Review of upper-limb occupational exoskeletons: From technology to assessment

Occupational exoskeletons are emerging as a promising solution to reduce work-related musculoskeletal disorders (MSDs) across various industries. Upper-limb exoskeletons are particularly relevant, given the high prevalence of MSDs associated with repetitive arm motions and overhead tasks. However, evaluating the effectiveness of these devices requires careful analysis of the specific technologies and kinematic designs they incorporate to ensure their safe and effective integration. This paper presents a detailed technological review and analysis of the existing literature, focusing on the diversity of technologies and the need for more comprehensive studies addressing challenges in both laboratory and real-world settings. This study particularly highlights the necessity of assessments that account for the unique characteristics of different exoskeleton technologies, rather than generalizing across them. It also emphasize the need to examine not only reductions in muscle activity but also the potential for overlooked side effects, long-term impacts, and adaptations across different task types. These factors are crucial, as upper-limb exoskeletons are planned to be deployed for prolonged use in complex industrial environments. • Upper-limb exoskeletons reduce muscle activity during overhead tasks. • Passive exoskeletons are preferred in industrial settings for simplicity and reliability. • Long-term effects and side effects of exoskeleton use remain underexplored. • Real-world assessments highlight gaps in task-specific adaptability of exoskeletons. • Comprehensive evaluation methods are necessary for safe industrial integration.