Use Of Exoskeletons Research Articles

Experience of using the passive exoskeleton EXAR-34 in complex rehabilitation of a patient with post-traumatic plexopathy due to gunshot cervicothoracic wound (clinical observation)

The use of passive exoskeletons is a promising direction in the treatment of patients with severe combat injuries to the shoulder girdle, leading to disability in 30 % of cases. Aim: To demonstrate the capabilities of the passive exoskeleton EXAR-34 in the rehabilitation and habilitation of a victim with damage to the branches of the brachial nerve plexus. Materials and methods: An analysis of medical documentation, physical examination, morphometry, and goniometry were carried out. Clinical observation and discussion: A patient with post-traumatic left-sided plexopathy due to a gunshot perforating shrapnel cervicothoracic wound with gunshot fractures of the transverse processes of C6, C7, Th3 vertebrae, I–III ribs on the left after reconstructive intervention on elements of the brachial nerve plexus, when previously carried out rehabilitation measures were ineffective, during the first fitting of the EXAR-34 device, the range of active movements in the joints of the injured limb increased to 37,1–60,7 %, and routine motor skills were restored. Conclusion:The experience of using the EXAR-34 device demonstrates high promise in complex rehabilitation and habilitation of patients after reconstructive interventions on the brachial plexus for combat wounds.

Gender differences in the use of an upper-extremity exoskeleton during physically and cognitively demanding tasks- a study protocol for a randomized experimental trial.

Upper limb exoskeletons are recommended to alleviate muscle fatigue, particularly in working conditions inducing musculoskeletal discomfort like overhead work. However, wearing an exoskeleton might introduce cognitive-motor interference, affecting performance. Understanding its neural impact and potential gender differences in design effects is crucial. Therefore, the aim of this study is to examine exoskeleton effects addressing cross-gender comparisons, and exploring the impact on cognitive and physical workload in real-world scenarios. The research questions address the impact of exoskeleton use on muscle synergies, upper body posture, cognitive resources, comfort/discomfort, acceptance and usability. The cross-sectional study integrates a multifactorial mixed-measure design. Participants are grouped by gender (female vs. male) and working condition (with vs. without exoskeleton). Motor performance and underlying neuronal correlates (fNIRS) will be analyzed. Based on an a priori sample size calculation, 80 participants (40 female/40 male) will be recruited. Working performance will be assessed by 1. Physical Performance Task (PILE task) and 2. Precision Task (following the Fitts paradigm), while body postures will be monitored with an Xsens motion capture system. Brain activation will be captured with an fNIRS system comprising 32 active optodes. Postural comfort/discomfort, acceptance, and usability will be reported via standardized questionnaires. The study will gain insights into potential gender differences in exoskeleton use and will contribute to designing and optimizing the implementation of exoskeletons by considering muscle synergies, movement variability and cognitive resource allocation. Additionally, the study also highlights user discomfort, a crucial factor that could impede widespread adoption, particularly among females, in real-world scenarios.

Dosing overground robotic gait training after spinal cord injury: a randomized clinical trial protocol

BackgroundRobotic exoskeletons have changed rehabilitation care available to people after spinal cord injury (SCI). Yet, the current evidence base is insufficient to identify the optimal dose and neurophysiological mechanism of robotic exoskeleton gait training (RGT) as an effective rehabilitation approach. This study will (1) examine whether the frequency of RGT after motor incomplete SCI impacts function and health outcomes, (2) analyze the neuroplastic effects of RGT dose, and (3) evaluate the safety, tolerability, and feasibility of delivering RGT.MethodsWe will enroll 144 participants with motor incomplete SCI admitted to inpatient rehabilitation within 6 months of SCI. Participants will be randomized based on injury severity and level into one of 3 RGT frequency groups (high, moderate, low) or none/usual care only. Participants will complete 24 RGT sessions and be assessed at admission and discharge to inpatient rehabilitation, post-RGT intervention, 1-month post-RGT, and 9-month post-SCI. Outcomes include Walking Index for Spinal Cord Injury-II, health outcomes (gait speed, Spinal Cord Independence Measure, pain, fatigue, spasticity, general health, quality of life, physical activity), and motor evoked potential amplitudes obtained using transcranial magnetic stimulation.DiscussionSuccessful completion of this study will provide an evidence-based intervention, specifically tailored to meet the unique needs of people with SCI, which supports walking recovery; maximizing health, function, and ultimately participation. The intervention will further support widespread clinical implementation of exoskeleton use during acute rehabilitation.Trial registrationClinicalTrials.gov NCT05218447. Registered on June 23, 2022.

Gender Differences in Performing an Overhead Drilling Task Using an Exoskeleton-A Cross-Sectional Study.

(1) Exoskeletons offer potential benefits for overhead working tasks, but gender effects or differences are unclear. This study aimed to compare the performance as well as subjective body strain and comfort of men and women using an upper-body exoskeleton. (2) n = 20 female and n = 16 male participants performed an overhead drilling task with and without a passive upper-body exoskeleton in a randomized cross-over study. The task performance of different movement phases, perceived exertion, and ease of use were measured to compare gender differences. One- and two-way analyses were used to compare genders in the different conditions. The body mass index (BMI) was included as a covariate. (3) Gender differences in task performance were found for error integrals (p < 0.001) with higher values in male participants. Moreover, there was a significant interaction effect for gender x exoskeleton use. While females showed performance decrements in aiming with exoskeleton use, the males' performance increased (p = 0.025). No other gender differences were observed. (4) Gender differences in task performance using an upper-body industrial exoskeleton were less detectable than expected, indicating that body composition and anthropometrics might be valuable indicators for performance including assisting devices. Moreover, future studies should also integrate the examination of muscle activity to gain more insights into potential gender movement control patterns.

Shoulder-assist exoskeleton effects on balance and muscle activity during a block-laying task on a simulated mast climber

Interest in utilizing exoskeletons to mitigate the risks of musculoskeletal disorders (MSDs) among construction workers is growing, spurred by encouraging results in other industries. However, it is crucial to carefully examine their impact on workers' stability and balance before implementation. In this study, seven male participants lifted a 35-lb cinder block from a production table to a simulated wall at two heights—elbow and shoulder levels—using three different exoskeleton models on an unstable platform, where their balance and shoulder muscle activity were assessed. Balance-related parameters, included mean distance (MDIST), total excursion (EXCUR), and mean velocity (VEL) of the center of pressure, were derived from force plate data. Muscle activity in six shoulder and upper arm muscles was estimated using electromyography (EMG) data. The results indicated that wearing two of the exoskeletons significantly increased both total and medio-lateral (ML) MDIST compared to not wearing an exoskeleton. Wearing one of the exoskeletons significantly increased total and ML VEL and ML EXCUR. Although lifting level did not have a significant impact on the balance parameters, it did affect the muscle activity in most of the measured muscles. Moreover, only one exoskeleton significantly reduced the activity in a particular shoulder muscle compared to no exoskeleton use. In conclusion, the evaluated shoulder-assist exoskeletons showed limited benefits for preventing upper extremity MSDs and may negatively affect whole-body balance during a block-laying task on an unstable platform. These findings underscore the importance of comprehensive evaluations of balance and effectiveness prior to adopting exoskeletons in construction.

From unknown to familiar: An exploratory longitudinal field study on occupational exoskeletons adoption

Occupational exoskeletons hold promise in preventing musculoskeletal disorders, but their effectiveness relies on their long-term use by workers.This study aims to characterize the adoption process of occupational exoskeletons by analyzing the experiences of 25 operators. Using a mixed-methods approach, both quantitative and qualitative data were collected before and during a four-week familiarization period. We primarily focused on users' expectations, subjective assessments over time, and initial experiences.Findings elucidate shifts in operators' perceptions of the devices over time. Through their narratives, we highlight how exoskeleton use impact operators' movements and the subsequent adaptations. Operators demonstrated diverse exploratory behaviors, indicating their efforts to get to grips with the effects of exoskeletons in their own ways.This study offers insights into the initial stages of occupational exoskeleton adoption, thus enriching our comprehension of rejection patterns and pathways toward their widespread acceptance.

The effects of soft vs. rigid back-support exoskeletons on trunk dynamic stability and trunk-pelvis coordination in young and old adults during repetitive lifting

While back-support exoskeletons are increasing in popularity as an ergonomic intervention for manual material handling, they may cause alterations to neuromuscular control required for maintaining spinal stability. This study evaluated the effects of soft and rigid passive exoskeletons on trunk local dynamic stability and trunk-pelvis coordination. Thiry-two young (18–30 years) and old (45–60 years) men and women completed repetitive lifting and lowering tasks using two different exoskeletons and in a control condition. Both exoskeletons significantly reduced the short-term maximum Lyapunov exponent (LyE) of the trunk (p < 0.01), suggesting improved local dynamic stability. There was also a significant main effect of age (p = 0.05): older adults exhibited lower short-term LyE that young adults. Use of the soft exoskeleton significantly increased, while the rigid exoskeleton significantly decreased, long-term LyE, and these changes were more pronounced in the young group compared to the old group. Additionally, exoskeleton use resulted in significant increase (p < 0.001) of mean absolute relative phase (MARP) and deviation phase (DP) by ∼30–60 %, with greater increases due to the rigid than the soft device. Thus, trunk-pelvic coordination and coordination variability were negatively impacted by exoskeleton use. Potential reasons for these findings may include exoskeleton-induced changes in lifting strategy, reduced peak trunk flexion velocity, and cycle-to-cycle variability of trunk velocity. Furthermore, although the soft and rigid devices caused comparable changes in trunk-extensor muscle activity, they exhibited differential effects on long-term maximum Lyapunov exponents as well as trunk-pelvic coordination, indicating that exoskeleton design features can have complex effects on trunk neuromuscular control.

Exoskeleton Use During Lifting Tasks May Impair Physical and Cognitive Performances among Novice Users

Exoskeleton Use During Lifting Tasks May Impair Physical and Cognitive Performances among Novice Users

Advancements And Challenges in Exoskeleton Technology: An In-Depth Exploration

The human body is relatively weak and fragile compared to animals. To overcome this limitation, humans have proposed various suggestions to improve the status quo. For example, there's the idea of replacing human body parts with machines or developing bulletproof skin. Additionally, films often depict technologies that could potentially make individuals invincible. However, one of the most prevalent approaches is the use of exoskeletons. In reality, the first creation of an exoskeleton-like device appeared in the mid-20th century. Rather than creating exoskeletons to make humans superhuman, the primary focus has been on applying exoskeletons to fields requiring services and rehabilitation, garnering significant attention. With cooperation between the biomedical and engineering fields, more people are becoming aware that this technology could serve as a solution for disabled individuals and as an apparatus for those in physically demanding positions. Perhaps in the near future, with further investigation, all human beings could eventually have access to exoskeletons with even more advanced features.

Absolute and Relative Reliability of Spatiotemporal Gait Characteristics Extracted from an Inertial Measurement Unit among Senior Adults Using a Passive Hip Exoskeleton: A Test-Retest Study.

Seniors wearing a passive hip exoskeleton (Exo) show increased walking speed and step length but reduced cadence. We assessed the test-retest reliability of seniors' gait characteristics with Exo. Twenty seniors walked with and without Exo (noExo) on a 10 m indoor track over two sessions separated by one week. Speed, step length, cadence and step time variability were extracted from one inertial measurement unit (IMU) placed over the L5 vertebra. Relative and absolute reliability were assessed using the intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimal detectable change (MDC). The relative reliability of speed, step length, cadence and step time variability ranged from "almost perfect to substantial" for Exo and noExo with ICC values between 0.75 and 0.87 and 0.60 and 0.92, respectively. The SEM and MDC values for speed, step length cadence and step time variability during Exo and noExo were <0.002 and <0.006 m/s, <0.002 and <0.005 m, <0.30 and <0.83 steps/min and <0.38 s and <1.06 s, respectively. The high test-retest reliability of speed, step length and cadence estimated from IMU suggest a robust extraction of spatiotemporal gait characteristics during exoskeleton use. These findings indicate that IMUs can be used to assess the effects of wearing an exoskeleton on seniors, thus offering the possibility of conducting longitudinal studies.

Can a Novel Light Weight Minimal Support Lifting Exoskeleton Modify Lifting Movement in People without Low Back Pain?

Low back pain (LBP) is a major contributor to lifting-related disabilities. To minimize the risk of back pain, emerging technologies known as lifting exoskeletons were designed to optimize lifting movements. However, it is currently unknown whether a minimally supportive exoskeleton can alter the lifting movement in people without LBP. This study aims to investigate if wearing a novel lightweight exoskeleton that minimally supports the back, hip, and knee can alter the lifting range of motion and movement variations in people without LBP. This study also aims to investigate if wearing this novel exoskeleton can result in a reliable between-day lifting movement. In two separate sessions (each one week apart), fourteen participants lifted a box (that weighed 10% of their body weight) ten times, once while wearing an exoskeleton and once while not wearing an exoskeleton. Wearing the novel exoskeleton during lifting produced moderate-high, test-retest reliability (Trunk: ICC3,1 = 0.89, 95% CI [0.67, 0.96], SEM = 9.34°; Hip: ICC3,1 = 0.63, 95% CI [0.22, 0.88], SEM = 2.57°; Knee: ICC3,1 = 0.61, 95% CI [0.23, 0.87], SEM = 2.50°). Wearing an exoskeleton significantly decreased the range of motion of the knee (F1,4 = 4.83, p = 0.031, ηp2 = 0.06). Additionally, wearing an exoskeleton significantly decreased hip (diff = 8.38, p = 0.045) and knee (diff = -8.57, p = 0.038) movement variability; however, wearing an exoskeleton did not decrease the movement variability of the body's trunk (diff = 0.60, p = 1.00). Therefore, minimally supported lifting through the use of exoskeletons can modify movement in people without LBP and produce reliable lifting movements. Wearing the novel exoskeleton is also desirable for monitoring lifting movements. Future studies should investigate the use of sensors and IMU to monitor lifting movement at work with the least amount of intrusion on an individual's movement.

Physiotherapy-assisted overground exoskeleton use: mixed methods feasibility study protocol quantifying the user experience, as well as functional, neural, and muscular outcomes in children with mobility impairments.

Early phase research suggests that physiotherapy paired with use of robotic walking aids provides a novel opportunity for children with severe mobility challenges to experience active walking. The Trexo Plus is a pediatric lower limb exoskeleton mounted on a wheeled walker frame, and is adjustable to fit a child's positional and gait requirements. It guides and powers the child's leg movements in a way that is individualized to their movement potential and upright support needs, and can provide progressive challenges for walking within a physiotherapy-based motor learning treatment paradigm. This protocol outlines a single group mixed-methods study that assesses the feasibility of physiotherapy-assisted overground Trexo use in school and outpatient settings during a 6-week physiotherapy block. Children ages 3-6 years (n = 10; cerebral palsy or related disorder, Gross Motor Function Classification System level IV) will be recruited by circle of care invitations to participate. Study indicators/outcomes will focus on evaluation of: (i) clinical feasibility, safety, and acceptability of intervention; (ii) pre-post intervention motor/functional outcomes; (iii) pre-post intervention brain structure characterization and resting state brain connectivity; (iv) muscle activity characterization during Trexo-assisted gait and natural assisted gait; (v) heart rate during Trexo-assisted gait and natural assisted gait; and (vi) user experience and perceptions of physiotherapists, children, and parents. This will be the first study to investigate feasibility indicators, outcomes, and experiences of Trexo-based physiotherapy in a school and outpatient context with children who have mobility challenges. It will explore the possibility of experience-dependent neuroplasticity in the context of gait rehabilitation, as well as associated functional and muscular outcomes. Finally, the study will address important questions about clinical utility and future adoption of the device from the physiotherapists' perspective, comfort and engagement from the children's perspective, and the impressions of parents about the value of introducing this technology as an early intervention. https://clinicaltrials.gov, identifier NCT05463211.

The effects of exoskeleton use on human response to simulated overhead tasks with vibration

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.

Analysis and comparison of exoskeleton prototypes to carry out activities under normal conditions in industrial companies to reduce risks

The use of exoskeleton prototypes in industrial companies has emerged as a technology strategy that helps reduce workplace accidents and improve productivity OEE. This qualitative research focuses on explaining observations, using data collected from various academic sources between 2018 and 2022, selecting 47 relevant articles that address the use of exoskeletons in industrial environments. Three main objectives are presented using exoskeletons: 1) Reduction of accidents, 2) Analyze the most suitable exoskeleton prototype for industrial activities, and 3) Compare the effectiveness with respect to the activities. Some studies were discarded and most articles were found to support the effectiveness of exoskeletons in reducing ergonomic risks and workplace accidents. The functionality and effectiveness of several exoskeleton prototypes is compared under normal working conditions and is highlighted as a tool to improve safety and productivity in the industrial field.

Updating the Montreal walking exoskeleton satisfaction and perspectives questionnaire (MWESP-Q) following a 16-week walking program with the use of a wearable robotic exoskeleton

BACKGROUND: Physical activity as one of the major lifestyle-related health determinants is partially addressed by the Montreal Walking Exoskeleton Satisfaction and Perspectives-Questionnaire (MWESP-Q). OBJECTIVE: To document satisfaction of people with chronic spinal cord injury after the completion of a 10 to 16 weeks of the wearable robotic exoskeleton-assisted walking program, with the MWESP-Q updated to a context of health promotion. METHODS: Following a walking program (10–16 weeks), wheelchair users with chronic SCI completed the MWESP-Q online. Modification of the original questionnaire was conducted with 4 experts to ensure its content validity with a human framework to promote physical activity for health. RESULTS: Ten wheelchair users completed the questionnaire (men = 6; 45.8 ± 13.4 years, SCI duration: 10.1 ± 5.8 years). Participants strongly agreed to be satisfied with the overall program; agreed to be satisfied towards exoskeleton, motivation to engage in physical activity, learnability and program attributes; rated “medium effort” for physical and cognitive exertion during training; reported light improvements for health benefit domain, but light to moderate improvements for general endurance (mean 5.5 /7, SD 1.4) and psychological well-being (mean 5.7 /7, SD 1.3). CONCLUSIONS: The updated MWESP-Q is now better equipped to measure physical and cognitive efforts in physical activity and changes in body and organic systems and in capabilities (health promotion). The updated MWESP-Q has 54 statements (14 additional statements and 1 deleted) organized around seven domains. The original measure was replaced by three 7-point Likert scales, one regarding agreement level (40 statements), level of effort (12 statements), and level of change (2 statements).

Preliminary Virtual Constraint-Based Control Evaluation on a Pediatric Lower-Limb Exoskeleton.

Pediatric gait rehabilitation and guidance strategies using robotic exoskeletons require a controller that encourages user volitional control and participation while guiding the wearer towards a stable gait cycle. Virtual constraint-based controllers have created stable gait cycles in bipedal robotic systems and have seen recent use in assistive exoskeletons. This paper evaluates a virtual constraint-based controller for pediatric gait guidance through comparison with a traditional time-dependent position tracking controller on a newly developed exoskeleton system. Walking experiments were performed with a healthy child subject wearing the exoskeleton under proportional-derivative control, virtual constraint-based control, and while unpowered. The participant questionnaires assessed the perceived exertion and controller usability measures, while sensors provided kinematic, control torque, and muscle activation data. The virtual constraint-based controller resulted in a gait similar to the proportional-derivative controlled gait but reduced the variability in the gait kinematics by 36.72% and 16.28% relative to unassisted gait in the hips and knees, respectively. The virtual constraint-based controller also used 35.89% and 4.44% less rms torque per gait cycle in the hips and knees, respectively. The user feedback indicated that the virtual constraint-based controller was intuitive and easy to utilize relative to the proportional-derivative controller. These results indicate that virtual constraint-based control has favorable characteristics for robot-assisted gait guidance.

Field assessment of active BSE: Trends over test days of subjective indicators and self-reported fatigue for railway construction workers

The research community has conducted several controlled “in -lab” assessments on the effectiveness of industrial exoskeletons, paving the way for their adoption. However, field testing, focusing on ergonomics and the user experience, could serve to enhance both end-users' awareness and address open doubts concerning true effectiveness of industrial exoskeletons. This study presents an analysis of qualitative data regarding the use of back-support exoskeletons during field trials in harsh civil engineering environments. This work evaluates the StreamEXO's (an active back-support exoskeleton) efficacy in reducing fatigue and the evolution of its perceived usefulness. This is achieved using qualitative data collection tools, during real scenarios testing over multiple-day trials. Collected data shows a positive correlation between self-reported fatigue, measured on a four verbal anchors-based Borg CR10 scale, and the use of the exoskeleton during physically demanding movements. Moreover, the evolution of scores throughout the testing sessions (90 minutes of exoskeleton use for three nonconsecutive days) suggests a trend due to the adaptation and learning curve of workers during the exoskeleton experience. The analysis of the open-ended answers highlights that the adaptation to physical interaction has a negative oscillation on day two to rise back during the third day, possibly correlated to a change in muscle pattern. The main critical factors affecting comfort during the exoskeleton experience are weight balance, body pressure, and thermal comfort, which can strongly affect device acceptance.

In-Field Training of a Passive Back Exoskeleton Changes the Biomechanics of Logistic Workers

OCCUPATIONAL APPLICATIONS Occupational exoskeletons receive rising interest in industry as these devices diminish the biomechanical load during manual materials handling. Still, we have limited knowledge when it comes to in-field use. This gap often contributes to failure in the implementation of exoskeleton in industry. In this study, we investigated how a training protocol consisting of in-field use of a passive back exoskeleton affected the biomechanics of logistic workers. More specifically, we focused on how the variation of the muscular and kinematic patterns of the user was altered after exoskeleton training. We found that training had a positive effect on exoskeleton use, as a relative decrease of 6–9% in peak back muscle activity was observed post-training. Additionally, training decreased knee flexion by 6°–16°, indicating a more stoop lifting technique. The findings point at the potential benefits of applying a training approach when implementing a back-supporting exoskeleton in logistics.

Safety and practicality study of using an exoskeleton in acute neurosurgery patients.

Early mobilization is key in neurologically impaired persons, limiting complications and improving long-term recovery. Self-balanced exoskeletons are used in rehabilitation departments to help patients stand and walk. We report the first case series of exoskeleton use in acute neurosurgery and intensive care patients, evaluating safety, clinical feasibility and patients' satisfaction. We report a retrospective observational study including individuals hospitalized in the neurosurgical intensive care and neurosurgery departments. We included patients with a medical prescription for an exoskeleton session, and who met no contraindication. Patients benefited from standing sessions using a self-balanced exoskeleton (Atalante, Wandercraft, France). Patients and sessions data were collected. Safety, feasibility and adherence were evaluated. Seventeen patients were scheduled for 70 standing sessions, of which 27 (39%) were completed. They were typically hospitalized for intracranial hemorrhage (74%) and presented with unilateral motor impairments, able to stand but with very insufficient weight shifting to the hemiplegic limb, requiring support (MRC 36.2 ± 3.70, SPB 2.0 ± 1.3, SPD 0.7 ± 0.5). The average duration of standing sessions was 16 ± 9min. The only side effect was orthostatic hypotension (18.5%), which resolved with returning to seating position. The most frequent reason for not completing a session was understaffing (75%). All patients were satisfied and expressed a desire to repeat it. Physiotherapy using the exoskeleton is safe and feasible in the acute neurosurgery setting, although it requires adaptation from the staff to organize the sessions. An efficacy study is ongoing to evaluate the benefits for the patients.

Enhancement of work place comfort through the use of soft landscape

The work environment has been shown to have a great influence on employees’ physical and mental state, as such employers try as much as possible to provide a comfortable working environment. However, recent studies have shown that the work environment is no longer as comfortable as it used to be due to heat gain from the increasing use of hard landscape features and neglect of soft landscape features in the work environment. This has resulted in stress causing both mild and severe health conditions for employees. Thus, this study aims to analyze the use of soft landscape in enhancing users' comfort with the view of reducing stress and health-related issues in the work environment. The paper adopted a mixed method using observation checklists, structured interviews, questionnaires, and case studies. A total of eighteen office complexes were selected to describe the existing situation as related to most office complexes and to also gain insight into the subject matter as already applied to life situations. Structured interviews and questionnaires were also conducted with occupants of the buildings and professionals to hear their perceptions and expectations of their work environment. Results showed that 20 percent of the offices give proper consideration to the use of soft landscapes in the work environment, and 40 percent give inconsiderable attention to soft landscapes while making use of them in small quantities solely for improving the aesthetical value of the building. In comparison, the remaining 40 percent do not consider landscape use as a means of improving comfort in the work environment. Findings also revealed that 80 percent of office buildings give major consideration to parking space using hard landscapes without a proper blend of soft landscapes after building design which hurts occupant comfort. The research concluded that the incorporation of soft landscape elements both within the building using recesses and protrusions and on the building walls through the use of exoskeleton and climbers while incorporating trees, shrubs, flowers, hedges and water around the building can have these required effects on employee’s comfort.