Exoskeleton acceptance and its relationship to self-efficacy enhancement, perceived usefulness, and physical relief: A field study among logistics workers

Wearing a back-support exoskeleton alters lower-limb joint kinetics during single-step recovery following a forward loss of balance

We assessed the effects of a passive, back-support exoskeleton (BSE) on lower-limb joint kinetics during the initiation and swing phases of recovery from a forward loss of balance. Sixteen (8M, 8F) young, healthy participants were released from static forward-leaning postures and attempted to recover their balance with a single-step while wearing a BSE (backXTM) with different levels of support torque and in a control condition. The BSE provided ∼ 15-20 Nm of external hip extension torque on the stepping leg at the end of initiation and beginning of swing phases. Participants were unable to generate sufficient hip flexion torque, power, and work to counteract this external torque, although they sustained hip flexion torque for a more prolonged period, resulting in slightly increased hip contribution to positive leg work (compared to control). However, net positive leg work, and the net contribution of hip joint (human + BSE) to total leg work decreased with BSE use. While all participants had changes in hip joint kinetics, a significant compensatory increase in ankle contribution to positive leg work was observed only among females. Our results suggest that BSE use adversely affects reactive stepping by decreasing the stepping leg kinetic energy for forward propulsion, and that the relative contributions of lower-limb joints to total mechanical work done during balance recovery are altered by BSE use. BSEs may thus need to be implemented with caution for dynamic tasks in occupational settings, as they may impair balance recovery following a forward loss of balance.

Biomechanical Effects of Using a Passive Exoskeleton for the Upper Limb in Industrial Manufacturing Activities: A Pilot Study

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.

Understanding contributing factors to exoskeleton use-intention in construction: a decision tree approach using results from an online survey

Work-related musculoskeletal disorders (WMSDs) are a major health concern in the construction industry. Occupational exoskeletons (EXOs) are a promising ergonomic intervention to help reduce WMSD risk. Their adoption, however, has been low in construction. To understand the contributing factors to EXO use-intention and assist in future decision-making, we built decision trees to predict responses to each of three EXO use-intention questions (Try, Voluntary Use, and Behavioural Intention), using online survey responses. Variable selection and hyperparameter tuning were used respectively to reduce the number of potential predictors and improve prediction performance. The importance of variables in each final tree was calculated to understand which variables had a greater influence. The final trees had moderate prediction performance. The root node of each tree included EXOs becoming standard equipment, fatigue reduction, or performance increase. Important variables were found to be quite specific to different decision trees. Practical implications of the findings are discussed.Practitioner summary: This study used decision trees to identify key factors influencing the use-intention of occupational exoskeletons (EXOs) in construction, using online survey data. Key factors identified included EXOs becoming standard equipment, fatigue reduction, and performance improvement. Final trees provide intuitive visual representations of the decision-making process for workers to use EXOs.

The impact of bionic prostheses on users' self-perceptions: A qualitative study

Bionic devices for reestablishing or augmenting users' capabilities (e.g., bionic prostheses or exoskeletons) are becoming increasingly common. While prior research examined how such devices affect others' perceptions of their users, little is known about how these devices affect users' self-image and -perception, and the corresponding theory is scarce. To account for this gap, we conducted semi-structured interviews with users of bionic upper limb prostheses to obtain insights into their self- and meta-perceptions. Results of our qualitative analysis indicate that using bionic prostheses influences the social (self-) perception of bionics users in multiple ways, such that users describe themselves as being seen as more competent by others and treated differently after receiving the bionic prosthesis in comparison to simpler models. Results imply a somewhat complex dual identity among users in the sense that the bionic device instills competence, but disability-related feelings of stigma are present simultaneously. Despite being exploratory, our findings thus indicate that using bionic devices affects users' self-perception, stereotypes, and interpersonal perceptions. The ongoing proliferation of restoring devices and the introduction of augmenting technologies in future work contexts, for example, might thus have unintended social consequences that need to be accounted for.

Manufacturing Industry Stakeholder Perspectives on Occupational Exoskeletons: Changes after a Brief Exposure to Exoskeletons

OCCUPATIONAL APPLICATIONSMultiple occupational exoskeletons have been developed recently with potential to reduce physical demands, muscle fatigue, and risk of over-exertion injuries in manufacturing, yet there are currently challenges in practical, large-scale deployment. We explored how stakeholder perceptions of exoskeletons were affected by exposure to passive arm- and back-support exoskeletons. Our outcomes indicate that even brief exposure to exoskeletons can positively influence worker and stakeholder perceptions on the usefulness and safety of exoskeletons. However, worker concerns about device usability and acceptability in the field were not mitigated by such brief exposure. This work may help manufacturing industry stakeholders understand what technology-adoption factors need further consideration when planning for exoskeleton deployment.

Industrial exoskeletons from bench to field: Human-machine interface and user experience in occupational settings and tasks

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.

The effect of a movable headrest in shoulder assist device for overhead work

Recently, many kinds of shoulder-support exoskeletons have been developed and some of them are commercially available. However, to the best of our knowledge, shoulder-support exoskeletons that have neck-support mechanism have not been found. During the overhead work, physical strain is added to not only upper limb and shoulder but also neck of workers since the workers work keeping their face raised. Therefore, in this study, to reduce the physical strain on the neck during the overhead work, a movable headrest that can be attached to the shoulder assist device was developed, which has reclining and slide functions of a head. The main purpose of this article was to evaluate usefulness of the proposed movable headrest. To this end, measurements of electromyogram were carried out under simulating an overhead work activity, and the reduction effect for physical strain of the neck was compared among three types of headrests: (a) slide-type headrest which can slide the head backward and forward, (b) reclining-type headrest which can recline the head, and (c) reclining and slide-type headrest which can recline and slide the head. In addition, usefulness of the shoulder assist device with the proposed headrest was evaluated for a realistic overhead work activity through measurements of muscular stiffness of neck and shoulder. The experimental results showed that the existence of the headrest in the shoulder assist device is effective to reduce the physical strain to the workers, and that (c) reclining and slide-type headrest is the most effective among these three types of headrests.

Social perception of embodied digital technologies—a closer look at bionics and social robotics

This contribution of the journal Gruppe. Interaktion. Organisation. (GIO) presents a study on the social perception of Embodied Digital Technologies (EDTs) and provides initial insights into social perception processes concerning technicality and anthropomorphism of robots and users of prostheses. EDTs such as bionic technologies and robots are becoming increasingly common in workspaces and private lives, raising questions surrounding their perception and their acceptance. According to the Stereotype Content Model (SCM), social perception and stereotyping are based on two fundamental dimensions: Warmth (recently distinguished into Morality and Sociability) and Competence. We investigate how human actors, namely able-bodied individuals, users of low-tech prostheses and users of bionic prostheses, as well as artificial actors, such as industrial robots, social robots, and android robots, are perceived in terms of Competence, Sociability, and Morality. Results show that individuals with low-tech prostheses were perceived as competent as users of bionic prostheses, but only users of low-tech prostheses were perceived less competent than able-bodied individuals. Sociability did not differ between users of low-tech or bionic prostheses or able-bodied individuals. Perceived morality was higher for users of low-tech prostheses than users of bionic prostheses or able-bodied individuals. For robots, attributions of competence showed that industrial robots were perceived as more competent than more anthropomorphized robots. Sociability was attributed to robots to a lesser extent. Morality was not attributed to robots, regardless of their level of anthropomorphism.

A Systematic Review on Evaluation Strategies for Field Assessment of Upper-Body Industrial Exoskeletons: Current Practices and Future Trends

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.