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This systematic review aimed to provide an overview of facilitators and barriers influencing OEX implementation, according to users and interest holders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of PubMed and EMBASE identified 28 studies on active or passive OEX and opinions on acceptance or rejection during implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Facilitators were reported slightly more often than barriers (128 times vs. 110 times), with 70 facilitators and 67 barriers identified. Barriers were most frequently associated with the Device domain (36.4%), followed by the Person\/User (24.5%), Work\/Job (20.0%), Company\/Management (14.5%), and Attitude (4.5%) domains. In contrast, facilitators were primarily linked to the Person\/User domain (28.1%), closely followed by the Work\/Job domain (26.6%) and then the Device (20.3%), Company\/Management (18.8%), and Attitude (6.3%) domains. Studies with short OEX exposure reported fewer barriers than those without actual OEX use or experience (25 vs. 50). Overall risk of bias was moderate across study designs, with common issues including limited reporting, small or convenience samples, and the unavoidable absence of blinding in trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>OEX adoption is shaped by multiple factors, some acting as both facilitators and barriers. User-centered strategies (such as training and hands-on familiarization) are critical, as short-term exposure appears to reduce barriers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p>PROSPERO (CRD420251090106).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10926-026-10397-5","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T19:43:34Z","timestamp":1778183014000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Occupational Exoskeletons as a Technological Solution for Musculoskeletal Disorders: A Systematic Review of Barriers and Facilitators for Sustainable Workplace Integration"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3299-7423","authenticated-orcid":false,"given":"D. 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