Abstract
Shoulder exoskeletons potentially reduce overuse injuries in industrial settings including overhead work or lifting tasks. Previous studies evaluated these devices primarily in laboratory setting, but evidence of their effectiveness outside the lab is lacking. The present study aimed to evaluate the effectiveness of two passive shoulder exoskeletons and explore the transfer of laboratory-based results to the field. Four industrial workers performed controlled and in-field evaluations without and with two exoskeletons, ShoulderX and Skelex in a randomized order. The exoskeletons decreased upper trapezius activity (up to 46%) and heart rate in isolated tasks. In the field, the effects of both exoskeletons were less prominent (up to 26% upper trapezius activity reduction) while lifting windscreens weighing 13.1 and 17.0 kg. ShoulderX received high discomfort scores in the shoulder region and usability of both exoskeletons was moderate. Overall, both exoskeletons positively affected the isolated tasks, but in the field the support of both exoskeletons was limited. Skelex, which performed worse in the isolated tasks compared to ShoulderX, seemed to provide the most support during the in-field situations. Exoskeleton interface improvements are required to improve comfort and usability. Laboratory-based evaluations of exoskeletons should be interpreted with caution, since the effect of an exoskeleton is task specific and not all in-field situations with high-level lifting will equally benefit from the use of an exoskeleton. Before considering passive exoskeleton implementation, we recommend analyzing joint angles in the field, because the support is inherently dependent on these angles, and to perform in-field pilot tests. This paper is the first thorough evaluation of two shoulder exoskeletons in a controlled and in-field situation.
Highlights
F ORTY percent of European workers suffer from neck, shoulder or low back pain and 60% of all permanent work incapacity results from work-related musculoskeletal disorders [1]
A trend of reduced trapezius muscle (TR) activity was observed during oneminute horizontal holding with ShoulderX (9.4±3.6% maximal voluntary isometric contractions (MVIC)) compared to Skelex (12.2 ± 3.8% MVIC, p = 0.068, rrb = 0.143) and NoExo (17.1 ± 2.9% MVIC, p = 0.068, rrb = 0.571)
TR activity reduced with ShoulderX (13.6± 6.2%) compared to Skelex (20.4 ± 6.1% MVIC, p = 0.045, η2p = 0.290) and a trend towards reduced TR activity was observed with ShoulderX compared to NoExo (25.5 ± 6.7%, p = 0.076, η2p = 0.209)
Summary
F ORTY percent of European workers suffer from neck, shoulder or low back pain and 60% of all permanent work incapacity results from work-related musculoskeletal disorders [1]. In the European Union, the total cost of productivity losses due to work-related musculoskeletal disorders rises up to 2.5% of the gross domestic product [2]. These high numbers reflect the frequent exposure of employees in industrial environments to high physical workloads [3]. Preventive strategies are preferred since evidence to advocate the use of exercise and ergonomic interventions in the treatment of work-related musculoskeletal disorders is limited [6]
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