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

OCCUPATIONAL APPLICATIONSOccupational 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.

Background: Occupational exoskeletons are an attractive solution to reduce the prevalence of attrition and work-related musculoskeletal disorders, such as low back pain, among manual workers. However, research has mostly focused on acute effects, while the effects of in-field use, and exoskeleton training are still to be addressed. Purpose: The aim of the present paper was to investigate how in-field use and exoskeleton training affected the biomechanics, acceptance, and comfort of logistic workers when using a passive back exoskeleton. Methods: Twenty workers were randomly distributed into control and intervention group. The tests consisted of standard lifting tasks with and without exoskeleton before and after a 5-week period. The intervention group underwent a 5-week progressive training protocol aiming at increasing the duration of use of the exoskeleton. The variation in muscle activity (surface electromyography) and full-body kinematics (IMU-based motion capture) were assessed during logistic work tasks. Additionally, acceptance, comfort, and perceived effort were collected. Compliance to the training protocol reached 74%. Results: Using the exoskeleton resulted in a 13­20% reduced variation in muscle activity of the back muscles across groups and lifting conditions including trunk extension. The changes in variation were driven by a decrease in peak muscle activity, which was further lowered by 6­9% after the 5-week training. Additionally, training induced decreased knee flexion indicating a more stoop lifting technique in the intervention group. Conclusions: The present results demonstrate that exoskeleton training optimized the human-exoskeleton interaction by deriving more effects of the exoskeleton ­ in this case by lowering the peak muscle activity of the user during manual materials handling. This underlines the importance of introducing training when implementing exoskeletons in industry. Additionally, the results indicate that a progressive implementation of back supporting exoskeletons in logistics can be beneficial in terms of lowering the biomechanical load during manual materials handling.