EXOTURN (2020-2021)

ExoTurn is an interdisciplinary project that was rapidly started in March 2020 to help the Hospital of Nancy in the fight against the COVID-19. The project is coordinated jointly by Serena Ivaldi (Inria) and Dr. Nicla Settembre (Hospital of Nancy) with the participation of INRS, CNRS and University of Lorraine.

The goal of the project is to investigate the feasibility and help of back-support exoskeletons to assist the medical staff during the exhausting procedures of Prone Positioning (PP) maneuvers in the ICU. Prone Positioning is a complex procedure that is necessary during treatment of acute respiratory distress syndrome (ARDS) to optimise oxygenation.

Between March and April 2020, we conducted a pilot study in simulation at the Simulation Center of the Hospital of Nancy (Hôpital Virtuel de Lorraine – HVL), to evaluate the need of back-support and probe into 4 commercial exoskeleton to find the most suitable to assist the medical staff in this task. We identified a promising candidate in the passive exoskeleton Laevo. In a second phase, the Laevo was used in the ICU by volunteers of a PP team. The participants perceived a physical benefit in using the exoskeleton, and a positive acceptance of this technology was observed in both the users of the exoskeleton and their colleagues. A short letter describing the pilot study was published in May 2020 in the journal Annals of Physical and Rehabilitation Medecine.

We conducted further experiments to clarify the beneficial effects of the exoskeleton for PP maneuvers, particularly with validated physiological measures (EMG, EKG). The experiments were carried out again in the HVL, with the Laevo exoskeleton worn by two volunteer physicians that used it in the ICU.

During the second wave of COVID-19 (October 2020 – May 2021) 4 exoskeletons were deployed in the ICU of the Hospital of Nancy to face with the increasing workload of physicians. In a first phase, the exoskeletons were shared among the physicians: more than 60 physicians used it. However, the shared mode was not optimal in terms of workflow and was causing organizational issues and sometimes frustration due to extra fitting time. In a second phase, the exoskeletons were assigned to specific individuals: this use was more efficient for the selected physicians. A paper describing the experimental studies, the feedback from the use in ICU and providing all the materials and methods was published in July 2021 in the Applied Human Factors and Ergonomics conference (AHFE 2021).

The project Exoturn is over, but we are continuing to investigate other ways to assist the physicians and the nurses in daily tasks with exoskeletons.