Mixed-Methods Evaluation of the Potential for Back-Support Exoskeletons to Assist Emergency Medical Services Clinicians in Performing Patient-Handling Tasks

Emergency medical services (EMS) clinicians are at high risk of workrelated musculoskeletal disorders (MSDs), with a significant annual prevalence of low back pain. We conducted two studies to explore the potential of back-support exoskeletons (BSEs) in assisting EMS clinicians during patient handling tasks. The first study, which assessed perceptions of BSEs through focus groups with 35 EMS clinicians, identified key factors related to exoskeleton adoption, such as storage location, donning and doffing, work performance, and safety. The second study, which investigated the biomechanical effects of BSEs with eight EMS clinicians, found that a powered BSE (Apogee) significantly reduced trunk extensor muscle activity and perceived exertion during most patient handling tasks, while a passive BSE (Apex) presented minimal effects on muscle activity but resulted in reduced perceived discomfort in the back. Although our findings suggest greater benefits for the powered BSE, further research is needed to evaluate the effects and barriers.