Development of an intervention framework for design, implementation and adoption of occupational exoskeletons

Abstract: During the last few years, wearable technologies or body-worn assistive devices have become very popular within the occupational field. Among them, there are the so-called exoskeletons which have shown a promising potential in several areas ranging from medical care, military to, particularly during the last five years, industrial applications. In this sense, exoskeleton could represent a novel technical solution, with the potential to tackle the perennial problem of work-related musculoskeletal disorders. However, within the industrial field, there are still issues to be addressed such as exoskeletons’ long-term effects and adaptation to multiple tasks. This should be done through multiyear and extensive studies in real-life scenarios, to avoid that any issues pertaining to the individual, group or organizational level, could be overlooked. This thesis aimed to investigate factors that can promote or hinder the implementation of exoskeletons from a ‘‘whole system approach’’. To achieve this, first, a literature review was conducted in order to provide an overview of key findings from ongoing research about industrial exoskeletons. These key findings, which included current trends and knowledge gaps, formed the theoretical basis of this study. This was used in the development of an interview guide, which was used in semi-structured interviews. Thus, through qualitative interviewing, the key findings from the theoretical basis were further investigated. Moreover, once the data was gathered, the interviews were analyzed in depth and a content analysis of the interviews was systematically carried out, in order to find emerging “themes”. Furthermore, these ‘‘themes’’ were used to investigate underlying norms, contextual factors and challenges that exoskeletons may pose. Finally, the main ‘‘themes’’ and the key findings from the theoretical basis, were integrated into an intervention framework, the development of which was the secondary aim of this study. The new framework was designed aiming to guide policy makers, management, and personnel in planning, designing, and implementing ergonomic interventions through exoskeletons. The results of this study showed that safety, comfort, and fit are major factors in driving the adoption and acceptance of occupational exoskeletons. At the center of this suggested trifecta, there is productivity. However, when productivity is prioritized over the safety and the well-being of the workers, an “ergonomic pitfall” could be the consequence. It means the risk to add new constraints and challenges in the work environment, instead of reducing the physical workload and the muscle fatigue of the worker. Further, in terms of adoption barriers, the interviewees, in line with research in the field, stressed the importance to give enough time to the employees to familiarize themselves with the exoskeleton technology. In addition, since exoskeletons are introduced from the management side, it is key to effectively communicate the value proposition of exoskeletons, namely to protect worker’s health status rather than enable them to work at a higher pace or to handle heavier loads. In addition, based on the results of this study, practitioners should consider engaging in more inclusive dialogues with academia and policymakers to overcome the fragmentation of the exoskeletons’ market. Only by working in close collaboration with these stakeholders, and making full use of their experience and expertise, it can be possible in the near future to develop exoskeletons which are both aligned with workers’ and society needs, as well as with companies’ demands.