1
|
Pentenga HM, Coenen P, Huysmans MA, Speklé EM. The effects of working with a passive arm-support exoskeleton on objective and self-reported measures during field tasks - a randomised cross-over study. ERGONOMICS 2024:1-17. [PMID: 39180210 DOI: 10.1080/00140139.2024.2392785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 08/07/2024] [Indexed: 08/26/2024]
Abstract
Musculoskeletal disorders (MSDs) are prevalent under poor working situations. Where it is not possible to remove the root cause of MSDs, passive exoskeletons could be a solution. In this randomised cross-over field study we investigated the effect of a passive arm-support exoskeleton. Ten participants, recruited from a Dutch gas company, were measured with and without exoskeleton assessing muscle activity, heart rate (HR), arm elevation, and reported about their experiences. Participants spent more time in high arm elevation levels with the exoskeleton than without. Muscle activity was lower in the trapezius (Beta: -1.8 [-3.1; -0.4]) and deltoid (Beta: -1.4 [-2.3; -0.6]) muscles, but not the biceps muscle, during the measurements with exoskeleton than without, suggesting effectiveness of the exoskeleton. HR and discomfort did not statistically significantly differ between the two conditions. Participants would recommend an exoskeleton to their colleagues, but mainly for repetitive work. Their opinions about the usefulness during work varied.
Collapse
Affiliation(s)
- Hilde M Pentenga
- Human Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Pieter Coenen
- Human Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, The Netherlands
| | - Maaike A Huysmans
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, The Netherlands
| | - Erwin M Speklé
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Arbo Unie Occupational Health Service, Nieuwegein, The Netherlands
| |
Collapse
|
2
|
Baltrusch SJ, Krause F, de Vries AW, de Looze MP. Arm-support exoskeleton reduces shoulder muscle activity in ceiling construction. ERGONOMICS 2024; 67:1051-1063. [PMID: 37938880 DOI: 10.1080/00140139.2023.2280443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 11/02/2023] [Indexed: 11/10/2023]
Abstract
The objective of this study was to assess the efficacy and user's impression of an arm-support exoskeleton in complex and realistic ceiling construction tasks. 11 construction workers performed 9 tasks. We determined objective and subjective efficacy of the exoskeleton by measuring shoulder muscle activity and perceived exertion. User's impression was assessed by questionnaires on expected support, perceived support, perceived hindrance and future intention to use the exoskeleton. Wearing the exoskeleton yielded persistent reductions in shoulder muscle activity of up to 58% and decreased perceived exertion. Participants reported limited perceived hindrance by the exoskeleton, as also indicated by no increase in antagonistic muscle activity. The findings demonstrate the high potential of an arm-support exoskeleton for unloading the shoulder muscles when used in the dynamic and versatile working environment of a ceiling construction worker, which is in line with the consistent intention of the workers to use the exoskeleton in the future.Practitioner Summary: The majority of research focuses on the effect of using an arm-support exoskeleton during isolated postures and prescribed movements. We investigated the efficacy of an exoskeleton during a complex and realistic work, namely ceiling construction. Shoulder muscle activity was lower in almost all tasks when wearing the exoskeleton.
Collapse
|
3
|
Xia T, Torkinejad-Ziarati P, Kudernatsch S, Peterson DR. The effects of exoskeleton use on human response to simulated overhead tasks with vibration. ERGONOMICS 2024:1-14. [PMID: 38963600 DOI: 10.1080/00140139.2024.2372003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 06/18/2024] [Indexed: 07/05/2024]
Abstract
The use of occupational exoskeletons has grown fast in manufacturing industries in recent years. One major scenario of exoskeleton use in manufacturing is to assist overhead, power hand tool operations. This preliminary work aimed to determine the effects of arm-supporting exoskeletons on shoulder muscle activity and human-hand tool coupling in simulated overhead tasks with axially applied vibration. An electromagnetic shaker capable of producing the random vibration spectrum specified in ISO 10819 was hung overhead to deliver vibrations. Two passive, arm-supporting exoskeletons, with one (ExoVest) transferring load to both the shoulder and pelvic region while the second one (ExoStrap) transferring load primarily to the pelvic region, were used in testing. Testing was also done with the shaker placed in front of the body to better understand the posture and exoskeleton engagement effects. The results collected from 6 healthy male subjects demonstrate the dominating effects of the overhead working posture on increased shoulder muscle activities. Vibration led to higher muscle activities in both agonist and antagonist shoulder muscles to a less extent. Exoskeleton use reduced the anterior deltoid and serratus anterior activities by 27% to 43%. However, wearing the ExoStrap increased the upper trapezius activities by 23% to 38% in the overhead posture. Furthermore, an increased human-shaker handle coupling was observed in the OH posture when wearing the ExoVest, indicating a more demanding neuromuscular control.
Collapse
Affiliation(s)
- Ting Xia
- Department of Mechanical Engineering, College of Engineering and Engineering Technology, Northern Illinois University, DeKalb, IL, USA
| | - Parisa Torkinejad-Ziarati
- Department of Mechanical Engineering, College of Engineering and Engineering Technology, Northern Illinois University, DeKalb, IL, USA
| | - Simon Kudernatsch
- Department of Mechanical Engineering, College of Engineering and Engineering Technology, Northern Illinois University, DeKalb, IL, USA
| | - Donald R Peterson
- Department of Mechanical Engineering, College of Engineering and Engineering Technology, Northern Illinois University, DeKalb, IL, USA
| |
Collapse
|
4
|
Cha JS, Athanasiadis DI, Asadi H, Stefanidis D, Nussbaum MA, Yu D. Evaluation of a passive arm-support exoskeleton for surgical team members: Results from live surgeries. JOURNAL OF SAFETY RESEARCH 2024; 89:322-330. [PMID: 38858056 DOI: 10.1016/j.jsr.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 08/16/2023] [Accepted: 02/05/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND Musculoskeletal symptoms and injuries adversely impact the health of surgical team members and their performance in the operating room (OR). Though ergonomic risks in surgery are well-recognized, mitigating these risks is especially difficult. In this study, we aimed to assess the impacts of an exoskeleton when used by OR team members during live surgeries. METHODS A commercial passive arm-support exoskeleton was used. One surgical nurse, one attending surgeon, and five surgical trainees participated. Twenty-seven surgeries were completed, 12 with and 15 without the exoskeleton. Upper-body postures and muscle activation levels were measured during the surgeries using inertial measurement units and electromyography sensors, respectively. Postures, muscle activation levels, and self-report metrics were compared between the baseline and exoskeleton conditions using non-parametric tests. RESULTS Using the exoskeleton significantly decreased the percentage of time in demanding postures (>45° shoulder elevation) for the right shoulder by 7% and decreased peak muscle activation of the left trapezius, right deltoid, and right lumbar erector spinae muscles, by 7%, 8%, and 12%, respectively. No differences were found in perceived effort, and overall scores on usability ranged from "OK" to "excellent." CONCLUSIONS Arm-support exoskeletons have the potential to assist OR team members in reducing musculoskeletal pain and fatigue indicators. To further increase usability in the OR, however, better methods are needed to identify the surgical tasks for which an exoskeleton is effective.
Collapse
Affiliation(s)
| | | | - Hamed Asadi
- Purdue University, West Lafayette, IN, United States
| | | | | | - Denny Yu
- Purdue University, West Lafayette, IN, United States
| |
Collapse
|
5
|
Raveendranath B, Pagano CC, Srinivasan D. Effects of arm-support exoskeletons on pointing accuracy and movement. Hum Mov Sci 2024; 95:103198. [PMID: 38452518 DOI: 10.1016/j.humov.2024.103198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/13/2024] [Accepted: 02/27/2024] [Indexed: 03/09/2024]
Abstract
Exoskeletons are wearable devices that support or augment users' physical abilities. Previous studies indicate that they reduce the physical demands of repetitive tasks such as those involving heavy material handling, work performed with arms elevated, and the use of heavy tools. However, there have been concerns about exoskeletons hindering movement and reducing its precision. To this end, the current study investigated how proprioception enables people to point to targets in a blindfolded, repetitive pointing task, and their ability to recalibrate their pointing movement based on visual feedback during an intervening calibration phase, both with and without an arm-support exoskeleton. On each trial, participants were instructed to follow a 40 BPM metronome to point six times alternating between two target points placed either on a vertical or horizontal line. Within a trial, each pointing movement alternated between flexion and extension. Results indicate that participants' average pointing error increased by 4% when they wore an exoskeleton, compared to when they did not. The average pointing error was 12% lower when the target points were aligned vertically as compared to horizontally. It was also observed that the average pointing error was 14% lower during flexion as compared to extension movement. Surprisingly, accuracy did not improve in the post-test as compared to the pre-test phase, likely due to accuracy being high from the beginning. Participants' movement dynamics were analyzed using Recurrence Quantification Analysis. It was found that movements were less deterministic (1% reduction in percentage of determinism) and less stable (13.6% reduction in average diagonal line length on the recurrence plot) when they wore the exoskeleton as compared to when they did not. These results have implications on the design of arm-support exoskeletons and for facilitating their integration into the natural motor synergies in humans.
Collapse
|
6
|
Mänttäri S, Rauttola AP, Halonen J, Karkulehto J, Säynäjäkangas P, Oksa J. Effects of upper-limb exoskeleton on muscle activity in tasks requiring arm elevation: Part II - In-field experiments in construction industry settings. Work 2024:WOR230218. [PMID: 38578911 DOI: 10.3233/wor-230218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024] Open
Abstract
Background The body of literature regarding the use of an upper limb exoskeleton during authentic working conditions is sparse. Objective The aim of this study was to evaluate the effectiveness of an upper limb exoskeleton in reducing muscle strain during authentic industrial construction work. Methods Fifteen male participants, comprising of roofers, scaffolders, builders, bricklayers, and graders performing overhead work participated in the study. During work without (REF) and with exoskeleton (EXO), muscle activity from 8 muscles, heart rate (HR), metabolic equivalent (MET), and upper arm elevation angles were recorded. Results When using the exoskeleton, a significant reduction of 20.2% in average muscle activity of 8 muscles was found. The largest effect focused on m. deltoideus, where 46.2 and 32.2% reduction occurred in medial and anterior parts of the muscle, respectively. HR and MET were unaffected. Upper arm elevation angles were similar between REF and EXO, indicating equal biomechanical loading. Conclusions This study indicates that exoskeletons show great promise in reducing the potential for musculoskeletal strain during authentic overhead construction work.
Collapse
Affiliation(s)
- Satu Mänttäri
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Oulu, Työterveyslaitos, Finland
| | - Ari-Pekka Rauttola
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Työterveyslaitos, Finland
| | - Janne Halonen
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Työterveyslaitos, Finland
| | - Jutta Karkulehto
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Oulu, Työterveyslaitos, Finland
| | - Pihla Säynäjäkangas
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Oulu, Työterveyslaitos, Finland
| | - Juha Oksa
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Oulu, Työterveyslaitos, Finland
| |
Collapse
|
7
|
Gutierrez N, Ojelade A, Kim S, Barr A, Akanmu A, Nussbaum MA, Harris-Adamson C. Perceived benefits, barriers, perceptions, and readiness to use exoskeletons in the construction industry: Differences by demographic characteristics. APPLIED ERGONOMICS 2024; 116:104199. [PMID: 38134719 DOI: 10.1016/j.apergo.2023.104199] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 11/29/2023] [Accepted: 12/03/2023] [Indexed: 12/24/2023]
Abstract
Exoskeletons (EXOs) are a promising wearable intervention to reduce work-related musculoskeletal disorder risks among construction workers. However, the adoption of EXOs may differ with demographic characteristics. Survey data (n = 361) were collected from construction industry stakeholders and a summation score method was used to summarize respondent's benefits and barriers to EXO use, along with perceptions and readiness to use. Responses were stratified by race (White vs. non-White), sex (male vs. female), and age (<47 years vs. ≥47 years). Both a higher Benefits score and a higher Perceptions score were significantly and positively associated with a higher Readiness to Use score. There were also significant differences in perceived barriers to EXO use by race and sex. These results demonstrate substantial interest in EXO use but also emphasize the need to ensure proportionate access to the potential benefits of EXO technology.
Collapse
Affiliation(s)
- Nancy Gutierrez
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Aanuoluwapo Ojelade
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Sunwook Kim
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Alan Barr
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Abiola Akanmu
- School of Construction, Virginia Tech, Blacksburg, VA, USA
| | - Maury A Nussbaum
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Carisa Harris-Adamson
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
| |
Collapse
|
8
|
Coccia A, Capodaglio EM, Amitrano F, Gabba V, Panigazzi M, Pagano G, D'Addio G. Biomechanical Effects of Using a Passive Exoskeleton for the Upper Limb in Industrial Manufacturing Activities: A Pilot Study. SENSORS (BASEL, SWITZERLAND) 2024; 24:1445. [PMID: 38474980 DOI: 10.3390/s24051445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/16/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024]
Abstract
This study investigates the biomechanical impact of a passive Arm-Support Exoskeleton (ASE) on workers in wool textile processing. Eight workers, equipped with surface electrodes for electromyography (EMG) recording, performed three industrial tasks, with and without the exoskeleton. All tasks were performed in an upright stance involving repetitive upper limbs actions and overhead work, each presenting different physical demands in terms of cycle duration, load handling and percentage of cycle time with shoulder flexion over 80°. The use of ASE consistently lowered muscle activity in the anterior and medial deltoid compared to the free condition (reduction in signal Root Mean Square (RMS) -21.6% and -13.6%, respectively), while no difference was found for the Erector Spinae Longissimus (ESL) muscle. All workers reported complete satisfaction with the ASE effectiveness as rated on Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST), and 62% of the subjects rated the usability score as very high (>80 System Usability Scale (SUS)). The reduction in shoulder flexor muscle activity during the performance of industrial tasks is not correlated to the level of ergonomic risk involved. This preliminary study affirms the potential adoption of ASE as support for repetitive activities in wool textile processing, emphasizing its efficacy in reducing shoulder muscle activity. Positive worker acceptance and intention to use ASE supports its broader adoption as a preventive tool in the occupational sector.
Collapse
Affiliation(s)
- Armando Coccia
- Bioengineering Unit of Telese Terme Institute, Istituti Clinici Scientifici Maugeri IRCCS, 82037 Telese Terme, BN, Italy
| | - Edda Maria Capodaglio
- Occupational Therapy and Ergonomics Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, PV, Italy
| | - Federica Amitrano
- Bioengineering Unit of Telese Terme Institute, Istituti Clinici Scientifici Maugeri IRCCS, 82037 Telese Terme, BN, Italy
| | - Vittorio Gabba
- Department of Clinical-Surgical, Diagnostic and Pediatrics, University of Pavia, 27100 Pavia, PV, Italy
| | - Monica Panigazzi
- Occupational Therapy and Ergonomics Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, 27040 Montescano, PV, Italy
| | - Gaetano Pagano
- Bioengineering Unit of Bari Institute, Istituti Clinici Scientifici Maugeri IRCCS, 70124 Bari, BA, Italy
| | - Giovanni D'Addio
- Bioengineering Unit of Telese Terme Institute, Istituti Clinici Scientifici Maugeri IRCCS, 82037 Telese Terme, BN, Italy
| |
Collapse
|
9
|
Watterworth MWB, Dharmaputra R, Porto R, Cort JA, La Delfa NJ. Equations for estimating the static supportive torque provided by upper-limb exoskeletons. APPLIED ERGONOMICS 2023; 113:104092. [PMID: 37499527 DOI: 10.1016/j.apergo.2023.104092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/19/2023] [Accepted: 07/09/2023] [Indexed: 07/29/2023]
Abstract
Upper-limb exoskeletons are gaining traction in industrial work environments. However, other than advertised general specifications (e.g., peak support angle), the support torque provided throughout the reach envelope is largely unknown to end users. As such, this paper describes a methodology for measuring the specific supportive torque provided by upper-limb exoskeletons. The support of four commercially available passive upper-limb exoskeletons was quantified using an isokinetic dynamometer for all support ranges and levels (n = 68). Tests were repeated four times to determine between-session reliability. Intraclass correlation coefficients demonstrated 'Good' to 'Excellent' reliability, except for one condition. Polynomial regression equations were developed for each condition to predict exoskeleton support for any upper-limb elevation angle between 10° and 180°. These equations can be used to approximate upper-limb exoskeleton support in digital human modeling assessments, or to aid selection of exoskeleton settings specific to a worker's anthropometry and work task location.
Collapse
Affiliation(s)
| | | | - Ryan Porto
- Global Ergonomics Lab, Manufacturing Engineering, General Motors Company, Detroit, MI, USA
| | - Joel A Cort
- University of Windsor, Windsor, Ontario, Canada
| | | |
Collapse
|
10
|
de Vries AW, Baltrusch SJ, de Looze MP. Field study on the use and acceptance of an arm support exoskeleton in plastering. ERGONOMICS 2023; 66:1622-1632. [PMID: 36546707 DOI: 10.1080/00140139.2022.2159067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
Exoskeleton use in day-to-day plastering may face several challenges. Not all plasterer's tasks comprise of movements that will be supported by the exoskeleton and might even be hindered. Furthermore, use in practice might be jeopardised by time pressure, colleagues being negative, discomfort, or any other hindrance of the exoskeleton. We set up a field study, in which 39 plasterers were equipped with an exoskeleton for six weeks, to study exoskeleton usage. Moreover, we studied workload and fatigue, behaviour, productivity and quality, advantages and disadvantages, and acceptance. Exoskeleton use was dependent on the task performed but did not change over the course of the six weeks. For three tasks, higher exoskeleton use was associated with lower perceived loads, although differences were small. Advantages outweighed disadvantages for the majority of our population. This study shows that a majority of plasterers will wear the exoskeleton and is enthusiastic about the load reducing effect. Practitioner summary: For exoskeletons to make an impact on the health and well-being of workers, they need to be applicable in real work situations and accepted by the users. This study shows that 65% of the plasterers in this study want to use the exoskeleton in the future, for specific tasks.
Collapse
|
11
|
Mitterlehner L, Li YX, Wolf M. Objective and subjective evaluation of a passive low-back exoskeleton during simulated logistics tasks. WEARABLE TECHNOLOGIES 2023; 4:e24. [PMID: 38487776 PMCID: PMC10936295 DOI: 10.1017/wtc.2023.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 05/28/2023] [Accepted: 07/06/2023] [Indexed: 03/17/2024]
Abstract
Musculoskeletal disorders remain the most common work-related health problem in the European Union. The most common work-related musculoskeletal disorder reported by workers is backache, especially in the logistics sector. Thus, this article aims to evaluate the effects of a commercial passive low-back exoskeleton during simulated logistics tasks. Thirty participants were recruited for this study. Typical logistics tasks were simulated in a laboratory environment. Cross-over research design was utilized to assess the effects of the exoskeleton on heart rate, trunk inclination, trunk acceleration, throughput, and perceived exertion. Also, usability and acceptance were obtained using a custom questionnaire. We found mostly non-significant differences. Effects on throughput varied widely between workplaces. Usability ratings were poor and acceptance moderate. The study suggests that a holistic evaluation and implementation approach for industrial exoskeletons is necessary. Further, prior to exoskeleton implementation, workplace adaptation might be required.
Collapse
Affiliation(s)
- Lukas Mitterlehner
- Institute of Innovation and Industrial Management, Graz University of Technology, Graz, Austria
| | - Yasmin Xinyue Li
- Institute of Innovation and Industrial Management, Graz University of Technology, Graz, Austria
| | - Matthias Wolf
- Institute of Innovation and Industrial Management, Graz University of Technology, Graz, Austria
| |
Collapse
|
12
|
Kuber PM, Alemi MM, Rashedi E. A Systematic Review on Lower-Limb Industrial Exoskeletons: Evaluation Methods, Evidence, and Future Directions. Ann Biomed Eng 2023:10.1007/s10439-023-03242-w. [PMID: 37248409 DOI: 10.1007/s10439-023-03242-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 05/14/2023] [Indexed: 05/31/2023]
Abstract
Industrial tasks that involve frequent sitting/standing transitions and squatting activities can benefit from lower-limb industrial exoskeletons; however, their use is not as widespread as their upper-body counterparts. In this review, we examined 23 articles that evaluated the effects of using Wearable Chair (WC) and Squat-assist (SA) exoskeletons. Evaluations mainly included assessment of muscular demands in the thigh, shank, and upper/lower back regions. Both types of devices were found to lessen muscular demands in the lower body by 30-90%. WCs also reduced low-back demands (~ 37%) and plantar pressure (54-80%) but caused discomfort/unsafe feeling in participants. To generalize outcomes, we suggest standardizing approaches used for evaluating the devices. Along with addressing low adoption through design upgrades (e.g., ground and body supports/attachments), we recommend that researchers thoroughly evaluate temporal effects on muscle fatigue, metabolic rate, and stability of wearers. Although lower-limb exoskeletons were found to be beneficial, discrepancies in experimental protocols (posture/task/measures) were discovered. We also suggest simulating more realistic conditions, such as walking/sitting interchangeability for WCs and lifting loads for SA devices. The presented outcomes could help improve the design/evaluation approaches, and implementation of lower limb wearable devices across industries.
Collapse
Affiliation(s)
- Pranav Madhav Kuber
- Biomechanics and Ergonomics Lab, Industrial and Systems Engineering Department, Rochester Institute of Technology, 1 Lomb Memorial Dr, Rochester, NY, 14623, USA
| | - Mohammad Mehdi Alemi
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA
- Training Services, MathWorks, Natick, MA, USA
| | - Ehsan Rashedi
- Biomechanics and Ergonomics Lab, Industrial and Systems Engineering Department, Rochester Institute of Technology, 1 Lomb Memorial Dr, Rochester, NY, 14623, USA.
| |
Collapse
|
13
|
Kranenborg SE, Greve C, Reneman MF, Roossien CC. Side-effects and adverse events of a shoulder- and back-support exoskeleton in workers: A systematic review. APPLIED ERGONOMICS 2023; 111:104042. [PMID: 37146320 DOI: 10.1016/j.apergo.2023.104042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 04/20/2023] [Accepted: 04/27/2023] [Indexed: 05/07/2023]
Abstract
INTRODUCTION While the biomechanical effects of exoskeletons are well studied, research about potential side-effects and adverse events are limited. The aim of this systematic review was to provide an overview of the side-effects and adverse events on shoulder- and back-support exoskeletons during work tasks. METHODS Four in-field studies and 32 laboratory studies were included in this review, reporting on n = 18 shoulder exoskeletons, n = 9 back exoskeletons, n = 1 full body with a supernumerary arm, and n = 1 combination of shoulder and back exoskeleton. RESULTS The most frequent side-effect reported is discomfort (n = 30), followed by a limited usability of the exoskeleton (n = 16). Other identified side-effects and adverse events were changes in muscle activity, mobility, task performance, balance and posture, neurovascular supply, gait parameters and precision. An incorrect fit of the exoskeleton and the decreased degrees of freedom are most often reported as causes of these side-effects. Two studies did not find any side-effects. This review also showed that there are differences in the occurrence of side-effects in gender, age, and physical fitness. Most studies (89%) were conducted in a laboratory setting. Most studies (97%) measured short-term effects only. Psychological and social side-effects or adverse events were not reported. Side-effects and adverse events for active exoskeletons were understudied (n = 4). CONCLUSION It was concluded that the evidence for side-effects and adverse events is limited. If available, it mainly consists of reports of mild discomfort and limited usability. Generalisation is limited because studies were conducted in lab settings and measured short term only, and most participants were young male workers.
Collapse
Affiliation(s)
- S E Kranenborg
- University of Groningen, University Medical Center Groningen, Department of Human Movement Science, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands
| | - C Greve
- University of Groningen, University Medical Center Groningen, Department of Human Movement Science, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands.
| | - M F Reneman
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands
| | - C C Roossien
- University of Groningen, University Medical Center Groningen, Department of Human Movement Science, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands
| |
Collapse
|
14
|
Pacifico I, Aprigliano F, Parri A, Cannillo G, Melandri I, Sabatini AM, Violante FS, Molteni F, Giovacchini F, Vitiello N, Crea S. Evaluation of a spring-loaded upper-limb exoskeleton in cleaning activities. APPLIED ERGONOMICS 2023; 106:103877. [PMID: 36095895 DOI: 10.1016/j.apergo.2022.103877] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
In the past few years, companies have started considering the adoption of upper-limb occupational exoskeletons as a solution to reduce the health and cost issues associated with work-related shoulder overuse injuries. Most of the previous research studies have evaluated the efficacy of these devices in laboratories by measuring the reduction in muscle exertion resulting from device use in stereotyped tasks and controlled conditions. However, to date, uncertainties exist about generalizing laboratory results to more realistic conditions of use. The current study aims to investigate the in-field efficacy (through electromyography and perceived exertion), usability, and acceptance of a commercial spring-loaded upper-limb exoskeleton in cleaning job activities. The operators were required to maintain prolonged overhead postures while holding and moving a pole equipped with tools for window and ceiling cleaning. Compared to the normal working condition, the exoskeleton significantly reduced the total shoulder muscle activity (∼17%), the activity of the anterior deltoid (∼26%), medial deltoid (∼28%), and upper trapezius (∼24%). With the exoskeleton, the operators perceived reduced global effort (∼17%) as well as a reduced local effort in the shoulder (∼18%), arm (∼22%), upper back (∼14%), and lower back (∼16%). The beneficial effect of the exoskeleton and its suitability in cleaning settings are corroborated by the acceptance and usability scores assigned by operators, which averaged ∼5.5 out of 7 points. To the authors' knowledge, this study is the first to present an experience of exoskeleton use in cleaning contexts. The outcomes of this research invite further studies to test occupational exoskeletons in various realistic applications to foster scientific-grounded ergonomic evaluations and encourage the informed adoption of the technology.
Collapse
Affiliation(s)
| | | | - Andrea Parri
- IUVO S.r.l., Via Puglie 9, 56025, Pontedera, Pisa, Italy
| | - Giusi Cannillo
- Formula Servizi, Via Monteverdi, 31, 47122, Forlì, Italy
| | | | - Angelo Maria Sabatini
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Viale Rinaldo Piaggio 34, 56025, Pontedera, Pisa, Italy
| | - Francesco Saverio Violante
- Division of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna.Occupational Medicine Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Franco Molteni
- Villa Beretta Rehabilitation Center, Valduce Hospital, Via N. Sauro 17, 23845, Costa Masnaga, Lecco, Italy
| | | | - Nicola Vitiello
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Viale Rinaldo Piaggio 34, 56025, Pontedera, Pisa, Italy; Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà, 33, 56127, Pisa, Italy; IRCCS Fondazione Don Carlo Gnocchi, 50143, Florence, Italy
| | - Simona Crea
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Viale Rinaldo Piaggio 34, 56025, Pontedera, Pisa, Italy; Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà, 33, 56127, Pisa, Italy; IRCCS Fondazione Don Carlo Gnocchi, 50143, Florence, Italy.
| |
Collapse
|
15
|
Madinei S, Kim S, Park JH, Srinivasan D, Nussbaum MA. A novel approach to quantify the assistive torque profiles generated by passive back-support exoskeletons. J Biomech 2022; 145:111363. [PMID: 36332510 DOI: 10.1016/j.jbiomech.2022.111363] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 11/17/2022]
Abstract
Industrial exoskeletons are a promising ergonomic intervention to reduce the risk of work-related musculoskeletal disorders by providing external physical support to workers. Passive exoskeletons, having no power supplies, are of particular interest given their predominance in the commercial market. Understanding the mechanical behavior of the torque generation mechanisms embedded in passive exoskeletons is, however, essential to determine the efficacy of these devices in reducing physical loads (e.g., in manual material handling tasks). We introduce a novel approach using a computerized dynamometer to quantify the assistive torque profiles of two passive back-support exoskeletons (BSEs) at different support settings and in both static and dynamic conditions. The feasibility of this approach was examined using both human subjects and a mannequin. Clear differences in assistive torque magnitudes were evident between the two BSEs, and both devices generated more assistive torques during trunk/hip flexion than extension. Assistive torques obtained from human subjects were often within similar ranges as those from the mannequin, though values were more comparable over a narrow range of flexion/extension angles due to practical limitations with the dynamometer and human subjects. Characterizing exoskeleton assistive torque profiles can help in better understanding how to select a torque profile for given task requirements and user anthropometry, and aid in predicting the potential impacts of exoskeleton use by incorporating measured torque profiles in a musculoskeletal modeling system. Future work is recommended to assess this approach for other occupational exoskeletons.
Collapse
Affiliation(s)
- Saman Madinei
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA 24061, USA
| | - Sunwook Kim
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA 24061, USA
| | - Jang-Ho Park
- Department of Industrial Engineering, Clemson University, Clemson, SC 29634, USA
| | - Divya Srinivasan
- Department of Industrial Engineering, Clemson University, Clemson, SC 29634, USA
| | - Maury A Nussbaum
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA 24061, USA.
| |
Collapse
|
16
|
Baldassarre A, Lulli LG, Cavallo F, Fiorini L, Mariniello A, Mucci N, Arcangeli G. Industrial exoskeletons from bench to field: Human-machine interface and user experience in occupational settings and tasks. Front Public Health 2022; 10:1039680. [PMID: 36478728 PMCID: PMC9720272 DOI: 10.3389/fpubh.2022.1039680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/26/2022] [Indexed: 11/22/2022] Open
Abstract
Objective Work-related musculoskeletal disorders (WRMSDs) are considered nowadays the most serious issue in the Occupational Health and Safety field and industrial exoskeletons appear to be a new approach to addressing this medical burden. A systematic review has been carried out to analyze the real-life data of the application of exoskeletons in work settings considering the subjective responses of workers. Methods The review was registered on PROSPERO. The literature search and its report have been performed following the PRISMA guidelines. A comprehensive literature search was performed in PubMed, EMBASE, Web of Science, and Scopus. Results Twenty-four original studies were included in the literature review; 42% of the papers retrieved included automobilist industry workers, 17% of the studies evaluated the use of exoskeletons in logistic facilities, and 17% of articles involved healthcare. The remaining six papers recruited farmers, plasterers, wasting collectors, construction workers, and other workmen. All the papers selected tested the use of passive exoskeletons, supporting upper arms or back. Usability, perceived comfort, perceived exertion and fatigue, acceptability and intention to use, occupational safety and health, and job performance and productivity were the main topic analyzed. Conclusion Exoskeletons are not a fix-all technology, neither for workers nor for job tasks; they tend to show more of their potential in static activities, while in dynamic tasks, they can obstacle regular job performance. Comfort and easiness of use are the key factors influencing the user's experience. More research is needed to determine the most effective and safe ways to implement exoskeleton use in occupational settings. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=275728, identifier CRD42021275728.
Collapse
Affiliation(s)
- Antonio Baldassarre
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Lucrezia Ginevra Lulli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Filippo Cavallo
- Department of Industrial Engineering, University of Florence, Florence, Italy
| | - Laura Fiorini
- Department of Industrial Engineering, University of Florence, Florence, Italy
| | | | - Nicola Mucci
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Giulio Arcangeli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| |
Collapse
|
17
|
A Systematic Review on Evaluation Strategies for Field Assessment of Upper-Body Industrial Exoskeletons: Current Practices and Future Trends. Ann Biomed Eng 2022; 50:1203-1231. [PMID: 35916980 DOI: 10.1007/s10439-022-03003-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/30/2022] [Indexed: 01/02/2023]
Abstract
With rising manual work demands, physical assistance at the workplace is crucial, wherein the use of industrial exoskeletons (i-EXOs) could be advantageous. However, outcomes of numerous laboratory studies may not be directly translated to field environments. To explore this discrepancy, we conducted a systematic review including 31 studies to identify and compare the approaches, techniques, and outcomes within field assessments of shoulder and back support i-EXOs. Findings revealed that the subjective approaches [i.e., discomfort (23), usability (22), acceptance/perspectives (21), risk of injury (8), posture (3), perceived workload (2)] were reported more common (27) compared to objective (15) approaches [muscular demand (14), kinematics (8), metabolic costs (5)]. High variability was also observed in the experimental methodologies, including control over activity, task physics/duration, sample size, and reported metrics/measures. In the current study, the detailed approaches, their subject-related factors, and observed trends have been discussed. In sum, a new guideline, including tools/technologies has been proposed that could be utilized for field evaluation of i-EXOs. Lastly, we discussed some of the common technical challenges experimenters face in evaluating i-EXOs in field environments. Efforts presented in this study seek to improve the generalizability in testing and implementing i-EXOs.
Collapse
|
18
|
Pinho JP, Forner-Cordero A. Shoulder muscle activity and perceived comfort of industry workers using a commercial upper limb exoskeleton for simulated tasks. APPLIED ERGONOMICS 2022; 101:103718. [PMID: 35202960 DOI: 10.1016/j.apergo.2022.103718] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 06/14/2023]
Abstract
We compared the effects of using a commercial exoskeleton on shoulder muscle activity, task completion time, perceived effort and comfort while performing four tasks in different shoulder positions. Fourteen automotive industry workers performed four simulated tasks with shoulder at A≈0°, B ≈ 45°, C ≈ 90° and D ≈ 115° flexion. The electromyographic activity of the Medial Deltoid (MD) and the Anterior Deltoid (AD) decreased when wearing the exoskeleton. The effect sizes (ES) were, for MD: ES = 0, ES = -0.2, ES = -0.6, ES = -0.3; and for AD: ES = 0.3, ES = -0.6, ES = -0.8, ES = -0.6; for tasks A, B, C and D, respectively. We also found increased Anterior Deltoid/Triceps Brachii co-contraction, a typical joint stabilization mechanism. Wearing the exoskeleton increased the completion time of task B and reduced the perceived effort of tasks A and C, improving overall comfort. These findings are useful to organize the logistics of the workstations that use upper limb exoskeletons to improve the effectiveness of this equipment.
Collapse
Affiliation(s)
- João Pedro Pinho
- Biomechatronics Laboratory, Department of Mechatronics and Mechanical Systems, Escola Politécnica of the University of São Paulo, Brazil.
| | - Arturo Forner-Cordero
- Biomechatronics Laboratory, Department of Mechatronics and Mechanical Systems, Escola Politécnica of the University of São Paulo, Brazil.
| |
Collapse
|
19
|
Moeller T, Krell-Roesch J, Woll A, Stein T. Effects of Upper-Limb Exoskeletons Designed for Use in the Working Environment—A Literature Review. Front Robot AI 2022; 9:858893. [PMID: 35572378 PMCID: PMC9099018 DOI: 10.3389/frobt.2022.858893] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/11/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction: Many employees report high physical strain from overhead work and resulting musculoskeletal disorders. The consequences of these conditions extend far beyond everyday working life and can severely limit the quality of life of those affected. One solution to this problem may be the use of upper-limb exoskeletons, which are supposed to relieve the shoulder joint in particular. The aim of this literature review was to provide an overview of the use and efficacy of exoskeletons for upper extremities in the working environment.Methods: A literature review was conducted using the PICO scheme and the PRISMA statement. To this end, a systematic search was performed in the PubMed, Web of Science and Scopus databases in May 2020 and updated in February 2022. The obtained studies were screened using previously defined inclusion and exclusion criteria and assessed for quality. Pertinent data were then extracted from the publications and analyzed with regard to type of exoskeleton used as well as efficacy of exoskeleton use.Results: 35 suitable studies were included in the review. 18 different exoskeletons were examined. The majority of the exoskeletons only supported the shoulder joint and were used to assist individuals working at or above shoulder level. The main focus of the studies was the reduction of muscle activity in the shoulder area. Indeed, 16 studies showed a reduced activity in the deltoid and trapezius muscles after exoskeleton use. Kinematically, a deviation of the movement behavior could be determined in some models. In addition, study participants reported perceived reduction in exertion and discomfort.Discussion: Exoskeletons for upper extremities may generate significant relief for the intended tasks, but the effects in the field (i.e., working environment) are less pronounced than in the laboratory setting. This may be due to the fact that not only overhead tasks but also secondary tasks have to be performed in the field. In addition, currently available exoskeletons do not seem to be suitable for all overhead workplaces and should always be assessed in the human-workplace context. Further studies in various settings are required that should also include more females and older people.
Collapse
|
20
|
Schwerha D, McNamara N, Kim S, Nussbaum MA. Exploratory Field Testing of Passive Exoskeletons in Several Manufacturing Environments: Perceived Usability and User Acceptance. IISE Trans Occup Ergon Hum Factors 2022; 10:71-82. [PMID: 35354354 DOI: 10.1080/24725838.2022.2059594] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OCCUPATIONAL APPLICATIONSResults of the current exploratory study suggest that use of an exoskeleton (EXO) has the potential to be accepted by workers as an intervention in diverse manufacturing environments. Also evident were that the major factors contributing to EXO-use-intention are perceived comfort, task-technology fit, perceived safety, and perceived usefulness. A user's perception of perceived usability may be established by using an exoskeleton during actual job tasks, yet some aspects of perceived usability likely require multiple exposures to an EXO for an accurate assessment. Many negative comments regarding EXO use were related to physical constraints (e.g., restricted movements, bulkiness), and to the EXO interface (e.g., straps, cuff designs), suggesting a need for further research on EXO design to minimize discomfort. In practice, there is likely value in having workers use and explore candidate EXOs during their actual job, both to accurately assess the usefulness of an EXO and to find the most effective EXO.
Collapse
Affiliation(s)
- Diana Schwerha
- Department of Industrial & Systems Engineering, Liberty University, Lynchburg, VA, USA
| | - Nathan McNamara
- Department of Industrial & Systems Engineering, Ohio University, Athens, OH, USA
| | - Sunwook Kim
- Department of Industrial & Systems Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Maury A Nussbaum
- Department of Industrial & Systems Engineering, Virginia Tech, Blacksburg, VA, USA
| |
Collapse
|
21
|
Kim S, Nussbaum MA, Smets M. Usability, User Acceptance, and Health Outcomes of Arm-Support Exoskeleton Use in Automotive Assembly: An 18-month Field Study. J Occup Environ Med 2022; 64:202-211. [PMID: 34873132 DOI: 10.1097/jom.0000000000002438] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Examine arm-support exoskeleton (ASE) user experience over time, identify factors contributing to ASE intention-to-use, and explore whether ASE use may influence the number of medical visits. METHODS An 18-month, longitudinal study with ASE (n = 65) and control groups (n = 133) completed at nine automotive manufacturing facilities. RESULTS Responses to six usability questions were rather consistent over time. ASE use perceived effective in reducing physical demands on the shoulders, neck, and back. Perceived job performance, and overall fit and comfort, appeared to be key determinants for ASE intention-to-use. Based on medical visits among both groups, ASE use may decrease the likelihood of such visits. CONCLUSIONS These field results support the potential of ASEs as a beneficial ergonomic intervention, but also highlight needs for further research on ASE designs, factors driving intention-to-use, and health outcomes.
Collapse
Affiliation(s)
- Sunwook Kim
- Department of Industrial & Systems Engineering, Virginia Tech, Blacksburg, Virginia (Dr Kim, Dr Nussbaum); Manufacturing Technology Development, Ford Motor Company, Glendale, Michigan (Mr Smets)
| | | | | |
Collapse
|