Passive arm-support and back-support exoskeletons have distinct phase-dependent effects on physical demands during cart pushing and pulling: An exploratory study

Arm-support exoskeletons (ASEs) and back-support exoskeletons (BSEs) can be effective in reducing physical demands during various occupational tasks, yet evidence of their effects in pushing and pulling tasks remains limited. We examined the effects of using a passive ASE and a BSE on task completion time, shoulder and trunk kinematics, and muscle activity in the shoulder and back while pushing and pulling a moderately loaded (100 kg) cart. Forty volunteers (24 M and 16 F) completed the study. Using the BSE substantially reduced thoracic and lumbar erector spinae muscle activity for males, especially during the initial and ending phases of pushing (by up to ∼31.4 %) and pulling (by up to ∼25.4 %) compared to the No Device (ND) condition. In contrast, using the ASE showed no significant benefits, with females experiencing an increase in anterior deltoid muscle activity (by up to ∼46.3 %) compared to ND. Findings from this study help to understand the effects of BSEs and ASEs in pushing and pulling tasks and support the development of more versatile exoskeletons.