Biomechanical evaluation of a new passive back support exoskeleton.

The number one cause of disability in the world is low-back pain, with mechanical loading as one of the major risk factors. To reduce mechanical loading, exoskeletons have been introduced in the workplace. Substantial reductions in back muscle activity were found when using the exoskeleton during static bending and manual materials handling. However, most exoskeletons only have one joint at hip level, resulting in loss of range of motion and shifting of the exoskeleton relative to the body. To address these issues, a new exoskeleton design has been developed and tested. The present study investigated the effect of the SPEXOR passive exoskeleton on compression forces, moments, muscle activity and kinematics during static bending at six hand heights and during lifting of a box of 10 kg from around ankle height using three techniques: Free, Squat and Stoop. For static bending, the exoskeleton reduced the compression force by 13-21% depending on bending angle. Another effect of the exoskeleton was that participants substantially reduced lumbar flexion. While lifting, the exoskeleton reduced the peak compression force, on average, by 14%. Lifting technique did not modify the effect of the exoskeleton such that the reduction in compression force was similar. In conclusion, substantial reductions in compression forces were found as a result of the support generated by the exoskeleton and changes in behavior when wearing the exoskeleton. For static bending, lumbar flexion was reduced with the exoskeleton, indicating reduced passive tissue strain. In addition, the reduced peak compression force could reduce the risk of compression induced tissue failure during lifting.