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Passive exoskeletons in healthcare practice: Usability and acceptance in a clinical setting 医疗保健实践中的被动式外骨骼:临床环境中的可用性和接受度
IF 3.4 2区 工程技术 Q2 ENGINEERING, INDUSTRIAL Pub Date : 2026-02-06 DOI: 10.1016/j.apergo.2026.104746
Britta Exner , Stefan Waßmann , Dana Gück , Fabian Frielitz

Background

Exoskeletons are gaining interest as ergonomic tools, but healthcare tasks’ variability, hygiene standards, and emergency demands pose challenges. Despite the high rate of musculoskeletal disorders, it remains unclear how feasible exoskeletons are in clinical practice.

Methods

In a clinical field trial at University Hospital Magdeburg, 17 healthcare professionals tested a passive exoskeleton over two months. Participants chose when to wear it. Data included wear duration, questionnaires on usability, support, comfort, technology affinity, and semi-structured interviews.

Results

Participants wore the exoskeleton for 312 h total (average 20 h/person across three shifts), mostly for specific tasks. All found it easy to use, but support and comfort ratings varied. Some noted improved posture and back stability; others reported discomfort and restricted movement. The mean overall rating was 2.7 ± 0.99 (German school grading). Further research is needed on long-term effects and task-specific use. A return on investment is possible if at least 18.5 sick days of a nurse per year are prevented, with purchase costs expected to drop. In settings with staff shortages, indirect effects may lower this threshold to 2.7 days.
骨骼作为人体工程学工具越来越受到关注,但医疗保健任务的可变性、卫生标准和紧急需求带来了挑战。尽管肌肉骨骼疾病的发病率很高,但外骨骼在临床实践中的可行性仍不清楚。方法在马格德堡大学医院进行的一项临床现场试验中,17名医疗保健专业人员对被动式外骨骼进行了为期两个月的测试。参与者可以选择何时佩戴。数据包括磨损时间、可用性、支持度、舒适度、技术亲和力问卷调查和半结构化访谈。结果:参与者穿戴外骨骼共312小时(平均每人20小时,三班倒),主要用于特定任务。所有人都认为它很容易使用,但支持度和舒适度评分各不相同。一些人注意到姿势和背部稳定性有所改善;其他人则表示身体不适,活动受限。平均总体评分为2.7±0.99(德国学校评分)。需要对长期影响和特定任务使用进行进一步研究。如果每年至少避免一名护士请18.5天病假,购买成本有望下降,投资回报是可能的。在人员短缺的情况下,间接影响可能会将这一阈值降低到2.7天。
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引用次数: 0
Effects of a passive neck support exoskeleton on neck-shoulder muscle fatigue and motion during live veterinary surgeries. 被动颈部支撑外骨骼对活体兽医手术中颈肩肌肉疲劳和运动的影响。
IF 3.4 2区 工程技术 Q2 ENGINEERING, INDUSTRIAL Pub Date : 2026-02-05 DOI: 10.1016/j.apergo.2026.104745
Bowen Zheng, Xuelong Fan, Sun Young Kim, Denny Yu
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引用次数: 0
Physiological data-driven models for motion sickness prediction. 晕动病预测的生理数据驱动模型。
IF 3.4 2区 工程技术 Q2 ENGINEERING, INDUSTRIAL Pub Date : 2026-02-04 DOI: 10.1016/j.apergo.2026.104739
Daniel Sousa Schulman, Bradley Kerr, Srikanth Kolachalama, Siyuan Yin, Jedidiah Pienkney, Michael Wachsman, Nishant Jalgaonkar, Ruimin Gao, Monica L H Jones, Shorya Awtar

With advances in autonomous vehicle technology and in-cabin occupant monitoring systems, prediction of motion sickness (MS) has emerged as a key challenge to improve passenger experience. In this paper, a framework for MS prediction is proposed leveraging classification algorithms and timeseries physiological data, including blood volume pulse, electrodermal activity, and neck surface electromyography. The dataset used for model training contains over 1500 min of in-vehicle data, three test conditions, and a range of subject demographics. Model predictions were able to achieve 81% accuracy for binary classification (sick or not sick) and 58% for ternary classification (low, moderate or high sickness). In addition, feature importance analysis identified electrodermal activity and surface electromyography as the most relevant data streams for MS prediction. Finally, the paper analyzed the temporal dependency of physiological data on MS response and found that physiological data can precede a subject's self-reporting of MS by up to 180 s.

随着自动驾驶汽车技术和车内乘员监控系统的进步,晕动病(MS)的预测已成为改善乘客体验的关键挑战。本文提出了一种利用分类算法和时间序列生理数据(包括血容量脉冲、皮电活动和颈表肌电图)预测多发性硬化症的框架。用于模型训练的数据集包含超过1500分钟的车内数据,三个测试条件和一系列受试者人口统计数据。模型预测在二元分类(生病或不生病)方面能够达到81%的准确率,在三元分类(低、中、高疾病)方面能够达到58%的准确率。此外,特征重要性分析确定皮电活动和表面肌电图是MS预测最相关的数据流。最后,本文分析了生理数据对MS反应的时间依赖性,发现生理数据可以比受试者的MS自我报告早180秒。
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引用次数: 0
Rigid and soft back-support exoskeletons affect biomechanical and perceptual demands, but in different ways, during simulated shingle installation. 在模拟瓦板安装过程中,刚性和软背支撑外骨骼影响生物力学和感知需求,但方式不同。
IF 3.4 2区 工程技术 Q2 ENGINEERING, INDUSTRIAL Pub Date : 2026-02-04 DOI: 10.1016/j.apergo.2026.104744
Jiwon Choi, Sunwook Kim, Ahmad Raza Usmani, Alan Barr, Carisa Harris-Adamson, Maury A Nussbaum

Passive back-support exoskeletons (BSEs) are promising but underexplored interventions to reduce the high physical demands of roofing shingling. Eighteen participants performed simulations of shingle installation tasks under 12 different conditions. These conditions included all combinations of three BSE levels (Rigid, Soft, and no BSE), two task orientations (peak-facing vs. side-facing), and two roof slopes (18° vs. 26°). Using the rigid BSE significantly reduced lumbar muscle activation (11-17%) compared to no BSE, without altering trunk flexion. In contrast, the soft BSE reduced trunk flexion (∼4%) without altering lumbar muscle activation. Both BSEs reduced perceived low back exertion (∼16%); however, the rigid BSE increased leg discomfort (∼26%), and the soft BSE increased shoulder exertion (∼19%). Our results suggest that using BSEs can be beneficial for shingle installation tasks but also highlight the importance of considering device-specific biomechanical benefits and associated trade-offs to ensure effective application.

被动式背支撑外骨骼(BSEs)是一种很有前途但尚未充分开发的干预措施,可以减少屋顶瓦的高物理要求。18名参与者在12种不同的条件下进行了瓦板安装任务的模拟。这些条件包括三种BSE水平(刚性、软性和无BSE)、两种任务方向(面向峰vs面向侧)和两种屋顶坡度(18°vs. 26°)的所有组合。在不改变躯干屈曲的情况下,与没有使用BSE相比,使用刚性BSE显著降低了腰肌激活(11-17%)。相比之下,软性疯牛病减少躯干屈曲(约4%),而不改变腰肌激活。两种BSEs都减少了腰背部劳累感(约16%);然而,刚性疯牛病增加了腿部不适(约26%),软性疯牛病增加了肩部劳累(约19%)。我们的研究结果表明,使用bse可以有利于瓦板安装任务,但也强调了考虑设备特定的生物力学效益和相关权衡的重要性,以确保有效的应用。
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引用次数: 0
Root cause analysis of airplane technical failures with Rasmussen's risk management framework (RRMF) based human-machine-environment-procedure (HMEP) taxonomy. 基于Rasmussen风险管理框架(RRMF)的人机环境程序(HMEP)分类的飞机技术故障根本原因分析。
IF 3.4 2区 工程技术 Q2 ENGINEERING, INDUSTRIAL Pub Date : 2026-02-02 DOI: 10.1016/j.apergo.2026.104723
Chia-Fen Chi, Vincent Tjendra, Steven Su

This study developed a taxonomic approach based on 30 technical failure occurrences between 2002 and 2020. This framework extends the author's previous work on human-machine-environment-procedure (HMEP) taxonomy through the application of Rasmussen's Risk Management Framework (RRMF), which can serve as a common framework to aggregate or compare datasets collected by different organizations. This RRMF-based HMEP taxonomy was used to categorize the contributing factors of 30 technical failure occurrences into seven mutually exclusive categories and respective subcategories for statistical analysis and other risk management analysis. The RRMF provided a hierarchical structure for these first-layer categories, including government oversight, manufacturer deficiency, company management, company procedure and documentation, people and activity management, technical failure, and environment. The functional block diagram and failure modes and effects analysis (FMEA) were applied to translate the technical failures of 12 environment control system failure cases into FMEA tabular statements. Several failure modes had been identified for environmental control system failure occurrences, e.g., sense line leakage, flawed sensor input, duct crack and leakage, broken part (pin and spring), seal degradation, contamination, tube rupture, mechanical joining defect, poor contact, and unanticipated failure instances for electronic centralized aircraft monitor (ECAM). Each failure mode can provide diagnostic information to identify and fix the environmental control system failure problem more effectively. In conclusion, this RRMF-based HMEP taxonomy provided a mental model to guide the data collection during an accident investigation and subsequently derive accident patterns as the core for Safety Management System (SMS) implementation.

本研究基于2002年至2020年间发生的30起技术故障开发了一种分类方法。该框架通过应用Rasmussen风险管理框架(RRMF)扩展了作者之前关于人-机器-环境-程序(HMEP)分类的工作,该框架可以作为汇总或比较不同组织收集的数据集的通用框架。该基于rrmf的HMEP分类法用于将30个技术故障事件的影响因素分为7个相互排斥的类别和各自的子类别,用于统计分析和其他风险管理分析。RRMF为这些第一层类别提供了一个层次结构,包括政府监督、制造商缺陷、公司管理、公司程序和文档、人员和活动管理、技术故障和环境。应用功能方框图和失效模式与影响分析法(FMEA),将12个环境控制系统失效案例的技术故障转化为FMEA表格式报表。环境控制系统故障发生的几种失效模式已被确定,例如,感测线泄漏、传感器输入有缺陷、管道裂纹和泄漏、部件损坏(销和弹簧)、密封退化、污染、管道破裂、机械连接缺陷、接触不良以及电子集中式飞机监视器(ECAM)的意外故障实例。每种故障模式都可以提供诊断信息,从而更有效地识别和修复环境控制系统的故障问题。总之,这个基于rrmf的HMEP分类法提供了一个心理模型,用于指导事故调查期间的数据收集,并随后得出事故模式,作为安全管理系统(SMS)实施的核心。
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引用次数: 0
Evaluation of a markerless motion capture to measure 3D joint kinematics during occupational lifting tasks using mobile devices. 评估无标记运动捕捉测量三维关节运动学期间使用移动设备的职业提升任务。
IF 3.4 2区 工程技术 Q2 ENGINEERING, INDUSTRIAL Pub Date : 2026-02-01 DOI: 10.1016/j.apergo.2026.104743
Mina Salehi, Ali Taheri, Seobin Choi, Jeong Ho Kim

Recent advances in human pose estimation (HPE) have enabled markerless motion capture (MoCap) techniques as a promising alternative to traditional marker-based MoCap systems. However, most HPE algorithms only provide sparse video keypoints, which are insufficient to estimate joint angles in all anatomical planes according to biomechanical guidelines. OpenCap, an open-source smartphone-based markerless MoCap platform, addresses this limitation using a deep learning model (named the marker augmenter) that predicts dense anatomical markers from sparse video keypoints. However, it has shown lower performance for activities not included in its training dataset, such as occupational lifting tasks. In this study, we adapted the original marker augmentation model of OpenCap and proposed a task-specific model for occupational lifting, trained on a large and diverse dataset of manual lifting tasks. The proposed model reduced both kinematic errors (mean RMSE = 9.45° vs. 15.04°) and error variability (SD = 7.26° vs. 16.13°) compared to the original model. These findings suggest that OpenCap can be adapted for occupational lifting tasks, offering a low-cost, easy-to-use, and field-viable solution to collect 3D lifting kinematics for ergonomics applications.

人体姿态估计(HPE)的最新进展使无标记动作捕捉(MoCap)技术成为传统的基于标记的MoCap系统的有前途的替代方案。然而,大多数HPE算法仅提供稀疏的视频关键点,不足以根据生物力学准则估计所有解剖平面上的关节角度。OpenCap是一个开源的基于智能手机的无标记动作捕捉平台,它使用深度学习模型(命名为标记增强器)来解决这一限制,该模型可以从稀疏的视频关键点预测密集的解剖标记。然而,对于未包含在其训练数据集中的活动,例如职业举重任务,它的表现较低。在本研究中,我们改编了OpenCap的原始标记增强模型,并提出了一个针对职业起重的任务特定模型,该模型在一个大型和多样化的手动起重任务数据集上进行了训练。与原始模型相比,所提出的模型降低了运动学误差(平均RMSE = 9.45°vs. 15.04°)和误差变异性(SD = 7.26°vs. 16.13°)。这些发现表明,OpenCap可以适用于职业起重任务,为人体工程学应用收集3D起重运动学提供了低成本、易于使用和现场可行的解决方案。
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引用次数: 0
Guidelines for developing digital triage tools to mitigate workload challenges: A scoping review 开发数字分类工具以减轻工作负载挑战的指南:范围审查
IF 3.4 2区 工程技术 Q2 ENGINEERING, INDUSTRIAL Pub Date : 2026-01-30 DOI: 10.1016/j.apergo.2026.104742
Jihyun Kim , Junho Park
Digital technologies are increasingly adopted in medical triage to address healthcare providers’ workload; however, workload-related effects remain insufficiently understood. This scoping review synthesizes how workload has been conceptualized, addressed, and evaluated in technology-supported medical triage. Following Joanna Briggs Institute methodology and PRISMA-ScR guidelines, six databases were searched (2020–2025), yielding 16 empirical studies across diverse triage contexts. The findings indicate that workload has been predominantly used as contextual justification rather than as an explicit evaluation target. Digital technologies were primarily evaluated using self-reported or performance-based methods, with workload-related implications inferred. No study systematically incorporated physiological workload measures. Although these technologies often improved performance, they did not consistently reduce workload and, in some cases, introduced additional demands. Technology interventions tended to redistribute rather than reduce workload. This review provides a foundation for evaluating workload in ways aligned with the intended functions of digital triage technologies, informing their human-centered design and evaluation.
数字技术越来越多地用于医疗分类,以解决医疗保健提供者的工作量;然而,与工作量相关的影响仍然没有得到充分的了解。此范围审查综合了在技术支持的医疗分类中如何对工作量进行概念化、处理和评估。遵循乔安娜布里格斯研究所的方法和PRISMA-ScR指南,检索了六个数据库(2020-2025),在不同的分类背景下产生了16项实证研究。调查结果表明,工作量主要被用作背景理由,而不是作为明确的评价指标。数字技术主要使用自我报告或基于绩效的方法进行评估,并推断出与工作量相关的影响。没有研究系统地纳入生理工作量测量。虽然这些技术经常提高性能,但它们并没有始终减少工作负载,而且在某些情况下还引入了额外的需求。技术干预倾向于重新分配而不是减少工作量。这篇综述为评估工作量提供了基础,以与数字分类技术的预期功能相一致的方式,为其以人为本的设计和评估提供信息。
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引用次数: 0
The effects of body mass index on foot shape among U.S. children 美国儿童体重指数对足型的影响
IF 3.4 2区 工程技术 Q2 ENGINEERING, INDUSTRIAL Pub Date : 2026-01-27 DOI: 10.1016/j.apergo.2026.104741
Hayoung Jung, Byoung-Keon D. Park, Sheila M. Ebert, Monica L.H. Jones, Matthew P. Reed
Understanding the three-dimensional shape of children's feet is valuable for designing appropriate footwear and orthotic devices, tracking growth trajectories, and supporting foot health and development. The most important anthropometric change in the U.S. in recent years is the increase in body mass at every age, but the effects of these trends on child foot shapes have not previously been studied. To address this gap, we collected high-resolution, three-dimensional (3d) foot surface data from 490 children ages 3–17 years across body mass index (BMI) from 12.4 to 52.6 kg/m2 and developed a statistical foot shape model to analyze the variations in foot morphology related to BMI. After accounting for age effects, a higher BMI was associated with differences in foot dimensions, including broader foot width, greater circumference, and increased thickness, as well as a larger cross-sectional area and volume. Higher BMI was also associated with lower arch height. Specific foot regions, including the medial and lateral sides, arch, and instep, showed more substantial shape differences with varying BMI levels. The observed differences were most pronounced in older children, with 10- and 17-year-olds showing the greatest discrepancy in foot dimensions. Differences in foot shape between median and 95th percentile BMI were much higher than the differences between the 5th percentile and median BMI, particularly concentrated in the hindfoot and anterior ankle area. This study provides the first comprehensive three-dimensional analysis of children's foot shape variations in relation to BMI, compared to previous research that focused primarily on linear dimensions. The findings suggest that the increasing body mass among children may necessitate the redesign of footwear to ensure a good fit. The foot shape model can be used to estimate foot shapes from demographic data, accurately fit low-resolution foot scan data, and aid in the design of footwear and orthotic devices. Future research should aim to collect more data from young children with high BMI, improve the representation of population subgroups, and include consideration of dynamic effects. The children's foot model is publicly available online at https://HumanShape.org/ChildFoot.
了解儿童足部的三维形状对于设计合适的鞋类和矫形器,跟踪生长轨迹,支持足部健康和发展是有价值的。近年来,美国最重要的人体测量变化是每个年龄段的体重都在增加,但这些趋势对儿童足型的影响以前没有研究过。为了解决这一差距,我们收集了490名3-17岁儿童的高分辨率三维足面数据,这些儿童的身体质量指数(BMI)从12.4到52.6 kg/m2不等,并建立了一个统计足形模型来分析足部形态与BMI相关的变化。在考虑了年龄的影响后,较高的BMI与脚尺寸的差异有关,包括更宽的脚宽、更大的周长、更厚的厚度,以及更大的横截面积和体积。BMI越高,足弓高度越低。特定的足部区域,包括内侧和外侧、足弓和脚背,在不同的BMI水平下显示出更大的形状差异。观察到的差异在年龄较大的孩子中最为明显,10岁和17岁的孩子在脚的尺寸上表现出最大的差异。BMI中位数与第95百分位之间的足型差异远高于BMI中位数与第5百分位之间的差异,尤其集中在后脚和踝关节前区。与之前主要关注线性维度的研究相比,这项研究首次对儿童足形变化与BMI的关系进行了全面的三维分析。研究结果表明,儿童体重的增加可能需要重新设计鞋子,以确保鞋子的合脚。脚型模型可用于从人口统计数据中估计脚型,准确拟合低分辨率足部扫描数据,并有助于设计鞋类和矫形器。未来的研究应旨在收集更多来自高BMI幼儿的数据,提高人口亚组的代表性,并考虑动态效应。儿童足部模型可在https://HumanShape.org/ChildFoot上公开获取。
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引用次数: 0
The psychological refractory period effect in an intelligent mine monitoring task 智能矿井监测任务中的心理不应期效应。
IF 3.4 2区 工程技术 Q2 ENGINEERING, INDUSTRIAL Pub Date : 2026-01-25 DOI: 10.1016/j.apergo.2026.104740
Rongjuan Zhu , Peiyu Liu , Huan Zhu , Shitong Han , Yaqi Wu , Qi Hui , Yuan Li , Xuqun You
In intelligent mining monitoring operations, operators are often required to perform multiple tasks, either simultaneously or sequentially, within a short time frame. However, the limits of individuals’ cognitive resources may lead to delayed responses on the second and subsequent tasks, also known as the psychological refractory period (PRP) effect. This study investigates the impacts of stimulus onset asynchrony (SOA), spatial presentation layout, and task load on the PRP effect in a simulated intelligent mining monitoring task. Across three experiments, a clear PRP effect was consistently observed in the secondary task (T2), with reaction times decreasing as SOA increased. Although the spatial presentation layout of the tasks did not directly alter the PRP effect for T2, it did significantly affect reaction times for both tasks, with faster responses observed when tasks were presented in the right visual hemifield. In addition, manipulating cognitive load revealed that high load conditions for T1 led to a noticeable PRP effect on T2, while both high and low load conditions for T2 similarly produced the PRP effect on T2. These findings underscore the necessity of applying ergonomic principles to the design of monitoring systems, specifically for optimizing task layout and managing task load to reduce cognitive bottlenecks in high-demand environments like intelligent mining.
在智能采矿监测作业中,操作员通常需要在短时间内同时或依次执行多项任务。然而,个体认知资源的有限性可能导致第二项及后续任务的反应延迟,也称为心理不应期(PRP)效应。在模拟智能采矿监控任务中,研究了刺激启动异步(SOA)、空间呈现布局和任务负载对PRP效应的影响。在三个实验中,在次要任务(T2)中一致观察到明显的PRP效应,随着SOA的增加,反应时间减少。虽然任务的空间呈现布局并没有直接改变T2的PRP效应,但它确实显著影响了两个任务的反应时间,当任务在右半视区呈现时,观察到反应更快。此外,对认知负荷的操纵表明,T1的高负荷条件会对T2产生显著的PRP效应,而T2的高负荷和低负荷条件同样会对T2产生PRP效应。这些发现强调了将人体工程学原理应用于监测系统设计的必要性,特别是优化任务布局和管理任务负载,以减少智能采矿等高需求环境中的认知瓶颈。
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引用次数: 0
A work systems approach to characterizing emergency department disposition decision-making under low and high demand 低需求和高需求情况下急诊科处置决策特征的工作系统方法。
IF 3.4 2区 工程技术 Q2 ENGINEERING, INDUSTRIAL Pub Date : 2026-01-20 DOI: 10.1016/j.apergo.2026.104737
Rachel A. Rutkowski , Michael S. Pulia , Megan E. Salwei , Emma Loveless , Lily Jaeger , Michael Rawson , Kathryn L. Wust , Peter L.T. Hoonakker , Barbara J. King , Manish N. Shah , Brian W. Patterson , Paula vW. Dáil , Maureen Smith , Pascale Carayon , Nicole E. Werner
Emergency department (ED) clinical decision-making, specifically for transfer or disposition decisions, has been challenging to characterize. The purpose of this descriptive study is to identify the work system elements that influence the ED disposition decision-making process and to identify those work system elements that vary under low and high demands. We conducted a work systems analysis of 20 contextual inquiry-based ED visit observations and 18 semi-structured interviews with ED clinicians. Results identified work system elements not previously characterized (i.e., physical environment) and revealed that a subset of elements within the ED work system vary with demand. To fully elucidate the meaning and effect of these differences, we must develop a systematic approach to eliciting the influence each work system element has on disposition decision-making process performance.
急诊科(ED)的临床决策,特别是转移或处置决定,一直具有挑战性的特征。本描述性研究的目的是识别影响ED处置决策过程的工作系统要素,并识别在低要求和高要求下变化的工作系统要素。我们对20个基于上下文询问的急诊科访问观察和18个与急诊科临床医生的半结构化访谈进行了工作系统分析。结果确定了以前未被描述的工作系统元素(即物理环境),并揭示了ED工作系统中元素的子集随着需求而变化。为了充分阐明这些差异的意义和影响,我们必须开发一种系统的方法来引出每个工作系统元素对处置决策过程绩效的影响。
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引用次数: 0
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Applied Ergonomics
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