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Mohamed Refai MI, Moya-Esteban A, van Zijl L, van der Kooij H, Sartori M. Benchmarking commercially available soft and rigid passive back exoskeletons for an industrial workplace. WEARABLE TECHNOLOGIES 2024; 5:e6. [PMID: 38510984 PMCID: PMC10952052 DOI: 10.1017/wtc.2024.2] [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: 06/20/2023] [Revised: 12/22/2023] [Accepted: 01/19/2024] [Indexed: 03/22/2024]
Abstract
Low-back pain is a common occupational hazard for industrial workers. Several studies show the advantages of using rigid and soft back-support passive exoskeletons and exosuits (exos) to reduce the low-back loading and risk of injury. However, benefits of using these exos have been shown to be task-specific. Therefore, in this study, we developed a benchmarking approach to assess exos for an industrial workplace at Hankamp Gears B.V. We assessed two rigid (Laevo Flex, Paexo back) and two soft (Auxivo Liftsuit 1.0, and Darwing Hakobelude) exos for tasks resembling the workplace. We measured the assistive moment provided by each exo and their respective influence on muscle activity as well as the user's perception of comfort and exertion. Ten participants performed four lifting tasks (Static hold, Asymmetric, Squat, and Stoop), while their electromyography and subjective measures were collected. The two rigid exos provided the largest assistance during the Dynamic tasks. Reductions in erector spinae activity were seen to be task-specific, with larger reductions for the two rigid exos. Overall, Laevo Flex offered a good balance between assistive moments, reductions in muscle activity, as well as user comfort and reductions in perceived exertion. Thus, we recommend benchmarking exos for intended use in the industrial workplace. This will hopefully result in a better adoption of the back-support exoskeletons in the workplace and help reduce low-back pain.
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Affiliation(s)
| | - Alejandro Moya-Esteban
- Department of Biomechanical Engineering, University of Twente, Enschede, The Netherlands
| | - Lynn van Zijl
- Department of Biomechanical Engineering, University of Twente, Enschede, The Netherlands
| | - Herman van der Kooij
- Department of Biomechanical Engineering, University of Twente, Enschede, The Netherlands
| | - Massimo Sartori
- Department of Biomechanical Engineering, University of Twente, Enschede, The Netherlands
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Mahmud D, Bennett ST, Zhu Z, Adamczyk PG, Wehner M, Veeramani D, Dai F. Identifying Facilitators, Barriers, and Potential Solutions of Adopting Exoskeletons and Exosuits in Construction Workplaces. SENSORS (BASEL, SWITZERLAND) 2022; 22:9987. [PMID: 36560355 PMCID: PMC9785667 DOI: 10.3390/s22249987] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 05/31/2023]
Abstract
Exoskeletons and exosuits (collectively termed EXOs) have the potential to reduce the risk of work-related musculoskeletal disorders (WMSDs) by protecting workers from exertion and muscle fatigue due to physically demanding, repetitive, and prolonged work in construction workplaces. However, the use of EXOs in construction is in its infancy, and much of the knowledge required to drive the acceptance, adoption, and application of this technology is still lacking. The objective of this research is to identify the facilitators, barriers, and corresponding solutions to foster the adoption of EXOs in construction workplaces through a sequential, multistage Delphi approach. Eighteen experts from academia, industry, and government gathered in a workshop to provide insights and exchange opinions regarding facilitators, barriers, and potential solutions from a holistic perspective with respect to business, technology, organization, policy/regulation, ergonomics/safety, and end users (construction-trade professionals). Consensus was reached regarding all these perspectives, including top barriers and potential solution strategies. The outcomes of this study will help the community gain a comprehensive understanding of the potential for EXO use in the construction industry, which may enable the development of a viable roadmap for the evolution of EXO technology and the future of EXO-enabled workers and work in construction workplaces.
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Affiliation(s)
- Dilruba Mahmud
- Wadsworth Department of Civil and Environmental Engineering, West Virginia University, Morgantown, WV 26506, USA
| | - Sean T. Bennett
- Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Zhenhua Zhu
- Department of Civil and Environmental Engineering, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Peter G. Adamczyk
- Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Michael Wehner
- Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Dharmaraj Veeramani
- Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Fei Dai
- Wadsworth Department of Civil and Environmental Engineering, West Virginia University, Morgantown, WV 26506, USA
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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.
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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
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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.
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Park JH, Lee Y, Madinei S, Kim S, Nussbaum MA, Srinivasan D. Effects of Back-Support Exoskeleton Use on Lower Limb Joint Kinematics and Kinetics During Level Walking. Ann Biomed Eng 2022; 50:964-977. [PMID: 35478066 DOI: 10.1007/s10439-022-02973-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/19/2022] [Indexed: 11/26/2022]
Abstract
We assessed the effects of using a passive back-support exoskeleton (BSE) on lower limb joint kinematics and kinetics during level walking. Twenty young, healthy participants completed level walking trials while wearing a BSE (backXTM) with three different levels of hip-extension support torque (i.e., no torque, low, and high) and in a control condition (no-BSE). When hip extension torques were required for gait-initial 0-10% and final 75-100% of the gait cycle-the BSE with high supportive torque provided ~ 10 Nm of external hip extension torque at each hip, resulting in beneficial changes in participants' gait patterns. Specifically, there was a ~ 10% reduction in muscle-generated hip extension torque and ~ 15-20% reduction in extensor power. During the stance-swing transition, however, BSE use produced undesirable changes in lower limb kinematics (e.g., 5-20% increase in ankle joint velocity) and kinetics (e.g., ~ 10% increase in hip flexor, knee extensor, and ankle plantarflexor powers). These latter changes likely stemmed from the need to increase mechanical energy for propelling the leg into the swing phase. BSE use may thus increase the metabolic cost of walking. Whether such use also leads to muscle fatigue and/or postural instability in long-distance walking needs to be confirmed in future work.
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Affiliation(s)
- Jang-Ho Park
- Department of Industrial Engineering, Clemson University, Freeman Hall, Clemson, SC, 29634, USA
| | - Youngjae Lee
- 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
| | - Maury A Nussbaum
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, 24061, USA
| | - Divya Srinivasan
- Department of Industrial Engineering, Clemson University, Freeman Hall, Clemson, SC, 29634, USA.
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Kim S, Nussbaum MA, Smets M, Ranganathan S. Effects of an arm-support exoskeleton on perceived work intensity and musculoskeletal discomfort: An 18-month field study in automotive assembly. Am J Ind Med 2021; 64:905-914. [PMID: 34363229 DOI: 10.1002/ajim.23282] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/16/2021] [Accepted: 07/22/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Exoskeleton (EXO) technologies are a promising ergonomic intervention to reduce the risk of work-related musculoskeletal disorders, with efficacy supported by laboratory- and field-based studies. However, there is a lack of field-based evidence on long-term effects of EXO use on physical demands. METHODS A longitudinal, controlled research design was used to examine the effects of arm-support exoskeleton (ASE) use on perceived physical demands during overhead work at nine automotive manufacturing facilities. Data were collected at five milestones (baseline and at 1, 6, 12, and 18 months) using questionnaires. Linear mixed models were used to understand the effects of ASE use on perceived work intensity and musculoskeletal discomfort (MSD). Analyses were based on a total of 41 participants in the EXO group and 83 in a control group. RESULTS Across facilities, perceived work intensity and MSD scores did not differ significantly between the EXO and control groups. In some facilities, however, neck and shoulder MSD scores in the EXO group decreased over time. Wrist MSD scores in the EXO group in some facilities remained unchanged, while those scores increased in the control group over time. Upper arm and low back MSD scores were comparable between the experimental groups. CONCLUSION Longitudinal effects of ASE use on perceived physical demands were not found, though some suggestive results were evident. This lack of consistent findings is discussed, particularly supporting the need for systematic and evidence-based ASE implementation approaches in the field that can guide the optimal selection of a job for ASE use.
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Affiliation(s)
- Sunwook Kim
- Department of Industrial & Systems Engineering, Virginia Tech, Blacksburg, Virginia, USA
| | - Maury A Nussbaum
- Department of Industrial & Systems Engineering, Virginia Tech, Blacksburg, Virginia, USA
| | - Marty Smets
- Manufacturing Technology Development, Ford Motor Company, Glendale, Michigan, USA
| | - Shyam Ranganathan
- Department of Statistics, Virginia Tech Virginia Tech Blacksburg, Blacksburg, Virginia, USA
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Crea S, Beckerle P, De Looze M, De Pauw K, Grazi L, Kermavnar T, Masood J, O’Sullivan LW, Pacifico I, Rodriguez-Guerrero C, Vitiello N, Ristić-Durrant D, Veneman J. Occupational exoskeletons: A roadmap toward large-scale adoption. Methodology and challenges of bringing exoskeletons to workplaces. WEARABLE TECHNOLOGIES 2021; 2:e11. [PMID: 38486625 PMCID: PMC10936259 DOI: 10.1017/wtc.2021.11] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 08/03/2021] [Accepted: 08/08/2021] [Indexed: 03/17/2024]
Abstract
The large-scale adoption of occupational exoskeletons (OEs) will only happen if clear evidence of effectiveness of the devices is available. Performing product-specific field validation studies would allow the stakeholders and decision-makers (e.g., employers, ergonomists, health, and safety departments) to assess OEs' effectiveness in their specific work contexts and with experienced workers, who could further provide useful insights on practical issues related to exoskeleton daily use. This paper reviews present-day scientific methods for assessing the effectiveness of OEs in laboratory and field studies, and presents the vision of the authors on a roadmap that could lead to large-scale adoption of this technology. The analysis of the state-of-the-art shows methodological differences between laboratory and field studies. While the former are more extensively reported in scientific papers, they exhibit limited generalizability of the findings to real-world scenarios. On the contrary, field studies are limited in sample sizes and frequently focused only on subjective metrics. We propose a roadmap to promote large-scale knowledge-based adoption of OEs. It details that the analysis of the costs and benefits of this technology should be communicated to all stakeholders to facilitate informed decision making, so that each stakeholder can develop their specific role regarding this innovation. Large-scale field studies can help identify and monitor the possible side-effects related to exoskeleton use in real work situations, as well as provide a comprehensive scientific knowledge base to support the revision of ergonomics risk-assessment methods, safety standards and regulations, and the definition of guidelines and practices for the selection and use of OEs.
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Affiliation(s)
- Simona Crea
- Scuola Superiore Sant’Anna, The BioRobotics Institute, Pontedera, Italy
- IRCCS Fondazione Don Gnocchi, Florence, Italy
| | - Philipp Beckerle
- Chair of Autonomous Systems and Mechatronics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Institute for Mechatronic Systems, Technische Universität Darmstadt, Darmstadt, Germany
| | | | - Kevin De Pauw
- Human Physiology and Sports Physiotherapy Research Group, and Brussels Human Robotics Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
| | - Lorenzo Grazi
- Scuola Superiore Sant’Anna, The BioRobotics Institute, Pontedera, Italy
| | - Tjaša Kermavnar
- School of Design, and Confirm Smart Manufacturing Centre, University of Limerick, Limerick, Ireland
| | - Jawad Masood
- Processes and Factory of the Future Department, CTAG – Centro Tecnológico de Automoción de Galicia, Pontevedra, Spain
| | - Leonard W. O’Sullivan
- School of Design, and Confirm Smart Manufacturing Centre, University of Limerick, Limerick, Ireland
| | - Ilaria Pacifico
- Scuola Superiore Sant’Anna, The BioRobotics Institute, Pontedera, Italy
| | - Carlos Rodriguez-Guerrero
- Robotics and Multibody Mechanics Research Group, Department of Mechanical Engineering, Vrije Universiteit Brussel and Flanders Make, Brussel, Belgium
| | - Nicola Vitiello
- Scuola Superiore Sant’Anna, The BioRobotics Institute, Pontedera, Italy
- IRCCS Fondazione Don Gnocchi, Florence, Italy
| | | | - Jan Veneman
- Chair of COST Action 16116, Hocoma Medical GmbH, Zürich, Switzerland
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Kermavnar T, de Vries AW, de Looze MP, O'Sullivan LW. Effects of industrial back-support exoskeletons on body loading and user experience: an updated systematic review. ERGONOMICS 2021; 64:685-711. [PMID: 33369518 DOI: 10.1080/00140139.2020.1870162] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/22/2020] [Indexed: 06/12/2023]
Abstract
This study is an updated systematic review of papers published in the last 5 years on industrial back-support exoskeletons. The research questions were aimed at addressing the recent findings regarding objective (e.g. body loading, user performance) and subjective evaluations (e.g. user satisfaction), potential side effects, and methodological aspects of usability testing. Thirteen studies of active and twenty of passive exoskeletons were identified. The exoskeletons were tested during lifting and bending tasks, predominantly in laboratory settings and among healthy young men. In general, decreases in participants' back-muscle activity, peak L5/S1 moments and spinal compression forces were reported. User endurance during lifting and static bending improved, but performance declined during tasks that required increased agility. The overall user satisfaction was moderate. Some side effects were observed, including increased abdominal/lower-limb muscle activity and changes in joint angles. A need was identified for further field studies, involving industrial workers, and reflecting actual work situations. Practitioner summary: Due to increased research activity in the field, a systematic review was performed of recent studies on industrial back-support exoskeletons, addressing objective and subjective evaluations, side effects, and methodological aspects of usability testing. The results indicate the efficiency of exoskeletons in back-load reduction and a need for further studies in real work situations. Abbrevaitions: BB: biceps brachii; BF: biceps femoris; CoM: centre of mass; DA: deltoideus anterior; EMG: electromyography; ES: erector spinae; ES-C: erector spinae-cervical; ESI: erector spinae iliocostalis; ESI-L: erector spinae iliocostalis-lumborum; ESL: erector spinae longissimus; ES-L: erector spinae-lumbar; ESL-L: erector spinae longissimus-lumborum; ESL-T: erector spinae longissimus-thoracis; ES-T: erector spinae-thoracic; GM: glutaeus maximus; LBP: low back pain; LD: latissimus dorsi; LPD: local perceived discomfort scale; LPP: local perceived pressure scale; MS: multifidus spinae; MSD: musculoskeletal disorder; M-SFS: modified spinal function sort; NMV: no mean value provided; OA: obliquus abdominis (internus and externus); OEA: obliquus externus abdominis; OIA : obliquus internus abdominis; RA: rectus abdominis; RF: rectus femoris; RoM: range of motion; SUS: system usability scale; T: trapezius (pars Ascendens and Descendens); TA: trapezius pars ascendens; TC: mid-cervical trapezius; TD: trapezius pars descendens; VAS: visual analog scale; VL: vastus lateralis; VM: vastus medialis.
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Affiliation(s)
| | | | | | - Leonard W O'Sullivan
- School of Design, Confirm Smart Manufacturing Centre and Health Research Institute, University of Limerick, Limerick, Ireland
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