A passive upper limb exoskeleton effectively reduces shoulder muscle activity over a large shoulder workspace

Industrial upper limb exoskeletons offload the upper limb during overhead tasks to help prevent musculoskeletal disorders to the shoulder. Although numerous studies showed reduced shoulder muscle activity during upper limb exoskeleton use for overhead postures, it remains unknown whether and how upper limb exoskeletons provide support over a large shoulder workspace beyond overhead work. Therefore, this study evaluated the <i>Ottobock Paexo Shoulder</i> over a large shoulder workspace from overhead to hip height with shoulder abduction and adduction. Upper body kinematics, muscle activity, and subjective user feedback were obtained by three-dimensional motion capture, surface EMG, and questionnaires, respectively, and captured while participants performed static and dynamic work tasks with an electric screwdriver. Participants completed these tasks (1) without the exoskeleton, (2) with a disengaged exoskeleton, (3) with moderate exoskeleton support, and (4) with high exoskeleton support. Exoskeleton support reduced deltoid muscle activity (-9 to -24 s%, <i>p</i> ≤ .001) in postures with an abducted shoulder, including nonoverhead postures. Exoskeleton support modestly decreased shoulder flexion (-3 to -5°, <i>p</i> ≤ .001) and increased shoulder abduction (2 to 5°, <i>p</i> ≤ .032), but the movement patterns during the dynamic task were unaffected. Additionally, exoskeleton-related effects increased with increasing support, but the subjective perception of change also increased, and perceived comfort decreased. Our results indicate that the tested exoskeleton provides support beyond overhead work and that there is a trade-off between exoskeleton support and subjective perception. Accordingly, further optimization of user-exoskeleton interaction is warranted for long-term prevention of musculoskeletal disorders in overhead workers.