IEEE Transactions on Biomedical Engineering最新文献

{"title":"Automated Mapping the Pathways of Cranial Nerve II, III, V, and VII/VIII: A Multi-Parametric Multi-Stage Diffusion Tractography Atlas.","authors":"Lei Xie, Jiahao Huang, Jiawei Zhang, Jianzhong He, Yiang Pan, Guoqiang Xie, Mengjun Li, Qingrun Zeng, Mingchu Li, Yuanjing Feng","doi":"10.1109/TBME.2025.3595182","DOIUrl":"https://doi.org/10.1109/TBME.2025.3595182","url":null,"abstract":"<p><strong>Objective: </strong>Cranial nerves (CNs) play a crucial role in various essential functions of the human brain, and mapping their pathways from diffusion MRI (dMRI) provides valuable preoperative insights into the spatial relationships between individual CNs and key tissues. However, mapping a comprehensive and detailed CN atlas is challenging because of the unique anatomical structures of each CN pair and the complexity of the skull base environment.</p><p><strong>Method: </strong>In this work, we present what we believe to be the first study to develop a comprehensive diffusion tractography atlas for automated mapping of CN pathways in the human brain. The CN atlas is generated by fiber clustering by using the streamlines generated by multi-parametric fiber tractography for each pair of CNs. Instead of disposable clustering, we explore a new strategy of multi-stage fiber clustering for multiple analysis of approximately 1,000,000 streamlines generated from the 50 subjects from the Human Connectome Project (HCP).</p><p><strong>Results: </strong>Quantitative and visual experiments demonstrate that our CN atlas achieves high spatial correspondence with expert manual annotations on multiple acquisition sites, including the HCP dataset, the Multi-shell Diffusion MRI (MDM) dataset and two clinical cases of pituitary adenoma patients.</p><p><strong>Conclusion: </strong>The proposed CN atlas can automatically identify 8 fiber bundles associated with 5 pairs of CNs, including the optic nerve CN II, oculomotor nerve CN III, trigeminal nerve CN V and facial-vestibulocochlear nerve CN VII/VIII, and its robustness is demonstrated experimentally.</p><p><strong>Significance: </strong>This work contributes to the field of diffusion imaging by facilitating more efficient and automated mapping the pathways of multiple pairs of CNs, thereby enhancing the analysis and understanding of complex brain structures through visualization of their spatial relationships with nearby anatomy.</p>","PeriodicalId":13245,"journal":{"name":"IEEE Transactions on Biomedical Engineering","volume":"PP ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Preliminary Numerical Study of Nasal Air Conditioning following Maxillary Sinus Stent Implantation.","authors":"R P Ma, Z H Li, H X Ren, F L Yang, Y S Wang, L Y Zhang, G X Zheng, K Zhu, S Cheng, Y Zhang, J L Dong","doi":"10.1109/TBME.2025.3594491","DOIUrl":"https://doi.org/10.1109/TBME.2025.3594491","url":null,"abstract":"<p><p>Sinus stent implantation (SSI) has been widely used in refractory sinusitis surgery, but it often leads to postoperative crusting and infections, while its impact on nasal air conditioning remains unclear. In this study, two post- functional endoscopic sinus surgery (FESS) sinonasal cavity models were used to virtually reconstruct three left maxillary sinus stent implantation (MSSI) models with varying implantation depths (D). Computational analysis was conducted to evaluate temperature and humidity changes in the nasal cavity and around the stent under different D and inhalation conditions. Results showed no significant changes in overall airflow distribution following MSSI. However, local airflow velocity increased slightly inside the stent and decreased outside. Temperature and humidity exchanges were primarily concentrated in the anterior nasal cavity. In addition, there was a decrease of water exchange and an increase of the temperature at the implantation site, and the water mass fraction and temperature correlated with the stent geometry. The reduction in average relative humidity within the characteristic section decreased with greater D. These findings indicate that MSSI alters water transfer at the implantation site, which laid a theoretical foundation for an in-depth understanding of post-MSSI nasal care and protection. This study introduced a novel approach for sinus stent design and surgical simulation.</p>","PeriodicalId":13245,"journal":{"name":"IEEE Transactions on Biomedical Engineering","volume":"PP ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coordinate-independent Ultrasound Assessment for Complex Tissue Kinematics: A Preliminary Study on Median Nerve Mobility.","authors":"Yuchen Tang, He Li, Xue Deng, Xin Zhang, Beibei Feng, Wing-Yuk Ip, Wei-Ning Lee","doi":"10.1109/TBME.2025.3590541","DOIUrl":"https://doi.org/10.1109/TBME.2025.3590541","url":null,"abstract":"<p><strong>Objective: </strong>This paper presents an ultrasound strain-divergence imaging technique, which quantifies complex tissue kinematics without being constrained by imaging coordinates. An in vivo application of the technique was demonstrated on median nerve (MN) mobility. Transverse mobility of MN, a potential biomarker for evaluating MN entrapment in carpal tunnel syndrome (CTS), is featured with large variations across different active gestures, individuals, and operators, so it remains inconclusive in literature.</p><p><strong>Methods: </strong>Ultrasound data of the MN in the transverse view during active thumb and finger gestures at five wrist angles were acquired synchronously with electromyography and optical tracking of hand skeletons from 25 asymptomatic participants and 5 patients (7 CTS wrists). Two-dimensional mapping of both strain tensor $E(E_{yy}, E_{xx}, E_{xy})$ and motion divergence $D$ was obtained for MN kinematics assessment.</p><p><strong>Results: </strong>In the healthy group, statistical analysis revealed significant MN kinematic adaptation to different wrist postures by the regional median value of MN strains $tilde{E}$ (thumb motion: p<.001; finger motion: p<.001) and that of divergence $tilde{D}$ (thumb motion: p=.008; finger motion: p<.001) averaged from three repeated experiments. Thanks to its inherent coordinate-independence, $tilde{D}$ consistently showed local dilation/compression at volar-extended/flexed wrist positions.</p><p><strong>Conclusion: </strong>Comparison of $tilde{E}$ and $tilde{D}$ between healthy and CTS groups through linear regression underlined a decreased ability of the MN to adapt to different compressional levels, mimicked by different wrist angles, in CTS patients.</p><p><strong>Significance: </strong>The proposed ultrasound strain-divergence imaging is recommended for comprehensive kinematics assessment of biological tissues with an ill-defined geometry, complex motion patterns, or a large intra-/inter-subject variance.</p>","PeriodicalId":13245,"journal":{"name":"IEEE Transactions on Biomedical Engineering","volume":"PP ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-Driven Electrographic Seizure Classification and Seizure Onset Detection Using Image- and Time-Series-Based Approaches.","authors":"Muhammad Furqan Afzal, Sharanya Arcot Desai, Wade Barry, Jonathan Kuo, Shawna W Benard, Christopher B Traner, Erik J Kobylarz, Thomas K Tcheng, David Greene, Cairn Seale, Martha J Morrell","doi":"10.1109/TBME.2025.3594592","DOIUrl":"https://doi.org/10.1109/TBME.2025.3594592","url":null,"abstract":"<p><strong>Objective: </strong>Manually distinguishing between seizure and non-seizure events in intracranial electroencephalography (iEEG) recordings is highly time-consuming. In this study, we explored AI-based approaches for electrographic seizure classification (ESC) and seizure onset detection (SOD) in treatment-resistant epilepsy patients. ESC involves distinguishing seizure events from non-seizure activity, while SOD focuses on pinpointing the exact moment a seizure begins.</p><p><strong>Methods: </strong>We assessed several image-based and time-series-based model architectures for ESC and SOD, including convolutional neural networks (CNNs), vision transformers (ViTs), and time-series transformers. We used a dataset of approximately 560,000 iEEG traces from 291 focal epilepsy patients implanted with the NeuroPace RNS^® system. We conducted extensive experimentation, varying the number of trainable parameters, input formats, and weight initializations to assess performance.</p><p><strong>Results: </strong>ViTs showed superior performance across both ESC and SOD, outperforming other models. For ESC, ViTs achieved a mean seizure classification accuracy of 97$%$ across five folds of data, and an accuracy of 96$%$ on a separate clinician-annotated test dataset. In the SOD task, ViTs showed an average median absolute error (MAE) of 1.4 seconds between model-predicted and human-labeled seizure onsets across five folds, and an MAE of 0.8 second on the separate clinician-annotated test dataset.</p><p><strong>Conclusion: </strong>These findings highlight the advantage of image-based AI approaches, particularly ViTs, in capturing nuanced seizure patterns from iEEG data.</p><p><strong>Significance: </strong>AI-driven ESC and SOD could support the development of more personalized treatment strategies for epilepsy patients while reducing the time required for manual review.</p>","PeriodicalId":13245,"journal":{"name":"IEEE Transactions on Biomedical Engineering","volume":"PP ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Speed Intravascular Near-infrared Fluorescence-Ultrasound Imaging In Vivo.","authors":"Philipp Rauschendorfer, Andrew Thrapp, Abhishek Srinivas, Rylan Carleton, Adam Mauskapf, Khailah N-R Griffin, Vasilis Ntziachristos, Guillermo J Tearney, Farouc A Jaffer","doi":"10.1109/TBME.2025.3594136","DOIUrl":"https://doi.org/10.1109/TBME.2025.3594136","url":null,"abstract":"<p><strong>Objective: </strong>The combination of near-infrared fluorescence (NIRF) with intravascular ultrasound (IVUS) has shown promising applications for imaging atherosclerosis in ex vivo human arteries and in vivo animal models. However, long acquisition times, rotational distortion causing inconsistent image quality and poor catheter durability have hampered clinical translation. Technical limitations have included motor drive unit (MDU) instability, and catheter designs with a single-layer drive shaft and long rigid length of the distal tip.</p><p><strong>Methods: </strong>Herein, we present an improved, next-generation NIRF-IVUS system by integrating an aluminum v-block-based high-speed MDU and 3.0 French (∅ = 1.0mm) catheter with a dual-layer drive shaft and reduced rigid tip length. We show a sixfold increase in imaging speed (30 FPS, 6 mm/s pullback) mirroring speed capabilities of standalone, commercial IVUS imaging.</p><p><strong>Results: </strong>In phantoms, we find that key NIRF-IVUS specifications like co-registration, rotational stability and NIRF resolution/sensitivity are preserved. Furthermore, we demonstrate that NIRF-IVUS molecular imaging of cathepsin protease activity can highlight stent-induced arterial inflammation independent of imaging speed, in rabbits in vivo. We calculate similar (not significant, p = 0.65) NIRF target-to-background ratios (TBRs) in stented tissue areas at low-speed (1.88) and high-speed (2.00) imaging. Finally, in vivo NIRF-IVUS imaging of FDA-approved indocyanine green detects early-stage plaques in rabbit aorta not visible on standalone IVUS. Similar NIRF TBRs are calculated in low-speed (4.13) and high-speed (4.08) pullbacks.</p><p><strong>Conclusion and significance: </strong>Our study demonstrates that NIRF-IVUS can highlight key pathobiological markers of atherosclerosis beyond standalone IVUS at clinical imaging speeds, further supporting the clinical translation of the NIRF-IVUS technology.</p>","PeriodicalId":13245,"journal":{"name":"IEEE Transactions on Biomedical Engineering","volume":"PP ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ripple-spikes localize the epileptogenic zone and its interpretation: integrating data-driven and model-driven methods.","authors":"Qiang Li, Min Pan, Bo Wang, Wenhua Wang, Jiangling Song, Rui Zhang","doi":"10.1109/TBME.2025.3593788","DOIUrl":"https://doi.org/10.1109/TBME.2025.3593788","url":null,"abstract":"<p><strong>Objective: </strong>First, this study evaluates whether ripples co-occurring with epileptiform spikes (i.e., ripple-spikes) in scalp EEG provide a reliable biomarker for epileptogenic zone (EZ) localization compared to ripples or spikes alone. Then, this study develops a novel computational hippocampo-cortical model to explore the mechanisms underlying ripple-spikes and provides a mechanistic explanation for why ripple-spikes locate EZ more effectively than ripples or spikes.</p><p><strong>Methods: </strong>We apply automated detectors to identify ripples, spikes, and ripple-spikes on scalp EEG recordings in patients with focal epilepsy from two public datasets, and further perform a statistical analysis of the rates of these three events in EZ and non-epileptogenic zone (NEZ); the model consists of a hippocampal CA1 module and a cortical module, where an electrical synaptic current is introduced in the CA1 module and the reducing of GABAergic inhibition is modeled in the cortical module.</p><p><strong>Results: </strong>Real data analysis results show a significantly higher ratio of ripple-spike rate in EZ to that in NEZ, compared to ripple ($p=0.01$) or spike ($p=0.008$); simulation results demonstrate that: 1) ripple-spikes can be mediated by the hippocampo-cortical connection strength; 2) and such connection may be stronger for EZ than that for NEZ, leading to a higher ratio of ripple-spike rate.</p><p><strong>Conclusion: </strong>Ripple-spikes in scalp EEG may serve as an improved biomarker for EZ identification, potentially explained by stronger hippocampo-cortical connection for EZ.</p><p><strong>Significance: </strong>Providing a meaningful attempt in terms of the computational method to studying ripple-spikes, offering both data and theoretical support for advancing noninvasive methods of EZ localization.</p>","PeriodicalId":13245,"journal":{"name":"IEEE Transactions on Biomedical Engineering","volume":"PP ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal Wavelength Bands for Remote Blood Glucose Estimation Using Facial NIR Spectroscopic Images Measured At 800-1650 Nm.","authors":"Kosuke Oiwa, Mayuko Nakagawa, Yasushi Nanai, Kent Nagumo, Akio Nozawa","doi":"10.1109/TBME.2025.3593467","DOIUrl":"https://doi.org/10.1109/TBME.2025.3593467","url":null,"abstract":"<p><strong>Objective: </strong>Traditional blood glucose measurement methods are invasive, leading to discomfort and inconvenience. Recently, non-invasive techniques using near-infrared (NIR) spectroscopy have gained attention. This study explores a novel approach to estimating blood glucose levels by analyzing spatial features from facial NIR images.</p><p><strong>Methods: </strong>Unlike previous studies that have relied on broadband NIR light sources (760-1650 nm), this study focuses on identifying an optimal narrowband wavelength to reduce noise and enable simpler hardware implementation. Facial NIR spectroscopic images were captured using discrete light sources spanning 800-1650 nm, and spatial features were extracted using independent component analysis (ICA) from single-frame images.</p><p><strong>Results: </strong>The estimation accuracy was maximized at 1200 nm, with spatial features strongly expressed along the side of the nose-corresponding to major superficial arteries. Although the root mean square error ($RMSE$) was higher than that of contact-based systems, the method offers a favorable trade-off for unobtrusive, scalable monitoring.</p><p><strong>Conclusion: </strong>The analysis identified 1200 nm as a practically viable wavelength for non-contact blood glucose estimation.</p><p><strong>Significance: </strong>These findings support the feasibility of a compact, low-cost NIR imaging system for real-world deployment in non-invasive glucose monitoring applications such as telehealth, smart homes, or public health settings.</p>","PeriodicalId":13245,"journal":{"name":"IEEE Transactions on Biomedical Engineering","volume":"PP ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Graph convolutional networks enable fast hemorrhagic stroke monitoring with electrical impedance tomography.","authors":"J Toivanen, V Kolehmainen, A Paldanius, A Hanninen, A Hauptmann, S J Hamilton","doi":"10.1109/TBME.2025.3594249","DOIUrl":"https://doi.org/10.1109/TBME.2025.3594249","url":null,"abstract":"<p><strong>Objective: </strong>To develop a fast image reconstruction method for stroke monitoring with electrical impedance tomography with image quality comparable to computationally expensive nonlinear model-based methods.</p><p><strong>Methods: </strong>A post-processing approach with graph convolutional networks is employed. Utilizing the flexibility of the graph setting, a graph U-net is trained on linear difference reconstructions from 2D simulated stroke data and applied to fully 3D images from realistic simulated and experimental data. An additional network, trained on 3D vs. 2D images, is also considered for comparison.</p><p><strong>Results: </strong>Post-processing the linear difference reconstructions through the graph U-net significantly improved the image quality, resulting in images comparable to, or better than, the time-intensive nonlinear reconstruction method (a few minutes vs. several hours).</p><p><strong>Conclusion: </strong>Pairing a fast reconstruction method, such as linear difference imaging, with post-processing through a graph U-net provided significant improvements, at a negligible computational cost. Training in the graph framework vs classic pixel-based setting (CNN) allowed the ability to train on 2D cross-sectional images and process 3D volumes providing a nearly 50x savings in data simulation costs with no noticeable loss in quality.</p><p><strong>Significance: </strong>The proposed approach of post-processing a linear difference reconstruction with the graph U-net could be a feasible approach for on-line monitoring of hemorrhagic stroke.</p>","PeriodicalId":13245,"journal":{"name":"IEEE Transactions on Biomedical Engineering","volume":"PP ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FedEMG: Achieving Generalization, Personalization, and Resource Efficiency in EMG-based Upper-Limb Rehabilitation through Federated Prototype Learning.","authors":"Hunmin Lee, Ming Jiang, Qi Zhao","doi":"10.1109/TBME.2025.3593485","DOIUrl":"https://doi.org/10.1109/TBME.2025.3593485","url":null,"abstract":"<p><p>Upper extremity amputation, often necessitated by traumatic injuries, significantly impacts an individual's well-being. This paper addresses the critical challenges of deploying deep learning for real-time electromyography-based gesture recognition in prosthetic control: generalization across users and time, the personalization-generalization trade-off, and computational constraints. We propose Federated Electromyography (FedEMG), a novel Federated Prototype Learning (FPL) framework that leverages a prototype-based approach for efficient knowledge transfer and a unique adaptive personalization mechanism. Unlike existing Federated Learning (FL) methods, FedEMG balances global knowledge with user-specific adaptations, achieving high accuracy and personalization without sacrificing generalization. Furthermore, FedEMG utilizes a lightweight gesture detector in combination with an efficient neural network architecture optimized for resource-constrained devices, enabling real-time performance. Extensive evaluations on public and neural-prosthetic interface datasets demonstrate FedEMG's superior accuracy in intra- and inter-subject gesture recognition under various non-IID cases, while also highlighting its efficient resource utilization. FedEMG thus advances the field of upper-limb rehabilitation through improved and accessible prosthetic control.</p>","PeriodicalId":13245,"journal":{"name":"IEEE Transactions on Biomedical Engineering","volume":"PP ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a Lower Limb Exosuit Anchor Points on Energetics and Biomechanics.","authors":"Chiara Lambranzi, Giulia Oberti, Christian Di Natali, Darwin G Caldwell, Manuela Galli, Elena De Momi, Jesus Ortiz","doi":"10.1109/TBME.2025.3593040","DOIUrl":"https://doi.org/10.1109/TBME.2025.3593040","url":null,"abstract":"<p><p>Anchor point placement is a crucial yet often overlooked aspect of exosuit design since it determines how forces interact with the human body. This work analyzes the impact of different anchor point positions on gait kinematics, muscular activation and energetic consumption. A total of six experiments were conducted with 11 subjects wearing the XoSoft exosuit, which assists hip flexion in five configurations. Subjects were instrumented with an IMU-based motion tracking system, EMG sensors, and a mask to measure metabolic consumption. The results show that positioning the knee anchor point on the posterior side while keeping the hip anchor on the anterior part can reduce muscle activation in the hip flexors by up to 10.21% and metabolic expenditure by up to 18.45%. Even if the only assisted joint was the hip, all the configurations introduced changes also in the knee and ankle kinematics. Overall, no single configuration was optimal across all subjects, suggesting that a personalized approach is necessary to transmit the assistance forces optimally. These findings emphasize that anchor point position does indeed have a significant impact on exoskeleton effectiveness and efficiency. However, these optimal positions are subject-specific to the exosuit design, and there is a strong need for future work to tailor musculoskeletal models to individual characteristics and validate these results in clinical populations.</p>","PeriodicalId":13245,"journal":{"name":"IEEE Transactions on Biomedical Engineering","volume":"PP ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}