Effects of an arm‐support exoskeleton on perceived work intensity and musculoskeletal discomfort: An 18‐month field study in automotive assembly

Abstract

Background: Exoskeleton (EXO) technologies are a promising ergonomic intervention to reduce the risk of work-related musculoskeletal disorders, with efficacy supported by laboratory-and field-based studies. However, there is a lack of fieldbased evidence on long-term effects of EXO use on physical demands.Methods: A longitudinal, controlled research design was used to examine the effects of arm-support exoskeleton (ASE) use on perceived physical demands during overhead work at nine automotive manufacturing facilities. Data were collected at five milestones (baseline and at 1, 6, 12, and 18 months) using questionnaires. Linear mixed models were used to understand the effects of ASE use on perceived work intensity and musculoskeletal discomfort (MSD). Analyses were based on a total of 41 participants in the EXO group and 83 in a control group.Results: Across facilities, perceived work intensity and MSD scores did not differ significantly between the EXO and control groups. In some facilities, however, neck and shoulder MSD scores in the EXO group decreased over time. Wrist MSD scores in the EXO group in some facilities remained unchanged, while those scores increased in the control group over time. Upper arm and low back MSD scores were comparable between the experimental groups. Conclusion:Longitudinal effects of ASE use on perceived physical demands were not found, though some suggestive results were evident. This lack of consistent findings is discussed, particularly supporting the need for systematic and evidencebased ASE implementation approaches in the field that can guide the optimal selection of a job for ASE use.

Usability, User Acceptance, and Health Outcomes of Arm-Support Exoskeleton Use in Automotive Assembly

“…16,19 We also reported earlier that there were only slightly lower musculoskeletal discomfort scores reported for the neck and shoulder in a group that used an ASE (vs no ASE) during automotive assembly work. 21 The current results agree with those earlier reports, in that the current participants reported the same or slight better perceived safety and job performance using an ASE (Fig. 2).…”

“…Interestingly, though, De Bock et al 19 compared the impacts of using an ASE between laboratory and actual work environments, finding that the magnitude of beneficial effects of ASE use was smaller in the latter. We also observed relatively small, positive impacts of using an ASE on neck and shoulder discomfort during an 18-month field test in an automotive assembly environment, 21 which contrasts with more substantial benefits obtained in earlier lab studies that examined the same or other ASEs. 10,22 Earlier field studies also revealed usability and safety concerns that were often not fully identified or understood from labbased studies.…”

“…Though still much scarcer that lab-based studies, an increasing number of studies have reported outcomes from using ASEs in field settings. [15][16][17][18][19][20][21] These studies generally have supported findings from lab-based studies, showing that using an ASE can reduce physical demands on the shoulder (eg, reduced muscle activity in the shoulder region, perceived discomfort/exertion). Interestingly, though, De Bock et al 19 compared the impacts of using an ASE between laboratory and actual work environments, finding that the magnitude of beneficial effects of ASE use was smaller in the latter.…”

“…This study was reviewed and approved by the UAW/Ford National Joint Committee on Health and Safety and by the Institutional Review Board at Virginia Tech. A detailed description of the participants, experimental design, and procedures can be found in a companion paper 21 ; thus, only an overview is provided below.…”

Exploratory Field Testing of Passive Exoskeletons in Several Manufacturing Environments: Perceived Usability and User Acceptance

“…Though limited in number and scope, some field-based studies have been completed, the results of which have identified potential EXO usage concerns that may not be evident in lab-based studies. For example, using an EXO may substantially reduce physical demands in controlled (lab-based) tests, yet in some cases such beneficial effects were smaller in practice (Amandels, Eyndt, Daenen, & Hermans, 2019;De Bock et al, 2021;Kim, Nussbaum, Smets, & Ranganathan, 2021). A longitudinal study reported by Kim et al (2021) examined the use of an arm-support exoskeleton during overhead work in automotive assembly facilities, finding that beneficial effects were only modest and differed across facilities.…”