Objective: Design proposal for a body-weight support system to overcome current limitations faced by therapists at Stroke Rehabilitation Center, Buffalo General Hospital.
The design proposal included extensive work on the operations, mechanical, software, electrical, and control aspects.
6.
maximum and minimum dimensions and weight. An appendix in the back of the report contains some
data used.
Electrical:
This system includes a patient lift system and a force detection and feedback system. The patient
lift system is activated by a separate remote control, which then signals a motor to lift the patient to a
standing position. Once the patient is ready to begin walking with the device, the force feedback systems
can be activated.
The force detection and feedback section allows the device to detect the force output by the
patient, transmit the information to the visual display via Bluetooth. Physical feedback is also given, via
vibrating motors.
Software:
The main software component of this device is a downloadable application (app) onto an iPad
mini which can be hooked up directly to the device or removed and used separately. This app, named gait
provision system or GPS for short, will play a part in being our main user interface, information
processor, and operating system. Several functions of the GPS include a library of patient data for quick
and easy use, visual feedback for the patient as they are using the device, and an adjustable metronome.
There are four main stages of use which are focused on throughout the paper: caregiver input, patient use,
data output and review, and online access.
There are also two forms of feedback, visual and physical, that will come from force sensors
placed within the side supports. These sensors will be linked directly to the iPad for the visual feedback
and once reached a specified threshold, will initiate small vibrations to the side of the patient letting them
know where most of their weight is leaning.
Control:
The Gait Provision System has two main control components; a lift and vibration motor. The
control requirements for each of these will be described in the first section of the report as well as some
foreseen limitations. The preceding section prioritizes each component and provides flow charts for better
understanding of the autonomous and manual controls. Lastly, the third section will go into some basic
calculations and models of the system behavior.
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9.
1.3 OBJECTIVES
Need & Requirements Rationale
1. Easy attachment The first requirement is that the device should be
easy for attachment. If it’s hard to get the patient
harnessed properly, the further steps become
difficult. This can be worn while the patient is on
the wheelchair.
2. No harm to the patient (safety) If the device isn’t safe, the rehabilitation gait
training loses its purpose. So the second
consideration should be the safety issue. For
example, the device should hold the patient tightly
so that patient does not fall down during the
training.
3. Support
For a BWSS, the weight supporting issue after we
get the patient to fit comfortably and safely is
important. As people have different weight
ranging from around 100 pounds to more than 300
pounds, the system should be able to hold the
weight, or even measure the weight and adjust the
parameters corresponding to it.
4. Keeps patient balanced It is essential to keep the patient balanced during
the training. It is partly a safety issue, but more
importantly, balanced training can get a better
result (especially for patients who have trouble
distributing weight equally to both feet) because
normal people walk stably. The individual
supports (arm supports and front and back
supports) contribute to it.
5. Feedback To know the improvement of the patient with
every passing session, a feedback component is
required in the device. Visual feedback and a
physical feedback are provided.
6. Improve human gait Finally, after all necessary considerations the
patient’s gait should be restored to maximum or
complete normalcy.
Table 1.31: List of need and requirements for our design with their rationale
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1.4 OPERATIONS OVERVIEW
1.4.1 Prioritized Functional Requirements
Components Implications
1. Upper body supports (under the arms) Necessary for stabilization. Ensures that the
patient remains in an upright position when
mobile. Without this component, the patient
would be susceptible to falling.
2. Movable front/back support Also allows for the stabilization of the individual.
Must be movable for the sake of adjustments for
each person and each use.
3. Hand Grips Method to avoid slipping when the patient is
walking and it allows for extra upper body
support and helps in balancing during gait.
6. Feedback Useful to track progress of the patient with
consecutive sessions. The visual feedback can be
observed on the iPad that is wirelessly linked to
the microcontroller of a force sensor. The physical
feedback would be provided in terms of the
vibrations felt by the patient after a certain force is
reached. Some patients have trouble distributing
weight between both sides of their body during
rehabilitation. This would display the results on
the iPad.
Table 1.4.11: List of components for our design and their respective implications
1.4.2 Prioritized Performance Requirements:
● Machine Movability/adjustability Success can be quantified by the seamlessness of motion.
More specifically, any choppiness found when using the machine would be considered negative
results. Furthermore, the ease of adjustability would also be a measure of performance. Finding
the right settings for an individual should take a minimal amount of time and should be accurate
every time. Range of motion would be dependent on the design construction of the device and in
this one, most components are fairly adjustable. This makes range of motion easier as it will be
suited to the patient’s needs. Normal gait pattern is the final and the most important parameter of
usefulness of the device.
● Ease of use Performance can also be gauged upon the user friendliness for the therapist. This
design should allow use of the machine with only one therapist assisting in the way of settings
and guidance. The patient’s progress is the most effective way of knowing whether the device has
been easy for the patient to use and this can be tracked by the feedback results discussed in detail
in the software phase of Section 3.3 and 3.5.
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17.
2. MECHANICAL PHASE
2.1 MECHANICAL SCOPE
When looking at the mechanical design of a bodyweight support system (BWS) the main goals
would be to safely support the load for patients within a specified weight range, allow for unrestricted
natural movement and gait, be easy to use, and provide optimal comfort and security when in use.
The system designed in this report contains four main segments and two stages of use. The
segments include base and frame, front and back supports, passive harness and its supports, and the
motor. Each of these segments are then divided into smaller components and compared with other
tradeoffs. The two stages of use, which are described in detail in the system overview, are a standing
assist and walking assist.
The measurements used in each aspect of the design follow anthropometric data found from The
Ergonomics Center. 5th Percentile female data and 95th percentile male data were used as limits for the
maximum and minimum dimensions and weight. An appendix in the back of the report contains some
data used.
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19.
2.2.1 System Overview:
The proposed bodyweight support system has two separate stages of use and therefore two
distinct mechanical systems: active standing assist, and walking assist.
Standing Assist: is a powered system where the patient is moved from a seated position to
standing, assisted by the support system.
Mechanical components:
Frame
Base
Wheels
Foot rest
Knee rest
Harness
Attachment cables
Lift motor
1) Base wheels are locked
2) Seated patient dons harness
3) Patient’s feet and knees are secured to the feet and knee rests, respectively.
4) The harness is attached to the active lift motor via cords.
5) The force generated by the lift motor lifts the patient to a standing position
Walking Assist: The patient is using the support system to help balance and walk, while
supported by arm, torso and back supports, as well as the harness which is disconnected from the
lifting assist and secured overhead.
Mechanical Components:
Frame
Base
Torso support
Back Support
Arm support and grip
Harness
Overhead attachment cables
Overhead attachment clip
1) Once the patient is standing, the back support is attached to the device, and adjusted to lie
securely with his or her back.
2) The arm and torso supports are also adjusted to suit the patient
3) The patient is attached to the overhead harness attachment
4) The wheel locks are released
5) The patient can now move forward using the assist device.
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TradeOffs :
1. No cut out: Leaving the wood in a rectangular shape can cause discomfort to the patient
since the force of the device when moving will be directed to the center of their body
rather than being distributed.
2. Flips which flip out: would not provide enough force to support patient
2.2.3 Passive Harness and Harness Support
Harness
REQUIREMENTS CRITERIA
To support optimal weight of
the patient
Have a harness that can carry the weight of an average American
– strong and flexible material
Maximum comfort to the
patient
Thick padding to prevent the patient from feeling
scratchy/irritable. The material plays a cardinal role in this case
too and it should ideally be soft yet provide the tensile strength to
handle the weight of the patient.
Easy adjustability and
positioning of the harness
(easy donning and doffing)
Quick release fasteners/buckles through the harness make the
process rapid. Also detachability of the harness with respect to
being able to be hung through Drings from the top pole.
Table 2.2.3.1. List of requirements for the harness and their criteria
Material
Lycra, Rayon, Cotton (Selected for the design) – In combination, this is the most preferred one as is used
in the bioness model BWSS harness [4]. The ratio of each material is subjective and a detailed technical
aspect. The
Lycra – Stretch ability and the elasticity aspect wonderfully for adjustability.
Cotton – Material for inner quality linings would provide the thick padding and the comfort to prevent
irritation.
Rayon – For breathability through the material in the sense that it doesn’t interfere with the blood
circulation of the patient, usually due to the tightness of the harness around the patient.
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28.
Table 2.2.3.2 Material comparision
Tradeoff:
Polyester This was the most likely one that was used at the hospital and in the earlier systems. It is a
synthetic and isn’t the softest material available which would most likely result in irritation to the patient
which is certainly undesirable.
Size
For our design, the following specification works well [5]:
Torso Circumference 28" to 50" (71 to 127 cm)
User Capacity For 300 lb (136 kg)
The general harness sizing chart can also be followed for the design to accommodate individual sizing of
the harness according to the height and weight [6].
Type of harness (in terms of the length of the harness)
Harness until the hip/waist (Selected configuration) – As shown in the figure below, this one gels
with the design overview discussed earlier. Advantages of the harness type shown below:
● Enough space for the front and underarm support for our design idea
● Drings on the harness to make it attach to the top frame and considers the detachability factor.
The patient can wear it on the wheelchair and then as the gait rehabilitation session begins, can
attach the ring to the frame at the top.
● We are going to incorporate the harness until the thighs so that it is detachable just to have an
option of having the patient being pulled in from the wheelchair from the waist. This would
incorporate the addition of extra support for heavyweighted persons.
● Range of motion wouldn’t be an issue in terms of the joints (which is usually 0 to 360 degrees).
Since the harness has attachment points and adjustable buckles, it can be according to the
patient’s wish and hence, that would be important in determining the range of motion
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29.
Figure 2.3.3.3 A general overview of the harness that we would require with the attachments labeled [7]
Tradeoff:
Harness until the knees – This design has been used for various BWS systems and provides the
advantages in terms of support to the knees and the hip area in order to distribute the force and weight
optimally. This has not been considered for our design purpose since the knee caps are already being
implemented in a different manner as discussed. Also, the complications of having a large harness and too
many attachment issues/points, it’s best to avoid especially if that advantage is already being taken care
of.
Attachment points/fasteners:
There are straps for shoulders and the chest with attachment points in order to provide the
performance and adjustability to the patient in the case of a fall event. The harness has to be snug and not,
overly tight which makes it irritable.
Single attachment point at the back – To aid the distribution of pressure, improving the user’s comfort as
shown in the figure below.
Figure 2.3.3.4 Attachment point at the back [8]
Velcro fasteners – To the attachment straps, it provides an ease of use.
Requires low maintenance
Strong material can hold the weight required in this design
Secure
Buckles:
Quickconnect buckles (for selected configuration)
Also called the loadbearing buckles is the strongest one available in the market that don’t open
while under load.
Highest degree of safety
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31.
Clip device shall be strong enough to support
opposing forces
Clip material and size are the best proportion
of size to strength.
Table 2.2.4.1. List of requirements for the harness support and their criteria
Figure 2.2.4.2. Bungee cord segment with a ZipHook hook on either end. Process used to decide on this
material is outlined below.
Cable Material: Upon comparison of different materials, sizes, and costs, the optimal material decided
upon was bungee cord. This eliminates the need for a pulley system and can work well with the motors
and the harness Drings through the use of a hook. The type of hook used will be discussed in the next
section. The bungee cord that will be used will be 1.27 cm in diameter and each has a tensile strength of
about 204 kg. It is made of a rubber fiber core and the outer jacket is a nylon and polyester blend. The
cost needed for this material is $90 for 7.62 meters or $325 for 30.48 meters. Using these calculated costs,
it would be prudent to use the larger amount and split it into segments to use throughout the 3 sections
that require bungee cord on this device. The pieces attaching to the back harness must be 90 cm each.
That allows for excess material to be held by the motors as well as accounting for the fact that the patient
will be assisted in standing from a seated position. While seated in a wheelchair, an average sized man
has a waist height of 68.5 cm and the wheelchair has a distance from front to back of 106.5 cm [28].
Using pythagorean theorem along with these values, the cable must measure 78.82 cm. Using 90 cm
accounts for this and the extra cable needed. The third piece of cable will reach from the top of the device
to the back of the harness upon standing the patient up. Using the patient height previously described and
the height of the device, this cable should measure 65 cm. Once again, this will allow for taller patients to
be able to use this system as well.
Tradeoffs: Rope was considered as an alternative to the bungee cord that was ultimately used. The chart
below demonstrates the types of rope that were considered along with their properties. While rope has
some properties that are superior to bungee material such as a greater tensile strength, eliminating the cost
and possible problems surrounding a pulley system seems to outweigh the benefits.
Rope comparison chart:
Material (1.27 cm) Thickness (cm) Minimum Tensile Strength Cost (per m)
Nylon 0.566 6,200 lbs $2.95
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Polyester 0.648 5,085 lbs $5.54
Polypropylene 0.966 4,200 lbs $0.72
Table 2.2.4.3. Material comparison table for different types of rope [10, 11, 12]
Bungee cord hook: Four ZipHook hooks will be attached to the various cables used in this device. The
two cords that attach to the harness will each have a hook opposite the end with the motor. These will
attach to the Drings of the harness and assist in lifting the patient. The other hooks are used used in the
cable that attaches the harness to the top of the machine. One hook will be attached to the main frame and
the other will attach to a Dring on the back of the harness. Other hooks were looked into and the
reasoning for not using them is outlined below.
Trade offs: The ultimate decision to use the ZipHook was based on the criteria outlined below. The other
options were not as heavy duty and that was the overwhelming factor here. Safety was the ultimate goal
and even though the vinyl coated steel hook was less expensive, the safety factor outweighed that cost.
Bungee cord hook comparison chart:
Type of hook Advantage Price (each)
Dichromated Light to medium duty $0.56
Highimpact vinyl coated steel Resists rust $0.10
ZipHook High strength, adjustable $0.55
Table 2.2.4.4 Compares three different types of hooks [13, 14, 15]
2.4 MOTOR UNITS
Requirements Criteria
Should be able to support the
maximal body weight.
The motors should be able to lift the patient’s body, based on
motor specs.
Slow and safe movement Motor will have high torque and low rpm
Small and light enough to fit
into the machine
Our smart device will have a small size and be lightweight. We
want to fit the motors into the frame of our device, so the
dimension of the motors need to be small enough to fit well
inside the frame.
Table 2.4.1 List of requirements for the motor unit
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39.
● Operating system: iOS 9 (with updates when new operating systems are released)
● Display: 7.9inch (diagonal) LEDbacklit MultiTouch with IPS technology
● Resolution: 1536 x 2048 pixels (~324 ppi pixel density)
● Builtin 24.3watthour rechargeable lithiumpolymer battery, 6470 mAh (up to 10 h capacity
after browsing, and media usage)
● Sensors: Threeaxis gyro, accelerometer, ambient light sensor
Advantages of chosen device:
● Most accessible in terms of the memory required
● Userfriendly design for the therapists and patients to use
● Large and easy touchinterface
Patient data storage:
● 32 GB internal storage
● Alternatives available for extreme cases – online storage through apps – Google Drive/Dropbox
● iCloud for backup and saving device space. Also allows other devices connected to the cloud to
access this information.
Viewing sensor information/feedback:
● Power requirement & Battery – optimal as per specifications
● Data monitored through iCloud – no installation of software required – easy and costeffective
● iOS is updated – prevent hindrance to the working of the app
● Communication requirement between the sensor element and the iOS hardware’s microcontroller
system (that contains userdefined touch screen interface)
● Display resolution – 1024X768 – 32bit color depth – 12,28 MB
Metronome:
● Audio features: Noise 93.8dB / Crosstalk 82.9dB & stereospeakers [29]
● Display resolution as above
● Alternative to the inbuilt in our app design – App Ludwig Metronome or TempoPerfect
Metronome Software could be used alongside – App space is around 10 MB [30]
Motor:
● For resolution – Max voltage = 20V span – Effective number of bits required = 16 bits
Smallest possible increment that can be detected at 16bits = 216
, 20V divided by the
increment gives us 305µV per count
The precision values chosen allow for precision of the motor speed. If the motor
moves too quickly, the patient may be lifted at an unsafe speed. A high level of
precision is necessary alongside the low rpm for optimal speed and safety.
Smallest theoretical change that can be detected is 305µV – precision that can be
acquired
Works for our system since it doesn’t require a large motor load, nor is a complex
functioning required – hence, works for the speed required by our motor
● For motor control – waveform of 8 bits – each of which can be “on” or “off” mode [31]
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43.
Figure 3.6.12: Steps needed to activate and use the
metronome option
Figure 3.6.11: Steps used in the force
sensing and feedback segments of use
3.6.2 Low Battery Operation:
Since the iPad will be charged separately, low battery operations must be considered. While the battery
should last so long as the iPad is being charged nightly, there will be a low battery mode. At this point,
the vibration will yield to preserve battery. The metronome or music will also pause. For this reason, it
would be recommended that the hospital has more than one iPad that can access the cloud or the iPad is
within reach of a charging station when the battery is running low.
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48.
Model Sensitivity (mV/lb) Current Draw (mA) Voltage Draw (V) Weight (oz)
208C01 500 220 1830 0.80
208C03 10 220 2030 0.80
208C04 5 220 2030 0.80
Table 3: General Purpose Quartz Force Sensors [3]
A vibration motor combining a 1.56V DC motor and a weight totaling one gram proved
to be a strong option to act alongside the force sensors. The output force measured by the sensor
will dictate when vibration feedback will be reinforced to the patient. When the force exceeds a
certain threshold, it will be indicated on the screen for the patient and the vibration mechanism
will begin. It will cease when the aforementioned force sensors compute a leaning force below
the threshold. These sensors will be placed on either side so the feedback is directly related to the
side that is receiving too much force.
4.2.3. iPad
An IPad will provide visual feedback to the patient while the system is in use, as well as
serve as the caregiver’s interface for analyzing force output data after a therapy session.
The iPad will not have an external power supply while in use with the walking assist
device. Since charging cords and additional battery packs can be restrictive and easy to misplace,
only the iPad’s internal battery will be used as a power supply. The iPad battery can power it
uninterrupted for up to six hours; this should be adequate for multiple therapy sessions
throughout a day.
● Power consumption (display on) : 2.69W
● Charging Time :10W USB power adaptor – Requirement 2.1 A at a min voltage of 4.97V
● 4 – 6 hours Battery life
● Battery:–24.3W lithiumpolymer battery
Communication requirement –
● Via Bluetoothbased wireless communication system – between the microcontroller
element in the sensor and iPad’s Bluetooth 4.0 Wireless system
● Distance between the devices – factor for communication – required would be 10 – 15 m
– not an issue as it’ll be within the system
● Accuracy in detecting the correct device
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Table 4.3.2.1. Comparison of serial communications: RS232, RS422, RS485
4.4 Power Consumption
Mode 100 V 115V 230V
Sleep 0.17W 0.18W 0.18W
Idle – Display on 2.7W 2.69W 2.80W
Power adapter – no load 0.09W 0.09W 0.09W
Power Adapter efficiency 80% 81% 80%
Table 4.3.2.2. Power consumption for iPad mini 2
iPad
For a 24.3 Wh LiPo battery,
● Using a power adaptor: At 4.9V and 2.1A for 4960 mAh, will work for 2.36 hours
● When displayon (continuously) & a fully charged battery at 4.2V, 0.66A, 6470 mAh, will work
for 9.8 hours – works because a session wouldn’t last for this long. Can probably be used for two
sessions without charging
[The number of hours considered for further calculations]
Force Sensor communication –
● 3V DC with Max current rating – 90mA
● Rated power consumption = 195mW, 1.12 Wh and 373 mAh
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53.
● Can be used for – 4.14 hours continuously with the above power consumption with respect to the
iPad use as well
● Energy consumed per day – 0.8073 Wh/day
Bluetooth communication –
● For Bluetooth Low Energy (BLE): Peak current consumption = 15mA and Max Voltage = 0.034
V, Output Power – 10mW and use for average 9.8 hours/day
● Energy consumed per day = 0.098 Wh/day– clearly low!
● General reviews – that the battery drain is not visibly faster for an iPad when the Bluetooth is on
Motor communication –
● For the motors
● Current rating – 5 A, Supply voltage – 24V DC
● Rated power consumption = 40 W
● Energy consumed per day = 0.392 kWh/day
As seen in the figure below, the Bluetooth and the force sensor hardly take up energy consumption as
compared to the motor and the display.
Figure 4.3.2.3. Summation of the energy consumption for different communications
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63.
APPENDIX
1. Anthropometric data:
Figure 1: Anthropometric data. All data were taken from 5th percentile female to 95 percentile male.
A: Stature; B: Elbow Rest Height, Standing; C: Buttock Height; D: ElbowCenter of Grip Length; E:
ShoulderElbow Length; F: ButtockKnee Length; G: ButtockPopliteal Length; H: Knee Height,
Sitting; I: Popliteal Height; J: ForearmForearm Breadth;
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64.
Ideas for further exploration:
1. Motorized wheels to help patient walk on the ground.
REQUIREMENTS CRITERIA
To help patient walk on the ground Walking on the ground provides different feelings as
compared to walking on a treadmill. It could be a good
improvement if our device can help the patient walk on
the ground.
Safety The whole device should stay balanced when the
patient is walking. A zero moment arm around the
middle of the device would be indicative of this.
Lock system The device should not be movable before the patient is
ready to walk. The wheels should remain locked before
walking, and unlocked when the patient is prepared to
walk.
Table 8.
We could design 4 casters on the bottom to help the whole device move on the ground. 4 motors are
connected to the casters to generate the force (needs further calculation, for example, if the body weight
of the whole device is G, and the friction factor is u, so the total force the 4 motor can generate should be
set to N=uG ) that is needed to move the whole device, so that when patient is walking, there is no
resistance from the device. The casters need to have a switch to control them and lock the wheels before
actually walking. We found a set of 4 lockable casters available online for only $25. [25]
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65.
2. Counterweight system
REQUIREMENTS CRITERIA
Counterweight The center of body gravity is actually moving when
people walk on the ground. It could be much better if
we can have a Zdirection movable counterweight
system. The system should also be able to change the
counterweight load so that therapist can adjust the
weight to the most comfortable load for the patient.
Safety Adding a counterweight system may introduce extra
weight to the whole device. This will introduce a need
to check for balance forces among the device.
Table 9.
There have been publishings discussing a counterweight segment which is composed of a passive
elastic spring element to take over the main body weight and a controlled electric drive element to
generate accurate extra force which is convenient to adjust. [26] Both of the counterweight elements
would be connected to a polyester rope which would be connected to the patient through roller wheels and
an electric winch. The two roller wheels are exclusively for connection, the electric winch can be helpful
to adjust the rope length to adapt to different
patient size. As for the safety concern, it is
hypothesized that the counterweight
system is not feasible for our device, it
may increase complexity and safety
problems. Please look to the right for a
detailed design (figure 15).
Figure 15. Passive elastic spring counter
weight system [26]
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List of changes:
1. Operations phase:
● Revision of Objectives minor changes in accordance to the final design and grammatical fix
(Section 1.3)
● Revision of the prioritized functional requirements removal of elliptical and adjustable seater
(Section 1.4.1)
● Revision of the prioritized performance requirements minor fix in accordance to the suggestions
provided (Section 1.4.2)
● Shift of phases of use to the end of the operations phase with additional diagrams (Section 1.6.1)
2. Mechanical phase:
● Revised the order for material comparison table.
● Revised the pictures for front back support.
● The loading capacity for the buckles is 4000 lbs.
● Move the material comparison for different polymer to the harness support part.
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