Influence of a passive shoulder exoskeleton on drilling performance in women- a cross- sectional study

Background: Work-related musculoskeletal disorders are common, especially among women performing repetitive overhead tasks. Methods: In a randomized 2x2 crossover study with 14 female participants, we investigated the effects of a passive upper-body exoskeleton during an overhead precision task, involving the tightening of 20 bolts into a sensor-based workstation, while muscle activation, task performance, and usability were assessed. Results: The results showed significant reduced M. Trapezius activations during arm lowering ( p = .041), task duration ( p = .014), and target accuracy ( p < .001) when using the exoskeleton. Subjective strain was significantly lower only in the shoulders ( p = .035). The usability was rated as “unacceptable”, with users criticizing the complexity and learning effort. While the exoskeleton reduced muscle load, its mechanical limitations impaired precision and usability, especially for women. Conclusion: These results highlight the importance of sex-specific, ergonomic, and adaptive designs to improve exoskeleton effectiveness and acceptance.