activities. Consequently, it is not understood how humans adapt motion in response to assistance from a shoulder exosuit. In this study, we developed a cable-driven shoulder exosuit and evaluated its effect on reaching and drinking tasks within a cohort of 18 healthy subjects to quantify changes to muscle activity and kinematics as well as trial-to-trial learning in duration and actuator switch timing. The exosuit successfully reduced mean muscle activity in the middle (reaching: 23.4 ± 26.3%, drinking: 20.0 ± 25.1%) and posterior (reaching: 12.8 ± 10.3%, drinking: 4.0 ± 7.2%) deltoid across both functional tasks. Likewise, the exosuit reduced integrated muscle activity in the middle deltoid (reaching: 22.2 ± 22.7%, drinking: 14.9 ± 27.0%). Exosuit assistance also altered kinematics such that individuals allowed their arms to follow forces applied by the exosuit. In terms of learning, subjects reduced movement duration by 15.6 ± 11.9% as they practiced using the exosuit. Reducing movement duration allowed subjects to reduce integrated muscle activity in the anterior (15.2 ± 10.3%), middle (14.7 ± 9.7%), and posterior (14.8 ± 9.7%) deltoids. Similarly, subjects activated the actuator switch earlier over the course of many assisted trials. The muscle activity reductions during both reaching and drinking demonstrate the promise of shoulder exosuits to enable independent function among individuals with neuromuscular impairments. The kinematic response to assistance and learning features observed in movement duration provide insight into human-exosuit interaction principles that could inform future exosuit development.NEW & NOTEWORTHY Shoulder exosuits assist arm function, but it is not understood how assistance affects motion. We evaluated spatiotemporal movement features and muscle activity during assisted and unassisted arm motions. Introducing the exosuit caused individuals to let their arms follow assistive forces. Furthermore, individuals learned to use the exosuit with practice by moving more quickly to reduce cumulative effort and by activating assistance earlier. These results demonstrate that individuals adapt exosuit-assisted motion to reduce effort.