Modeling the impact of long-term exoskeleton use on achilles tendon mechanical and morphological properties

Wearable device adoption is on the horizon for various populations, however there has been little consideration of long-term device impacts on the musculoskeletal system. Using a computational model, we investigated the influence of both exoskeleton device parameters and anticipated user behavioral response on tendon remodeling. We found critical differences in tendon remodeling depending on exoskeleton stiffness and predicted human behavior. Behavioral criteria for locomotion dominated remodeling outcomes and dictated the effects of a given exoskeleton stiffness. This work has implications for prescribing exoskeletons with parameters tailored to both an individual’s behavior and their physiology.