{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T13:23:27Z","timestamp":1775913807423,"version":"3.50.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T00:00:00Z","timestamp":1723766400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Bioeng. Biotechnol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Assessing the influence of respiratory assistive devices on the diaphragm mobility is essential for advancing patient care and improving treatment outcomes. Existing respiratory assistive robots have not yet effectively assessed their impact on diaphragm mobility. In this study, we introduce for the first time a non-invasive, real-time clinically feasible ultrasound method to evaluate the impact of soft wearable robots on diaphragm displacement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We measured and compared diaphragm displacement and lung volume in eight participants during both spontaneous and robotic-assisted respiration. Building on these measurements, we proposed a human-robot coupled two-compartment respiratory mechanics model that elucidates the underlying mechanism by which our extracorporeal wearable robots augments respiration. Specifically, the soft robot applies external compression to the abdominal wall muscles, inducing their inward movement, which consequently pushes the diaphragm upward and enhances respiratory function. Finally, we investigated the level and shape of various robotic assistive forces on diaphragm motion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This robotic intervention leads to a significant increase in average diaphragm displacement by 1.95 times and in lung volume by 2.14 times compared to spontaneous respiration. Furthermore, the accuracy of the proposed respiratory mechanics model is confirmed by the experimental results, with less than 7% error in measurements of both diaphragm displacement and lung volume. Finally, the magnitude of robotic assistive forces positively correlates with diaphragm movement, while the shape of the forces shows no significant relationship with diaphragm activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our experimental findings validate the effective assistance mechanism of the proposed robot, which enhances diaphragm mobility and assists in ventilation through extracorporeal robotic intervention. This robotic system can assist with ventilation while increasing diaphragm mobility, potentially resolving the issue of diaphragm atrophy. Additionally, this work paves the way for improved robotic designs and personalized assistance, tailored to the dynamics of the diaphragm in respiratory rehabilitation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fbioe.2024.1436702","type":"journal-article","created":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T04:40:04Z","timestamp":1723783204000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluation and modeling of diaphragm displacement using ultrasound imaging for wearable respiratory assistive robot"],"prefix":"10.3389","volume":"12","author":[{"given":"Yan","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danye","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengyao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zongyu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Xue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaolu","family":"Nan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nianming","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xilai","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weidong","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuru","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongmei","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qinggang","family":"Ge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dangxiao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,8,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"765257","DOI":"10.3389\/fbioe.2021.765257","article-title":"Systematic review of back-support exoskeletons and soft robotic suits","volume":"9","author":"Ali","year":"2021","journal-title":"Front. Bioeng. Biotechnol."},{"key":"B2","first-page":"242","article-title":"Medical device applications of dielectric elastomer-based artificial muscles","volume-title":"Medical device materials IV: proc. 2007 materials and processes for medical devices Conference, 2007 desert springs resort, palm desert, CA, USA","author":"Bashkin","year":"2007"},{"key":"B3","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1002\/9780470744697.ch21","volume-title":"Biomedical applications of electroactive polymer actuators","author":"Bashkin","year":"2009"},{"key":"B4","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.compositesb.2018.08.001","article-title":"Mimicking nature: fabrication of 3D anisotropic electrospun polycaprolactone scaffolds for cartilage tissue engineering applications","volume":"154","author":"Girao","year":"2018","journal-title":"Compos. B. Eng."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1461","DOI":"10.1164\/rccm.200111-087OC","article-title":"Diaphragm length during tidal breathing in patients with chronic obstructive pulmonary disease","volume":"166","author":"Gorman","year":"2002","journal-title":"Am. J. Respir."},{"key":"B6","doi-asserted-by":"publisher","first-page":"S2146","DOI":"10.1016\/j.athoracsur.2010.03.021","article-title":"Diaphragm plication for eventration or paralysis: a review of the literature","volume":"89","author":"Groth","year":"2010","journal-title":"Ann. Thorac. Surg."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/0471440264.pst658","article-title":"Polycaprolactone: synthesis, properties, and applications","author":"Guarino","year":"2002","journal-title":"Encycl. Polym. Sci. Eng."},{"key":"B8","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1080\/14686996.2018.1431862","article-title":"3D printing for soft robotics\u2013a review","volume":"19","author":"Gul","year":"2018","journal-title":"Sci. Technol. Adv. Mater."},{"key":"B9","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1097\/WCO.0000000000000363","article-title":"Respiratory failure because of neuromuscular disease","volume":"29","author":"Howard","year":"2016","journal-title":"Curr. Opin. Neural"},{"key":"B10","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1038\/s41551-022-00971-6","article-title":"An implantable soft robotic ventilator augments inspiration in a pig model of respiratory insufficiency","volume":"7","author":"Hu","year":"2023","journal-title":"Nat. Biomed. Eng."},{"key":"B11","doi-asserted-by":"publisher","first-page":"e001006","DOI":"10.1136\/bmjresp-2021-001006","article-title":"Ultrasonographic assessment of diaphragmatic contraction and relaxation properties: correlations of diaphragmatic displacement with oesophageal and transdiaphragmatic pressure","volume":"8","author":"Koco","year":"2021","journal-title":"BMJ Open Respir."},{"key":"B12","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1152\/jappl.1967.22.3.407","article-title":"Measurement of the separate volume changes of rib cage and abdomen during breathing","volume":"22","author":"Konno","year":"1967","journal-title":"J. Appl. Physiol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"2994","DOI":"10.1109\/TRO.2022.3167399","article-title":"Exo-Abs: a wearable robotic system inspired by human abdominal muscles for noninvasive and effort-synchronized respiratory assistance","volume":"38","author":"Lee","year":"2022","journal-title":"IEEE Trans. Robot."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1327","DOI":"10.1056\/NEJMoa070447","article-title":"Rapid disuse atrophy of diaphragm fibers in mechanically ventilated humans","volume":"358","author":"Levine","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"B15","doi-asserted-by":"publisher","first-page":"e56137","DOI":"10.1371\/journal.pone.0056137","article-title":"A simple exoskeleton that assists plantarflexion can reduce the metabolic cost of human walking","volume":"8","author":"Malcolm","year":"2013","journal-title":"J. PloS. one"},{"key":"B16","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1007\/s00134-013-2823-1","article-title":"Sonographic evaluation of the diaphragm in critically ill patients. Technique and clinical applications","volume":"39","author":"Matamis","year":"2013","journal-title":"Intensive Care Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1016\/j.patcog.2014.08.027","article-title":"A survey of hough transform","volume":"48","author":"Mukhopadhyay","year":"2015","journal-title":"Pattern Recognit."},{"key":"B18","doi-asserted-by":"publisher","first-page":"eadd1504","DOI":"10.1126\/scitranslmed.add1504","article-title":"Restoring arm function with a soft robotic wearable for individuals with amyotrophic lateral sclerosis","volume":"15","author":"Proietti","year":"2023","journal-title":"Sci. Transl. Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"537","DOI":"10.3389\/fphys.2016.00537","article-title":"Reduced phrenic motoneuron recruitment during sustained inspiratory threshold loading compared to single-breath loading: a twitch interpolation study","volume":"7","author":"Raux","year":"2016","journal-title":"Front. Bioeng. Biotechnol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"5239","DOI":"10.1109\/LRA.2021.3072810","article-title":"Origami-structured actuating modules for upper limb support","volume":"6","author":"Seo","year":"2021","journal-title":"IEEE Trans. Robot. Autom."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1391322","DOI":"10.3389\/fbioe.2024.1391322","article-title":"Robotic exoskeleton-assisted walking rehabilitation for stroke patients: a bibliometric and visual analysis","volume":"12","author":"Wen","year":"2024","journal-title":"Front. Bioeng. Biotechnol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"7276","DOI":"10.3390\/jcm11247276","article-title":"Characteristics of diaphragmatic and chest wall motion in people with normal pulmonary function: a study with free-breathing dynamic MRI","volume":"11","author":"Yang","year":"2022","journal-title":"J. Clin. Med."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1280","DOI":"10.1126\/science.aal5054","article-title":"Human-in-the-loop optimization of exoskeleton assistance during walking","volume":"356","author":"Zhang","year":"2017","journal-title":"Science"},{"key":"B24","doi-asserted-by":"publisher","first-page":"117407","DOI":"10.1016\/j.jsv.2022.117407","article-title":"Tunable dynamics in Yoshimura origami by harnessing pneumatic pressure","volume":"544","author":"Zhang","year":"2023","journal-title":"J. Sound. Vib."},{"key":"B25","doi-asserted-by":"publisher","first-page":"936","DOI":"10.1109\/TNSRE.2022.3162578","article-title":"Soft exoskeleton mimics human cough for assisting the expectoration capability of SCI patients","volume":"30","author":"Zhang","year":"2022","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"B26","first-page":"866","article-title":"Design of respiratory training robot in rehabilitation of chronic obstructive pulmonary disease","author":"Zhu","year":"2015"},{"key":"B27","doi-asserted-by":"publisher","first-page":"966","DOI":"10.1016\/j.chest.2016.06.006","article-title":"ICU\u2013Acquired Weakness","volume":"150","author":"Zorowitz","year":"2016","journal-title":"Chest"}],"container-title":["Frontiers in Bioengineering and Biotechnology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2024.1436702\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T04:40:08Z","timestamp":1723783208000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2024.1436702\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,16]]},"references-count":27,"alternative-id":["10.3389\/fbioe.2024.1436702"],"URL":"https:\/\/doi.org\/10.3389\/fbioe.2024.1436702","relation":{},"ISSN":["2296-4185"],"issn-type":[{"value":"2296-4185","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,16]]},"article-number":"1436702"}}