Passive Exoskeletons During Live Surgeries: Supporting Forward Head Postures Among Veterinary Surgeons

TECHNICAL ABSTRACT<b>Background:</b> Musculoskeletal symptoms (MSS) are prevalent among veterinary surgeons. Recent research has proposed exoskeletons as potential solutions in reducing the risk of musculoskeletal disorders among surgeons, but no studies have addressed the neck forward postures (opposite of overhead work), a unique ergonomic neck risk, commonly required during live, open surgery. <b>Purpose:</b> We explored the effectiveness of a passive neck-support exoskeleton during live veterinary surgical procedures with experienced surgeons. <b>Methods:</b> We employed a within-subject crossover design involving surgeons who participated in procedures across specialties including soft tissue and orthopedics. Participants performed entire surgeries with and without a front head posture support prototype exoskeleton, and they completed pre- and post-surgical surveys to assess MSS and perceived effort. The Wilcoxon Signed Rank Test was used to compare median values of MSS and the perceived effort of each participant when they operated with and without the exoskeleton. <b>Results:</b> We collected data during 28 procedures involving eight surgeons, with each subject performing at least one surgery with (intervention) and at least one surgery without (control) the exoskeleton (randomized order). The number of control and intervention cases for each participant was balanced. We found that the difference in neck stiffness before and after surgery was greater in the control surgeries compared to when using the exoskeleton intervention. Increases in neck pain and neck stiffness were only observed in control cases, whereas no participant reported increased neck pain or neck stiffness when the exoskeleton was used. <b>Conclusion:</b> Our results indicate that a passive forward head posture support exoskeleton is a promising intervention for reducing the risk of MSS in live surgical procedures.