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Nurses face significant physical demands during patient care, leading to high rates of musculoskeletal disorders (MSDs) among nurses in long-term care. Exoskeletons demonstrate promise in supporting nurses and nurse managers with MSDs; however, social contextual factors are crucial to their design and implementation. Through thematic analysis of 17 semi-structured interviews, this paper reveals social contextual factors important to exoskeleton use among nurses and nurse managers in long-term care. Participants expressed concerns about workplace discrimination, co-worker perceptions of their capabilities, and patient confidence. Our findings highlight the need for supportive organizational cultures and open communication channels. Recommendations include in-depth systems analysis to assess exoskeleton feasibility and efficacy, involving input from frontline nurses/managers, management, and patients. These findings can aid human factors and ergonomics (HF/E) experts in balancing social contextual factors and other work system elements to design work system contexts and exoskeletons that promote optimal outcomes in long-term care settings. 

The mental demands associated with operating complex whole-body powered exoskeletons are poorly understood. This study aimed to explore the overall workload associated with using a powered wholebody exoskeleton among expert and novice users, as well as the changes in workload resulting from novices adapting to exoskeleton-use over time. We used eye-tracking measures to quantify the differences in workload of six novices and five experts while they performed a levelwalking task, with and without wearing a whole-body powered exoskeleton. We found that only novices’ pupil dilation (PD) increased, while experts showed a greater proportion of downward-directed pathfixations (PF) compared to novices while wearing the exoskeleton. These results indicate that novices’ mental demands were higher, and that experts and novices exhibited distinct visuomotor strategies. Eyetracking measures may potentially be used to detect differences in workload and skill-level associated with using exoskeletons, and also considered as inputs for future adaptive exoskeleton control algorithms. 

We explored the feasibility of using biomechanical simulations to predict altered spinal forces resulting from wearing a back-support exoskeleton (BSE) during repetitive lifting tasks. Twenty (10M, 10F) young, healthy participants completed repetitive lifting task, while wearing a BSE (‘with EXO’) and without wearing a BSE (‘without EXO’). Spinal forces were estimated by applying the BSE torque profile to body kinematics measured in ‘with EXO’ condition, while spinal forces were simulated by applying the same torque profile to body kinematics measured in ‘without EXO’ condition. Simulated compression force was higher than estimated compression force, probably due to lower trunk flexion angle in ‘without EXO’ condition. Such differences were larger among women than among men. However, simulated shear force was comparable with estimated shear force. Future works further need to compare simulated and estimated spinal forces for different BSEs (e.g., soft BSE), asymmetric lifting tasks, and different age group.