Balancing Support and Mobility: Multimodal Evaluation of Exoskeleton in Live Veterinary Surgeries

Passive neck-support exoskeletons may reduce surgical physical workload, but conventional summaries of the entire task may not catch when these benefits emerge and how muscle activity and posture evolve together. This study evaluated a passive neck-support exoskeleton during 36 live veterinary surgeries performed by 10 surgeons using EMG and IMU measures. Statistical analyses included linear mixed models for task-average EMG and IMU outcomes, generalized additive mixed models for time-varying intervention effects, and lagged cross-correlation analyses for EMG-IMU temporal coupling. The exoskeleton significantly reduced the neck range of motion. Temporal analyses showed delayed reductions in upper trapezius activation, with decreases during the middle-to-late phase of surgery, and direction-specific changes in head-neck kinematics. Coupling analysis showed stronger %MVE-posture coupling in the control condition, but stronger MPF-posture coupling under intervention. These findings suggest that passive neck support may reduce muscle loading and alter fatigue-related muscle-posture coordination during prolonged surgical work.