Using exoskeletons to assist medical staff during prone positioning of mechanically ventilated COVID-19 patients: a pilot study

We conducted a pilot study to evaluate the potential and feasibility of back-support exoskeletons to help the caregivers in the Intensive Care Unit (ICU) of the University Hospital of Nancy (France) executing Prone Positioning (PP) maneuvers on patients suffering from severe COVID-19-related Acute Respiratory Distress Syndrome. After comparing four commercial exoskeletons, the Laevo passive exoskeleton was selected for use in the ICU in April 2020. The first volunteers using the Laevo reported very positive feedback and reduction of effort, confirmed by EMG and ECG analysis. Laevo has since been used to physically assist during PP in the ICU of the Hospital of Nancy, following the resurgence of COVID-19, with an overall positive feedback. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.

[1]  Divya Srinivasan,et al.  Effects of Two Passive Back-Support Exoskeletons on Muscle Activity, Energy Expenditure, and Subjective Assessments During Repetitive Lifting , 2020, Hum. Factors.

[2]  Serena Ivaldi,et al.  Learning Robust Task Priorities and Gains for Control of Redundant Robots , 2020, IEEE Robotics and Automation Letters.

[3]  Chiharu Ishii,et al.  Development of a New Type of Lightweight Power Assist Suit for Transfer Work , 2015, 2015 Asia-Pacific Conference on Computer Aided System Engineering.

[4]  Kevin Desbrosses,et al.  Occupational Exoskeletons: Overview of Their Benefits and Limitations in Preventing Work-Related Musculoskeletal Disorders , 2019, IISE Transactions on Occupational Ergonomics and Human Factors.

[5]  Joan M Stevenson,et al.  PLAD (personal lift assistive device) stiffness affects the lumbar flexion/extension moment and the posterior chain EMG during symmetrical lifting tasks. , 2009, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[6]  S. M. Bruijn,et al.  The effect of a passive trunk exoskeleton on metabolic costs during lifting and walking , 2019, Ergonomics.

[7]  J. Brugada,et al.  Investigation of palpitations , 1993, The Lancet.

[8]  W. E. Hoogendoorn,et al.  Flexion and Rotation of the Trunk and Lifting at Work Are Risk Factors for Low Back Pain: Results of a Prospective Cohort Study , 2000, Spine.

[9]  Idsart Kingma,et al.  Effects of a passive exoskeleton on the mechanical loading of the low back in static holding tasks. , 2019, Journal of biomechanics.

[10]  P. Vanhems,et al.  Prevalence of obesity among adult inpatients with COVID-19 in France , 2020, The Lancet Diabetes & Endocrinology.

[11]  Dimitrios Stefanidis,et al.  Supporting Surgical Teams: Identifying Needs and Barriers for Exoskeleton Implementation in the Operating Room , 2020, Hum. Factors.

[12]  Serena Ivaldi,et al.  Ethical and Social Considerations for the Introduction of Human-Centered Technologies at Work , 2018, 2018 IEEE Workshop on Advanced Robotics and its Social Impacts (ARSO).

[13]  M. de Looze,et al.  The effects of a passive exoskeleton on muscle activity, discomfort and endurance time in forward bending work. , 2016, Applied ergonomics.

[14]  S. Ivaldi,et al.  The use of exoskeletons to help with prone positioning in the intensive care unit during COVID-19 , 2020, Annals of Physical and Rehabilitation Medicine.

[15]  Michael J Agnew,et al.  Effectiveness of an on-body lifting aid at reducing low back physical demands during an automotive assembly task: assessment of EMG response and user acceptability. , 2009, Applied ergonomics.

[16]  H. Kadone,et al.  Successful Use of the Hybrid Assistive Limb for Care Support to Reduce Lumbar Load in a Simulated Patient Transfer , 2020, Asian spine journal.

[17]  Frank Krause,et al.  Exoskeletons for industrial application and their potential effects on physical work load , 2016, Ergonomics.

[18]  S. Jaber,et al.  Prone positioning in severe acute respiratory distress syndrome. , 2013, The New England journal of medicine.