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Abstract
Low-back pain is a major concern among healthcare workers. One cause is the frequent adoption of repetitive forward bent postures in their daily activities. Occupational exoskeletons have the potential to assist workers in such situations. However, their efficacy is largely task-dependent, and their biomechanical benefit in the healthcare sector has rarely been evaluated. The present study investigates the effects of a passive back support exoskeleton in a simulated patient bed bathing task. Nine participants performed the task on a medical manikin, with and without the exoskeleton. Results show that working with the exoskeleton induced a significantly larger trunk forward flexion, by 13 deg in average. Due to this postural change, using the exoskeleton did not affect substantially the muscular and cardiovascular demands nor the perceived effort. These results illustrate that postural changes induced by exoskeleton use, whether voluntary or not, should be considered carefully since they may cancel out biomechanical benefits expected from the assistance.
Practitioner summary: Low-back pain is a major concern among nurses, associated with bent postures. We observed that using a passive back-support exoskeleton during the typical patient bed bathing activity results in a larger trunk flexion, without changing muscular, cardiovascular or perceived physical effort.
Acknowledgements
The authors would like to thank Pr. Malikov and Dr. Settembre from the department of vascular surgery of the University Hospital of Nancy for facilitating access to the medical staff of the department. The authors would also like to thank the nurses and staff of the department of vascular surgery for their help and kind participation during the observation study. Finally, the authors would like to thank the members of the Department "Homme au Travail" of the French Occupational Health Institute (INRS) for their insightful discussion and advice when preparing the observational phase of the study.
Disclosure statement
The authors report there are no competing interests to declare.
Data availability statement
The data collected for our study are available upon request to the corresponding author.
Notes
1 A main effect of the trial factor and/or an interaction effect were detected for some muscles and some steps, however the effect sizes were all very small.
2 For Covid-19 related sanitary reasons, we were not allowed to invite participants from the hospital to participate in the lab study, despite the ethical approval of the study. Hence, we had to recruit participants locally within the limited population authorised to access the lab premises, which strongly constrained the participants’ profiles.