1. Introduction
Canada’s construction sector plays a vital role in our national and provincial economies; however, it faces record-high job vacancy rates that will impact its economic contribution and have made construction businesses less competitive. Typically, construction work exposes workers to numerous risk factors for the development of musculoskeletal disorders (MSD), including awkward postures, forceful exertions, contact stress, vibration, repetitive movements, overhead work, and low temperatures [1,2,3,4]. Incidence rates of MSD (40%) are among the highest in construction compared to all other industries combined [5]. These disproportionately high MSD rates, in combination with the aging workforce and the lack of young workers pursuing careers in construction, prioritize sustainability as a major issue for this sector [6]. Without intervention, the construction trades in Ontario alone expect a significant shortage of skilled workers over the next decade: at least 170,000 workers will be needed to meet industry demands by 2027, as 13% of the current labor force is expected to retire within the next 3 years [7]. As such, there is an immediate need to prolong the healthy working life of the existing and aging construction workforce, reduce MSD risks, and attract younger workers.
Adoption of industrial exoskeletons may contribute to better sustaining the construction industry (i.e., reducing MSD risks, enticing young workers to pursue a career in construction, and prolonging the working life of the aging construction workforce). Industrial exoskeletons are wearable, external mechanical structures designed to augment, amplify, or reinforce the performance of a worker’s body part(s). They are often classified by type (i.e., active or passive) and by which body part they support (i.e., lower body, upper body, back, or full body) [8]. Active exoskeletons consist of external actuators, such as electric motors, hydraulic actuators, and pneumatic muscles, to augment the user’s power and provide extra energy [8,9]. In contrast, passive exoskeletons do not use any actuators. Instead, they rely on mechanisms such as springs and dampers to store and release energy generated by the user’s movements [8,9]. While several types of exoskeletons exist for various applications, this study focuses on applying a passive shoulder exoskeleton intended for construction work.
With the emergence of commercially available passive shoulder exoskeletons, researchers and organizations have been trying to better understand the impacts of exoskeletons on workers’ health, safety, performance, and the organization’s economic viability [10]. Under controlled laboratory settings, passive shoulder exoskeletons have demonstrated their efficacy in decreasing muscle activity [11], increasing endurance [12], and improving work performance and productivity [12] for tasks across various industries. For example, using shoulder exoskeletons reduced shoulder discomfort and increased productivity and work quality in simulated painting and welding tasks [13]. Despite the demonstrated benefits of exoskeletons, some drawbacks have also been identified. For example, increased chest pressure and decreased mobility have been documented as a result of exoskeleton use [8,12,14].
Although exoskeletons have been implemented in other industries, such as automanufacturing and logistics [15,16,17], the integration of innovations aimed at reducing injury risks, such as exoskeletons, into the construction industry has been deemed challenging and ‘lagging behind’ [18,19,20,21]. Several studies have sought to better understand the barriers and facilitators in the uptake of exoskeletons in construction. For example, construction industry representatives (i.e., vice presidents, project managers, health and safety managers/directors, and carpenters) were interviewed about their perspectives on adopting exoskeletons [20]. Many stakeholders expressed concerns regarding the ruggedness, effectiveness, versatility, and usability of exoskeletons. They also questioned exoskeletons’ compatibility with personal protective equipment (PPE) and whether the utilization of exoskeletons could be perceived as a sign of weakness [20]. The authors identified five key research gaps that should be addressed to facilitate the adoption of exoskeletons in construction: (1) determining task- or job-specific benefits and limitations of exoskeletons, (2) assessing the short- and long-term effects of different exoskeletons on workers’ health and safety, acceptance, usability, and work performance, (3) assessing the compatibility of exoskeletons with different types of PPE, (4) developing training modules for exoskeleton use, and (5) obtaining empirical evidence to support cost-benefit analyses of exoskeleton use. Our research contributes to bridging these knowledge gaps and provides empirical evidence to support decision-making in adopting exoskeletons on construction worksites. Specifically, the objectives of this study are to:
explore construction workers’ perceptions of using passive shoulder exoskeletons,
identify tasks that may/may not benefit from using passive shoulder exoskeletons,
provide recommendations and considerations for further development and design of passive shoulder exoskeletons for construction use.
2. Materials and Methods
2.1. Study Overview
We report on workers’ feedback data after performing their regular duties while wearing an exoskeleton for two days. Study participants were trained and familiarized with using the exoskeleton prior to the study. Researchers met with the participants at three timepoints each day (i.e., beginning of shift, mid-shift, and end of shift; Figure 1). Over the shift, video recordings of tasks performed were collected. At the end of each day, participants completed a feedback survey about the exoskeleton (Supplementary Material A). Self-reported tasks performed in the morning and afternoon were also collected immediately before the lunch break, and at the end of the day (Figure 1). These timepoints were chosen to minimize interruptions over the workday and, as a test battery, have been shown to approximate perceptions and other biophysical manifestations if captured continuously [22,23]. This approach has been used for measuring fatigue in construction workers [24].
The study was conducted between October 2022 and August 2023, and participants provided their informed consent under ethics approval from the Conestoga College’s Research Ethics Board (REB No. 454).
2.2. Recruitment of Study Participants
Our recruitment efforts targeted sub-trades that may benefit from the overhead arm support of shoulder exoskeletons (i.e., those that commonly involved prolonged and/or repetitive overhead tasks). These sub-trades included electrical, plumbing, framing, drywalling, and taping. Relevant sub-contractors within Southern Ontario were first identified through our research partners and then contacted via email. We identified additional sub-contractors through the snowballing technique. Sub-contractors then assisted with participant (apprentice, journeyperson, and foreperson) recruitment.
Eligible participants included construction workers who frequently performed overhead work. Workers were deemed ineligible if they were under 18, did not understand or speak English, or had contraindications for wearing the exoskeleton. These contraindications included having a pre-existing debilitating musculoskeletal condition in the shoulders, arms, back, and hands; having skin diseases/injuries, sensitivities, inflammations, and raised scars with swellings; or having sensory and circulatory disorders in the upper extremities, hips, and back (e.g., diabetic neuropathy or lymphatic drainage disorders). Participants were screened using a Participant Screening Tool to ensure eligibility for the study (Supplementary Material B).
A total of 46 workers from 7 different construction sites within Southern Ontario participated in the study. Construction sites included ICI (industrial, commercial, and institutional), residential, civil, and modular. The study results are based on the 41 participants who trialed the exoskeleton for at least 1 workday.
2.3. Specifications of the Exoskeleton
Participants were outfitted with Hilti’s EXO-01 Overhead Exoskeleton (EXO-01) (Hilti, Schaan, Liechtenstein). The EXO-01 is a 2 kg passive exoskeleton designed for use on construction sites. The EXO-01 provides a support torque to the user’s arm by transferring a portion of the arm weight to a hip belt through a passive actuator. The arm support is maximum at a shoulder flexion angle of 90° and is zero when the arm is lowered along the body. Further, the level of support can be adjusted via a continuous dial to adapt to different arm weights or compensate for the weight of a tool. To the best of the authors’ knowledge, the EXO-01 has not been studied for its impact on injury risk, fatigue, work performance, or productivity in construction.
Exoskeleton Fitting and Orientation
Participants were fitted and orientated to the EXO-01 before the study. Participants became familiar with the components of the exoskeleton and were instructed on donning and doffing procedures and their manual adjustments. Participants were cautioned about the potential risks and hazards of using the exoskeleton. The researchers confirmed the exoskeleton was properly fitted for the participants by ensuring that the waist straps were snuggly secured on the iliac crest and that the ball sockets and the articulation units of the exoskeleton were aligned with the shape of the participant’s torso. The researchers also ensured that the upper edge of the articulation unit was at shoulder height, that the back plate was centered between the shoulder blades, and that the tension cord formed a widely opened V-shape between the shoulder blades. The level of arm support was adjusted to the participant’s preference. We ensured that participants could lower their arms naturally without excessive resistance. After a familiarization period with the exoskeleton, participants started their work shift. Participants were advised that they could take off the exoskeleton at any point during the day and to document when they took it off if they did. The researchers periodically checked in with the participants to ensure they were comfortable wearing the exoskeleton.
2.4. Data Acquisition and Instrumentation
2.4.1. Demographics
Participants completed a paper-and-pen-based demographic questionnaire on Day 1. The demographic questionnaire included questions related to age, sex, weight, height, occupation, tenure, trade, tools used, and dominant hand.
2.4.2. Tasks Performed
During the mid- and post-shift data collection timepoints, participants were asked to review the tasks that they performed in the morning and afternoon, respectively. Videos were taken periodically during the workday to contextualize and better understand the tasks.
2.4.3. Usability and Exoskeleton Feedback
At the end of each day, participants provided their feedback on the exoskeleton based on its comfort, ease of use, impact on fatigue, and impact on productivity and performance using a 5-point Likert scale. On the last day of the Exo condition, we asked participants to select their preferred method (i.e., with exoskeleton, without exoskeleton, or impartial) for overhead work based on eleven variables: maneuverability, speed, accuracy, control, comfort, effort, looks, feeling safe, performance, productivity, and thermal comfort. We also asked participants open-ended questions that sought to identify specific job tasks that may or may not benefit from exoskeleton use. Lastly, participants were asked if they had any suggestions for improving the EXO-01 and their likeliness to adopt the exoskeleton if their organization provided it. The usability and exoskeleton feedback questions were adapted from Robinovitch et al. (2010) [25].
2.5. Data Analysis
We summarized the demographics of the participants at each jobsite using descriptive statistics. Workers’ feedback on the exoskeletons was also summarized using descriptive statistics. For participants who wore the exoskeleton for both days, we determined if perceptions of the exoskeleton changed with successive days of use by comparing Likert scores between Day 1 and Day 2. We used the Wilcoxon signed-rank test to make these comparisons at an alpha level of 0.05. We used R version 4.3.1. for the quantitative data analysis. For the open-ended questions, we performed thematic analysis using the Braun and Clarke method to discern recurring types of tasks that may or may not benefit from exoskeletons [26].
3. Results
In this study, 80% of the participants were under the age of 35 (mean = 30; SD = 11), and their experience working in construction ranged from no experience to 33 years, with a mean of 5.5 years (SD = 7.2; Table 1 and Table 2). Fourteen participants worked on residential construction sites, seven on ICI sites, thirteen worked in modular construction, and seven worked in civil construction (i.e., bridge maintenance and repair). The majority of participants identified themselves as general carpenters (34%), electricians (22%), drywall, acoustic, and lathing applicators (20%), or skilled laborers (17%). Other trades included two (low-rise) sheet metal installers and one drywall finisher.
Participants typically worked 8–10 h each day for a total of 40 h per week. They all had a 30 min lunch break, and 15 min breaks in the morning and afternoon. Participants reported morning and afternoon tasks, and the proportion of exoskeleton usage time (Supplementary Material C). Sixteen participants wore the exoskeleton for the entirety of the two workdays. Another sixteen participants wore the exoskeleton for more than one but less than two full work shifts. When asked why exoskeleton usage was less than an entire shift, participants reported that it was not applicable for specific tasks, or it was cumbersome to re-wear for tasks that may benefit but occurred for short durations. Nine participants wore the exoskeleton for one day. Of the nine, two drywallers and two skilled laborers initially wore the exoskeleton for a brief period (less than 90 min) but found it uncomfortable and decided to continue to work without it. Two sheet metal workers wore the exoskeleton for an entire day but found the exoskeleton to hinder their work (e.g., restricted mobility to access key tools from the toolbelt) and opted not to wear it for a second day. The remaining three workers were unavailable to participate for both days of the study due to other job- and personal-related commitments.
Participants reported their feedback on the EXO-1’s comfort, ease of use, and how it impacted their performance, productivity, and fatigue after each day of use. For participants who wore the exoskeleton for two days (n = 32), their perceptions of the exoskeleton across all five variables did not change (Wilcoxon signed-rank test p-value > 0.05; Figure 2). Thus, perceptions did not significantly change with increasing wear and use over two days. Overall, across all 41 participants, over half of the participants found the EXO-01 to be comfortable, while less than one-quarter found it to be uncomfortable (Figure 3). Most participants (80%) found the EXO-01 to be easy or very easy to use, while three participants (7%) disagreed that exoskeletons were easy to use. Over half of all participants agreed or strongly agreed that they felt less physically fatigued and exhausted at the end of the day after wearing an exoskeleton. Lastly, the majority of participants (70%) agreed that the exoskeleton had no hindrance to their performance and productivity; in fact, over one-third agreed or strongly agreed that the exoskeleton improved their performance and productivity. Those who opted out from wearing the exoskeleton for the second day (n = 6) did not have the same positive experience with the exoskeleton: they either found it to be uncomfortable, irrelevant to the tasks they were conducting, or to impede performance.
Of the eleven variables that assessed participants’ preference for wearing the exoskeleton versus their usual method (i.e., no exoskeleton), we focused on the factors where over two-thirds of participants preferred the same method (Figure 4). Most (83%) preferred to wear the exoskeletons to reduce the required effort when performing overhead tasks. Conversely, the majority of participants (75%) preferred their usual method based on maneuverability. Despite these drawbacks, two-thirds of the participants, ultimately, were likely or very likely to use the exoskeleton if it were supplied by their employer.
Participants identified tasks that may or may not benefit from exoskeleton usage (Table 3). They also identified hindrances in exoskeleton use and provided suggestions for its design and application. In general, the EXO-01 was beneficial for tasks that involved overhead work, particularly those that included lifting and positioning materials, such as finishing drywall, installing electrical conduits, and installing upper tracks (Figure 5). Exoskeletons were also deemed helpful for operating tools in overhead and arm-extended positions, including the use of impact drills (~1 kg), grinders (~1.7 kg), hammer drills (~6 kg), and reciprocating saws (~2.2 kg) (battery weight not included). Overhead tasks and operating tools were often performed concurrently. For example, workers would use one hand to position the material on the ceiling and use their contralateral hand to operate a tool. In addition, participants found the exoskeleton to be valuable for pulling wire, tying in electrical boxes for lights and smoke detectors, installing light fixtures (e.g., pot lights, light covers, and chandeliers) and smoke detectors, and mudding and taping drywall. Three participants also reported that the EXO-01 was helpful for carrying and lifting drywall and other materials.
According to the workers, the exoskeleton was not helpful or effective when working in tight spaces (e.g., working in closets and framing around ducts) or performing tasks at or below shoulder height (Figure 6). Such tasks included picking up small objects off the ground, drilling downwards, boxing wires at knee height, taping windowsills, measuring and cutting, and general cleanup. Some participants reported that the exoskeleton affected tasks and actions below waist level because the arm support would elevate their arms and interfere with their movement, especially tasks that involved a stoop lift. Bridge workers found the exoskeleton helpful for overhead drilling into concrete, but three participants reported minor skin irritations resulting from falling concrete dust collecting within the arm cuffs. One recurring limitation was the incompatibility between the exoskeleton and other work equipment. Participants who wore the exoskeleton over the toolbelt found it challenging to access their primary tools positioned on the rear side of the toolbelt. Those who opted not to wear their toolbelt in favor of the exoskeleton reported decreased productivity due to not having their tools readily accessible. Similarly, despite the exoskeleton being compatible with harnesses, participants found it burdensome to wear it over the harness when working at heights. Many participants found the combination of wearing the toolbelt, harness, and exoskeleton bulky and cumbersome.
Regarding workplace application, participants consistently agreed that they could see how the exoskeleton would help reduce physical fatigue. However, they expressed that they would not wear exoskeletons daily due to the non-cyclical nature of construction work. Instead, they would don the exoskeleton when performing prolonged or sustained overhead tasks in open spaces.
4. Discussion
The uptake of exoskeleton use within the construction industry has been lagging, despite several studies demonstrating their benefits and positive user acceptance under simulated construction-related tasks. To facilitate adoption, our field study built upon the existing literature and bridged key knowledge gaps [20] by exploring end-users’ perspectives of exoskeletons to better understand their applicability, use cases, and whether the benefits observed in the simulations translated into the non-cyclical and complex nature of construction work.
Multiple simulation studies have assessed the Paexo Shoulder (Ottobock, Duderstadt, Germany), which is a similar exoskeleton to the one used in our study. A review of the user manuals for both exoskeletons showed similar, if not identical, technical specifications, features, and user instructions. In-lab evaluations of the Paexo Shoulder showed significant reductions in metabolic costs, whole-body joint effort, and shoulder muscle activity during simulated overhead drilling tasks without increasing low back strain, degrading balance, or compromising task performance [27,28,29,30]. Further, study participants did not express fear or concern about wearing the exoskeleton and stated they would want to use it again for a similar task [30]. Reductions in shoulder muscle activity were also found among aircraft workers when performing simulated horizontal riveting tasks when using the Paexo Shoulder [31].
Consistent with the findings above, over 80% of the construction workers in our study found the EXO-01 to be beneficial for reducing their efforts in overhead work. Our participants also liked how the exoskeleton was lightweight and easy to use. The majority also felt safer while wearing an exoskeleton for overhead work and liked how they looked with it on. In addition to overhead drilling, our participants found that the exoskeleton was applicable to tasks that involved lifting, positioning materials, and operating tools, such as installing electrical conduits, mudding and taping, or hand-tightening light fixtures. However, the adoption rate within our study sample was lower than the one reported in the simulated laboratory study, 66% vs. 100%, respectively [30]. Such contrasts may not be surprising given the different study samples (construction workers vs. students) and conditions under which the exoskeleton was placed (8 h construction work vs. 12 min simulated overhead drilling). Yet, the adoption rates from a six-week naturalistic study were comparable [14]. For example, the researchers implemented a different exoskeleton, the Skelex 360 (Skelex, Den Haag, The Netherlands), among drywall finishers and plasterers, and after six weeks, 65% of the workers reported that they would use it in the future for specific tasks. Application of the exoskeleton for actual tasks in the workplace revealed certain conditions that workers found challenging and identified specific design features construction workers found necessary for their work:
Compatibility with other tools and PPE. Participants felt encumbered when wearing the exoskeleton over their toolbelts, harnesses, and sometimes jackets. The exoskeleton should be compatible with toolbelts and harnesses to avoid overlapping of straps and belts around the waist area or covering the D-ring of the safety harness.
Sufficient mobility to access tools on toolbelt. Almost three-quarters of the participants mentioned that the EXO-01 reduced their maneuverability. Workers mentioned that reaching for the back of the thigh was restricted, an essential movement for accessing tools on the toolbelt. Although Maurice et al. (2020) did not find any mobility restrictions in their study, this range of movement may not have been examined in the simulated tasks [30]. It is to be expected that wearing an exoskeleton would reduce maneuverability. Kim et al. (2018) found that the EksoVest Prototype (Ekso Bionics, San Rafael, CA, USA) reduced maximum shoulder abduction by ~10%, and 36% of plasterers who trialed the Skelex 360 found it to obstruct their movements [12,14]. Our participants suggested that exoskeletons should not restrict essential movements to their tasks because this could lead to productivity decrements.
Ability to adjust the level of arm support without doffing. Some participants found that the exoskeleton interfered with non-overhead work. Since the exoskeleton was designed to support overhead work, it was not surprising that participants found the exoskeleton unhelpful for performing tasks below shoulder height, such as general cleanup, downward drilling, and measuring and cutting. A few participants reported needing to ‘fight against’ the exoskeleton during these tasks, which was more fatiguing. Workers suggested they should be able to adjust the level of arm support to match the task they are performing while wearing the exoskeleton.
Compact and close-fitting design to allow for working in small spaces. Participants found it challenging to work in tight spaces, such as installing lights in closets or showers, framing around ducts and vents, or installing range hoods while wearing the exoskeleton. They also noted that it was inconvenient to doff the exoskeleton when switching to seated tasks (i.e., moving materials with a forklift or skid steer). Similarly, plasterers in the study by de Vries et al. (2023) found the Skelex 360 to be a hindrance when working in smaller spaces, such as staircases and toilets [14]. Future exoskeletons should be designed to minimize obtrusiveness.
Breathable materials for extended use. A few participants reported skin irritations where the exoskeleton’s arm cuffs were secured. This was particularly evident amongst those working in warmer environments, such as outdoors during the summer or in heated worksites. Skin irritations associated with exoskeleton use have been recognized by public health agencies [32]. The participants recommended that materials used for the exoskeleton should be breathable.
Mechanism to prevent debris from entering the arm cuffs. Workers who were cutting or drilling overhead shared that debris fell between the arm cuffs and their arms, and they had to repeatedly doff and don the arm cuff to shake out the debris.
Despite the opportunities for improvement, our findings suggest that there is merit for implementing exoskeletons in construction, as over 70% of the participants found that the EXO-01 had no hindrance to their overall work performance and productivity, with over 35% reporting that the exoskeleton even enhanced their performance and productivity. Given the industry-specific benefits and drawbacks identified, we find that exoskeletons, at their current state, are most useful when the overhead task is performed for a sustained period without the need to be in tight spaces or working below shoulder height. We generated a list of tasks for which construction workers found the exoskeleton to be beneficial and not beneficial. We suggest that the use case for the exoskeleton be similar to a harness. Workers put on a harness when they will be working at heights—the harness is not worn all the time. Similarly, when workers know that they will be performing overhead work in an open area, without the need for much below-shoulder work, they would don the exoskeleton.
To our knowledge, there are two other naturalistic field studies evaluating arm support exoskeletons in construction work [14,33]. Perspectives from experienced workers offer invaluable insights into the applicability and adoptability of novel technologies. For example, findings from our study provided various use cases for engineers to consider when developing future exoskeletons for construction use. Additionally, it brings awareness to employers about the likelihood of their workers using the technology had it been provided. To further facilitate industry-wide adoption, there is still a need for understanding how exoskeletons fit into the larger context of organizations, such as their longer-term impacts on shoulder injuries, usage, and return on investment.
Study Limitations
First, only one exoskeleton, the Hilti EXO-01, was trialed in our study. Hence, our findings may not be generalizable to all commercially available exoskeletons. However, it is worth noting that in another study, which assessed three different arm-support exoskeletons (i.e., Ottobock Paexo, Skelex 360, and Ekso EVO), the users had no preference between the three [31]. We evaluated the EXO-01 because it was specifically designed for use in construction and is supported by a recognized brand in the construction industry. Further, we believe that the liked and disliked exoskeleton qualities and features identified in this study are generalizable for the future development of exoskeletons for the construction industry.
Second, it may be a concern that two days is insufficient for workers to trial the exoskeleton and accurately form their perceptions. However, field studies have demonstrated the consistency of workers’ perception of an exoskeleton over longer durations of use and workers’ ability to quickly assess its applicability to their work. For example, exoskeleton usage and perceptions remained consistent over 6 weeks and 18 months among plasterers and automotive assembly operators, respectively [14,17]. Bricklayers, in another field study trialing exoskeletons, identified that the exoskeleton was not suitable for their work after three days of wear [33]. The aforementioned literature and the consistency of our participants’ responses support our belief that two days is sufficient for the participants to have accurately formed their perceptions on the value, barriers, and challenges associated with the product for its intermediate/immediate use. Despite this, we cannot rule out that workers’ perceptions of the exoskeleton would change over time.
Third, there may be a geographical limitation in the applicability of the results, as all study participants worked in Southern Ontario. Our data were collected throughout the year, and outdoor temperatures within the region can range from below 30 to over 30 degrees Celsius. During warmer months, participants mainly wore t-shirts, while more layers were worn in the colder months. The choice of clothing worn underneath the exoskeleton may impact the participants’ perception of the exoskeleton’s comfort, maneuverability, and thermal comfort [33].
Lastly, sampling bias may be present in our study. We collected a convenience sample of construction workers who self-identified as someone who frequently performed overhead tasks. Hence, our participants were willing or open-minded enough to try the exoskeleton and participate in a research study. If a worker opted not to participate, we did not ask for them to provide a reason. We cannot determine whether they did not participate because they did not see a use for the exoskeleton or they could not commit to the study. Therefore, our sample may be biased toward those who wanted to try the exoskeleton. We cannot confirm how this impacted the results because there were participants who trialed the exoskeleton and did not like it. The inverse may also be true: those who did not try the exoskeleton may find value in it. We can only base our conclusion on the evidence that was collected.
5. Conclusions
This research aimed to address key research gaps in the adoption of exoskeletons in construction by exploring workers’ perceptions of using exoskeletons, identifying the skilled trades jobs and tasks that exoskeleton use will be helpful/unhelpful for, and providing recommendations and considerations for further development of shoulder exoskeletons. Two-thirds of the construction workers who trialed the exoskeleton would likely or very likely use the exoskeleton if their employer provided it; however, participants stated that they would only put it on when tasks were suitable for exoskeleton use (i.e., prolonged overhead work in open spaces). Such tasks may include installing upper tracks, framing and drywalling bulkheads, taping and mudding ceilings, and installing light fixtures. To improve the adoption of exoskeletons in construction, exoskeletons should be designed to be compatible with harnesses and toolbelts, be close-fitting to allow working in tight spaces, be easily adjustable (for fit and level of support), be rugged and easy to clean, and to not interfere with mobility.
Conceptualization, A.Y. and M.Y.; methodology, B.B.D., K.G.S., P.B., K.H.J., M.A.-E., M.Y. and A.Y.; software, B.B.D. and K.G.S.; validation, B.B.D., K.G.S., M.Y. and A.Y.; formal analysis, B.B.D., K.G.S., M.Y. and A.Y.; investigation, B.B.D., K.G.S. and A.J.; resources, A.Y. and M.Y.; data curation, B.B.D., K.G.S., M.Y. and A.Y.; writing—original draft preparation, B.B.D.; writing—review and editing, B.B.D., K.G.S., P.B., K.H.J., M.A.-E., M.Y. and A.Y.; visualization, B.B.D.; supervision, A.Y. and M.Y.; project administration, B.B.D., K.G.S., M.Y. and A.Y.; funding acquisition, P.B., K.H.J., M.A.-E., M.Y. and A.Y. All authors have read and agreed to the published version of the manuscript.
The study was conducted in accordance with the Declaration of Helsinki and approved by the Research Ethics Board of Conestoga College Institute of Technology and Advanced Learning (REB No. 454; date of approval: 22 September 2022).
Informed consent was obtained from all subjects involved in the study.
The original contributions presented in the study are included in the article and
The authors would like to acknowledge our research participants and industry partners who generously shared their time, experience, and insight for this project. The authors would also like to thank Victoria Gevaert for proofreading the article.
The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.
Footnotes
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Enlarge this image.Figure 2. Consistency of feedback between the first and second day of wear (n = 32).
Enlarge this image.Figure 3. Workers’ feedback on exoskeletons after the first day of wear (n = 41).
Enlarge this image.Figure 4. Preference of exoskeleton versus usual method for various overhead work-related variables (n = 40).
Enlarge this image.Figure 5. Examples of tasks that the exoskeleton was beneficial for: (a) installing light fixtures, (b) installing upper tracks, (c) taping and mudding ceiling joints, (d) finishing drywall, (e) building bulkheads, and (f) overhead concrete drilling.
Enlarge this image.Figure 6. Examples of tasks that the exoskeleton was unhelpful for: (a) measuring and cutting, (b) general cleanup, (c) walking between studs, (d) drilling downward, (e) working in tight spaces, and (f) challenges with accessing key tools on the toolbelt.
Individual characteristics of the study sample (N = 41), categorized by worksite.
| Individual Factors | Overall, | Construction Worksite | ||||||
|---|---|---|---|---|---|---|---|---|
| Site A | Site B (Modular), | Site C | Site D | Site E | Site F (Modular), | Site G | ||
| Sex | ||||||||
| Female | 3 (7.3%) | 0 (0%) | 3 (30%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) |
| Male | 38 (93%) | 7 (100%) | 7 (70%) | 7 (100%) | 5 (100%) | 2 (100%) | 3 (100%) | 7 (100%) |
| Age (years) | 30 ± 11 | 33 ± 6 | 30 ± 11 | 26 ± 10 | 23 ± 4 | 54 ± 10 | 38 ± 16 | 24 ± 3 |
| Age Group | ||||||||
| ≤25 | 19 (46%) | 0 (0%) | 5 (50%) | 5 (71%) | 4 (80%) | 0 (0%) | 1 (33%) | 4 (57%) |
| 26–35 | 14 (34%) | 5 (71%) | 4 (40%) | 1 (14%) | 1 (20%) | 0 (0%) | 0 (0%) | 3 (43%) |
| 36–45 | 3 (7.3%) | 2 (29%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 1 (33%) | 0 (0%) |
| 46–55 | 3 (7.3%) | 0 (0%) | 0 (0%) | 1 (14%) | 0 (0%) | 1 (50%) | 1 (33%) | 0 (0%) |
| ≥56 | 2 (4.9%) | 0 (0%) | 1 (10%) | 0 (0%) | 0 (0%) | 1 (50%) | 0 (0%) | 0 (0%) |
| Height (cm) | 178 ± 9 | 176 ± 8 | 173 ± 10 | 181 ± 8 | 175 ± 7 | 179 ± 9 | 185 ± 7 | 184 ± 5 |
| Weight (kg) | 81 ± 14 | 76 ± 7 | 81 ± 20 | 81 ± 6 | 71 ± 15 | 106 ± 5 | 88 ± 9 | 83 ± 14 |
| BMI (kg/m2) | 25.5 ± 4.9 | 24.7 ± 2.3 | 27.1 ± 7.2 | 24.7 ± 2.8 | 23.2 ± 5.0 | 33.1 ± 4.8 | 25.5 ± 1.3 | 24.4 ± 3.9 |
| BMI Classification | ||||||||
| Underweight (<18.5) | 2 (4.9%) | 0 (0%) | 1 (10%) | 0 (0%) | 1 (20%) | 0 (0%) | 0 (0%) | 0 (0%) |
| Healthy weight (18.5 to <25) | 21 (51%) | 4 (57%) | 5 (50%) | 4 (57%) | 2 (40%) | 0 (0%) | 2 (67%) | 4 (57%) |
| Overweight (25 to <30) | 14 (34%) | 3 (43%) | 1 (10%) | 3 (43%) | 2 (40%) | 1 (50%) | 1 (33%) | 3 (43%) |
| Class 1 Obese (30 to <35) | 1 (2.4%) | 0 (0%) | 1 (10%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) |
| Class 2 Obese (35 to <40) | 2 (4.9%) | 0 (0%) | 1 (10%) | 0 (0%) | 0 (0%) | 1 (50%) | 0 (0%) | 0 (0%) |
| Class 3 Obese (≥40) | 1 (2.4%) | 0 (0%) | 1 (10%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) |
| Dominant Hand | ||||||||
| Left | 4 (9.8%) | 0 (0%) | 1 (10%) | 2 (29%) | 1 (20%) | 0 (0%) | 0 (0%) | 0 (0%) |
| Right | 37 (90%) | 7 (100%) | 9 (90%) | 5 (71%) | 4 (80%) | 2 (100%) | 3 (100%) | 7 (100%) |
1 n (%); Mean ± SD.
Work characteristics of the study sample (N=41), categorized by worksite.
| Work-Related Factors | Overall, | Construction Worksite | ||||||
|---|---|---|---|---|---|---|---|---|
| Site A | Site B (Modular), | Site C | Site D (Residential), n = 5 1 | Site E (Residential), n = 2 1 | Site F (Modular), | Site G | ||
| Trade of Workers | ||||||||
| Drywall finisher and plasterer | 1 (2.4%) | 0 (0%) | 0 (0%) | 1 (14%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) |
| Drywall, acoustic, and lathing applicator | 8 (20%) | 6 (86%) | 1 (10%) | 1 (14%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) |
| Electrician | 9 (22%) | 0 (0%) | 0 (0%) | 4 (57%) | 5 (100%) | 0 (0%) | 0 (0%) | 0 (0%) |
| General carpenter | 14 (34%) | 1 (14%) | 9 (90%) | 1 (14%) | 0 (0%) | 0 (0%) | 3 (100%) | 0 (0%) |
| Residential (low-rise) sheet metal installer | 2 (4.9%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 2 (100%) | 0 (0%) | 0 (0%) |
| Skilled laborer | 7 (17%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 7 (100%) |
| Level of Practice | ||||||||
| Worker | 7 (17%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 7 (100%) |
| Apprentice | 23 (56%) | 2 (29%) | 10 (100%) | 6 (86%) | 4 (80%) | 0 (0%) | 1 (33%) | 0 (0%) |
| Lead hand | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) |
| Journeyman | 8 (20%) | 5 (71%) | 0 (0%) | 1 (14%) | 0 (0%) | 0 (0%) | 2 (67%) | 0 (0%) |
| Foreman | 3 (7.3%) | 0 (0%) | 0 (0%) | 0 (0%) | 1 (20%) | 2 (100%) | 0 (0%) | 0 (0%) |
| Years of experience | 5.5 ± 7.2 | 9.0 ± 5.2 | 1.9 ± 0.8 | 3.4 ± 2.2 | 3.4 ± 3.4 | 31.0 ± 2.8 | 10.0 ± 4.4 | 1.7 ± 2.1 |
| Tenure (years) | 1.79 ± 2.38 | 3.50 ± 3.84 | 0.44 ± 0.41 | 1.86 ± 0.75 | 2.35 ± 2.42 | 6.00 ± 1.41 | 2.00 ± 2.60 | 0.24 ± 0.42 |
| Number of working hours per day | 8.67 ± 0.78 | 8.71 ± 0.49 | 8.05 ± 0.16 | 8.21 ± 0.39 | 8.90 ± 0.22 | 9.00 ± 1.41 | 8.00 ± 0.00 | 10.00 ± 0.00 |
| Number of working days per week | 4.96 ± 0.39 | 4.57 ± 0.79 | 5.00 ± 0.00 | 5.07 ± 0.19 | 5.00 ± 0.00 | 5.00 ± 0.00 | 5.00 ± 0.00 | 5.14 ± 0.38 |
1 n (%); Mean ± SD.
Tasks that the exoskeleton was helpful and not helpful for.
| Tasks Exoskeleton Was Helpful for | Tasks Exoskeleton Was Not Helpful for |
|---|---|
Lifting and positioning materials overhead for installation *
| Tasks in tight spaces
|
* Tasks may be performed concurrently (e.g., the worker uses one arm/hand to position the material on the ceiling while operating a tool with the other arm/hand).
Supplementary Materials
The following supporting information can be downloaded at:
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Details
; Somasundram, Kumar G 1
; Johnston, Alex 1 ; Bigelow, Philip 2 ; Abdoli-Eramaki, Mohammad 3 ; Jordan, Kenrick H 4 ; Yung, Marcus 1 ; Yazdani, Amin 5 1 Canadian Institute for Safety, Wellness, and Performance, Conestoga College Institute of Technology and Advanced Learning, Cambridge, ON N3E 1A9, Canada;
2 School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
3 School of Occupational and Public Health, Toronto Metropolitan University, Toronto, ON M5B 1Z5, Canada;
4 School of Business, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON N2N 4M4, Canada;
5 Canadian Institute for Safety, Wellness, and Performance, Conestoga College Institute of Technology and Advanced Learning, Cambridge, ON N3E 1A9, Canada;