SPEXOR passive spinal exoskeleton decreases metabolic cost during symmetric repetitive lifting.

PURPOSE: Besides mechanical loading of the back, physiological strain is an important risk factor for low-back pain. Recently a passive exoskeleton (SPEXOR) has been developed to reduce loading on the low back. We aimed to assess the effect of this device on metabolic cost of repetitive lifting. To explain potential effects, we assessed kinematics, mechanical joint work, and back muscle activity. METHODS: We recruited ten male employees, working in the luggage handling department of an airline company and having ample experience with lifting tasks at work. Metabolic cost, kinematics, mechanical joint work and muscle activity were measured during a 5-min repetitive lifting task. Participants had to lift and lower a box of 10 kg from ankle height with and without the exoskeleton. RESULTS: Metabolic cost was significantly reduced by 18% when wearing the exoskeleton. Kinematics did not change significantly, while muscle activity decreased by up to 16%. The exoskeleton took over 18-25% of joint work at the hip and L5S1 joints. However, due to large variation in individual responses, we did not find a significant reduction of joint work around the individual joints. CONCLUSION: Wearing the SPEXOR exoskeleton decreased metabolic cost and might, therefore, reduce fatigue development and contribute to prevention of low-back pain during repetitive lifting tasks. Reduced metabolic cost can be explained by the exoskeleton substituting part of muscle work at the hip and L5S1 joints and consequently decreasing required back muscle activity.

The effect of a passive trunk exoskeleton on metabolic costs during lifting and walking.

The objective of this study was to assess how wearing a passive trunk exoskeleton affects metabolic costs, movement strategy and muscle activation during repetitive lifting and walking. We measured energy expenditure, kinematics and muscle activity in 11 healthy men during 5 min of repetitive lifting and 5 min of walking with and without exoskeleton. Wearing the exoskeleton during lifting, metabolic costs decreased as much as 17%. In conjunction, participants tended to move through a smaller range of motion, reducing mechanical work generation. Walking with the exoskeleton, metabolic costs increased up to 17%. Participants walked somewhat slower with shortened steps while abdominal muscle activity slightly increased when wearing the exoskeleton. Wearing an exoskeleton during lifting decreased metabolic costs and hence may reduce the development of fatigue and low back pain risk. During walking metabolic costs increased, stressing the need for a device that allows disengagement of support depending on activities performed. Practitioner summary: Physiological strain is an important risk factor for low back pain. We observed that an exoskeleton reduced metabolic costs during lifting, but had an opposite effect while walking. Therefore, exoskeletons may be of benefit for lifting by decreasing physiological strain but should allow disengagement of support when switching between tasks. Abbreviations: COM: centre of mass; EMG: electromyography; LBP: low back pain; MVC: maximum voluntary isometric contraction; NIOSH: National Institute for Occupational Safety and Health; PLAD: personal lift augmentation device; PWS: preferred walking speed without exoskeleton; PWSX: preferred walking speed with exoskeleton; ROM: range of motion; RER: respiratory exchange ratio; V ̇O2max: maximum rate of oxygen consumption.

Continuous ambulatory hand force monitoring during manual materials handling using instrumented force shoes and an inertial motion capture suit.

Hand forces (HFs) are commonly measured during biomechanical assessment of manual materials handling; however, it is often a challenge to directly measure HFs in field studies. Therefore, in a previous study we proposed a HF estimation method based on ground reaction forces (GRFs) and body segment accelerations and tested it with laboratory equipment: GFRs were measured with force plates (FPs) and segment accelerations were measured using optical motion capture (OMC). In the current study, we evaluated the HF estimation method based on an ambulatory measurement system, consisting of inertial motion capture (IMC) and instrumented force shoes (FSs). Sixteen participants lifted and carried a 10-kg crate from ground level while 3D full-body kinematics were measured using OMC and IMC, and 3D GRFs were measured using FPs and FSs. We estimated 3D hand force vectors based on: (1) FP+OMC, (2) FP+IMC and (3) FS+IMC. We calculated the root-mean-square differences (RMSDs) between the estimated HFs to reference HFs calculated based on crate kinematics and the GRFs of a FP that the crate was lifted from. Averaged over subjects and across 3D force directions, the HF RMSD ranged between 10-15N when using the laboratory equipment (FP + OMC), 11-18N when using the IMC instead of OMC data (FP+IMC), and 17-21N when using the FSs in combination with IMC (FS + IMC). This error is regarded acceptable for the assessment of spinal loading during manual lifting, as it would results in less than 5% error in peak moment estimates.