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

J. Gräf, Bettina Wollesen, María Alejandra Díaz, S. De Bock, Lasse Hansen, Vincent Ducastel, Alessandra Preckher, B. Roelands et al.

Scientific Reports, 2026

14 participants

Abstract

Work-related musculoskeletal disorders are common, especially among women performing repetitive overhead tasks. In a randomized 2 × 2 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. The results showed significant reduced M. Trapezius muscle activations during arm lowering (p = .041, 73%), and lower target accuracy (p < .001, 100%) when using the exoskeleton. Subjective strain in the shoulders was significantly lower when using the exoskeleton (p = .035, 15%). 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. These results highlight the importance of sex-specific, ergonomic, and adaptive designs to improve exoskeleton effectiveness and acceptance.

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 14 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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