Influence of a passive shoulder exoskeleton on drilling performance in women- a cross-sectional study
Clinical Snapshot
PICO Framework
| P — Population | 14 healthy female participants performing overhead precision tasks |
| I — Intervention | Passive upper-body exoskeleton during overhead bolt-tightening task |
| C — Comparator | No exoskeleton (control condition) |
| O — Outcomes | Muscle activation (M. Trapezius), task performance accuracy, subjective shoulder strain, and usability ratings |
Bottom Line
This small crossover study (n=14) found that a passive shoulder exoskeleton reduced trapezius muscle activation by 73% during overhead tasks in women, but completely eliminated task accuracy and received unacceptable usability ratings. While the biomechanical benefits are promising for reducing work-related musculoskeletal disorders, the substantial performance impairment and poor user acceptance make this technology unsuitable for precision work in its current form. The study highlights critical design limitations that must be addressed before workplace implementation. Clinicians should note that while exoskeletons show potential for reducing muscle strain, current devices may compromise work quality and safety. Larger, longer-term studies in real workplace settings are needed before recommending exoskeleton use for occupational health interventions.
Key Findings
P Value: p = 0.041 for muscle activation; p < 0.001 for accuracy reduction; p = 0.035 for subjective strain
Effect Size: 73% reduction in muscle activation with exoskeleton
Primary Outcome: M. Trapezius muscle activation during arm lowering phase
Nnt Or Sensitivity: 100% of participants showed reduced target accuracy with exoskeleton use
Confidence Interval: Not reported in abstract
Clinical Application
Poor feasibility given 'unacceptable' usability ratings and impaired task performance Relevant to Australian workplace safety regulations and ergonomic interventions, but current evidence insufficient for workplace implementation Limited applicability - healthy women only, laboratory conditions, single-session exposure
Abstract
Work-related musculoskeletal disorders are common, especially among women performing repetitive overhead tasks. In a randomized 2 × 2 crossover study with 14 female participants, we investigated the effects of a passive upper-body exoskeleton during an overhead precision task, involving the tightening of 20 bolts into a sensor-based workstation, while muscle activation, task performance, and usability were assessed. The results showed significant reduced M. Trapezius muscle activations during arm lowering (p = .041, 73%), and lower target accuracy (p < .001, 100%) when using the exoskeleton. Subjective strain in the shoulders was significantly lower when using the exoskeleton (p = .035, 15%). The usability was rated as "unacceptable", with users criticizing the complexity and learning effort. While the exoskeleton reduced muscle load, its mechanical limitations impaired precision and usability, especially for women. These results highlight the importance of sex-specific, ergonomic, and adaptive designs to improve exoskeleton effectiveness and acceptance.
References
- 1.Gräf, J. K., Wollesen, B., Díaz, M. A., De Bock, S., Hansen, L., Ducastel, V., Preckher, A., Roelands, B., & De Pauw, K. (2026). Influence of a passive shoulder exoskeleton on drilling performance in women- a cross-sectional study. Scientific Reports. https://doi.org/10.3390/biomimetics9100601
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