{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T18:52:05Z","timestamp":1789671125592,"version":"4.0.1"},"reference-count":60,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T00:00:00Z","timestamp":1687478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      The goal of this study was to compare erector spinae muscle fatigue, upper limb muscle activity, body areas discomfort, and heart rate during a 10-min carrying task with and without a passive upper-body exoskeleton (CarrySuit\n                      <jats:sup>\u24c7<\/jats:sup>\n                      ) while considering sex influences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Passive exoskeletons are commercially available to assist lifting or carrying task. However, evidence of their impact on muscle activity, fatigue, heart rate and discomfort are scarce and\/or do not concur during carrying tasks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Thirty participants (16 females and 14 male) performed a 10-min, 15kg load-carrying task with and without the exoskeleton in two non-consecutive days. Heart rate, and erector spinae, deltoid, biceps and brachioradialis muscle activity were recorded during the carrying tasks. In addition, erector spinae electromyography during an isometric hold test and discomfort ratings were measured before and after the task.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>While without the exoskeleton upper limb muscle activity increased or remained constant during the carrying task and showing high peak activation for both males and females, a significant activity reduction was observed with the exoskeleton. Low back peak activation, heart rate and discomfort were lower with than without the exoskeleton. In males muscle activation was significantly asymmetric without the exoskeleton and more symmetric with the exoskeleton.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The tested passive exoskeleton appears to alleviate the physical workload and impact of carrying heavy loads on the upper limbs and lower back for both males and females.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0287588","type":"journal-article","created":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T16:28:39Z","timestamp":1687624119000},"page":"e0287588","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":27,"title":["Impact of a passive upper-body exoskeleton on muscle activity, heart rate and discomfort during a carrying task"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5666-2156","authenticated-orcid":true,"given":"Gabriela","family":"Garcia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8724-7035","authenticated-orcid":true,"given":"Paul Gonzalo","family":"Arauz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Alvarez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Encalada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirley","family":"Vega","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5033-1607","authenticated-orcid":true,"given":"Bernard J.","family":"Martin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,6,23]]},"reference":[{"key":"pone.0287588.ref001","first-page":"196","volume-title":"Working conditions in a global perspective","author":"Eurofound and International Labour Organization","year":"2019"},{"issue":"1","key":"pone.0287588.ref002","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40557-017-0177-9","article-title":"Hazards and health problems in occupations dominated by aged workers in South Korea","volume":"29","author":"J Park","year":"2017","journal-title":"Ann Occup Environ Med"},{"issue":"11","key":"pone.0287588.ref003","doi-asserted-by":"crossref","first-page":"e1476","DOI":"10.7205\/MILMED-D-15-00435","article-title":"Heavy loads and lifting are risk factors for musculoskeletal injuries in deployed female soldiers","volume":"181","author":"TC Roy","year":"2016","journal-title":"Mil Med"},{"key":"pone.0287588.ref004","volume-title":"Occupational Biomechanics. Vol. 4rd ed.","author":"DB Chaffin","year":"2006"},{"issue":"7","key":"pone.0287588.ref005","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1007\/s00420-017-1220-4","article-title":"Lower limb pain among workers: a cross-sectional analysis of the fifth European Working Conditions Survey","volume":"90","author":"MG Garcia","year":"2017","journal-title":"Int Arch Occup Environ Health"},{"issue":"3","key":"pone.0287588.ref006","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1002\/ajim.20750","article-title":"Risk factors for work-related musculoskeletal disorders: A systematic review of recent longitudinal studies.","volume":"53","author":"BR da Costa","year":"2010","journal-title":"Am J Ind Med"},{"issue":"1","key":"pone.0287588.ref007","doi-asserted-by":"crossref","first-page":"36","DOI":"10.5271\/sjweh.3381","article-title":"Musculoskeletal pain in Europe: The role of personal, occupational, and social risk factors","volume":"40","author":"A Farioli","year":"2014","journal-title":"Scand J Work Environ Heal"},{"issue":"4","key":"pone.0287588.ref008","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1002\/ajim.22698","article-title":"Gender differences in occupations and complaints of musculoskeletal symptoms: Representative sample of South Korean workers","volume":"60","author":"J Park","year":"2017","journal-title":"Am J Ind Med"},{"issue":"1","key":"pone.0287588.ref009","doi-asserted-by":"crossref","first-page":"e919","DOI":"10.1097\/PR9.0000000000000919","article-title":"Prognostic factors for pain chronicity in low back pain: a systematic review","volume":"6","author":"LK Nieminen","year":"2021","journal-title":"PAIN Reports"},{"issue":"1","key":"pone.0287588.ref010","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12891-019-2594-0","article-title":"Prevalence of low back pain, seeking medical care, and lost time due to low back pain among manual material handling workers in the United States","volume":"20","author":"SA Ferguson","year":"2019","journal-title":"BMC Musculoskelet Disord"},{"issue":"13","key":"pone.0287588.ref011","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3390\/ijerph17134832","article-title":"Intervertebral disc disease of the lumbar spine in health personnel with occupational exposure to patient handling\u2014a systematic literature review and meta-analysis","volume":"17","author":"C Schr\u00f6der","year":"2020","journal-title":"Int J Environ Res Public Health"},{"issue":"7","key":"pone.0287588.ref012","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1007\/s00420-020-01544-3","article-title":"Musculoskeletal pain among offshore wind industry workers: a cross-sectional study","volume":"93","author":"M Velasco Garrido","year":"2020","journal-title":"Int Arch Occup Environ Health"},{"key":"pone.0287588.ref013","unstructured":"BLS. Employer-Reported Workplace Injury and Illness\u20142018. Washington, DC; 2019."},{"key":"pone.0287588.ref014","first-page":"1","article-title":"Safe Lifting and Movement of Nursing Home Residents","author":"J Collins","year":"2006","journal-title":"Department of health and human services. CDC NIOSH"},{"key":"pone.0287588.ref015","first-page":"1021","volume-title":"DHHS (NIOSH) Publication No. 2007\u2013131.","author":"NIOSH","year":"2007"},{"issue":"5","key":"pone.0287588.ref016","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1080\/00140139.2015.1081988","article-title":"Exoskeletons for industrial application and their potential effects on physical work load","volume":"59","author":"MP de Looze","year":"2016","journal-title":"Ergonomics"},{"issue":"February","key":"pone.0287588.ref017","article-title":"The influence of using exoskeletons during occupational tasks on acute physical stress and strain compared to no exoskeleton\u2013A systematic review and meta-analysis.","volume":"94","author":"M B\u00e4r","year":"2021","journal-title":"Appl Ergon."},{"issue":"1","key":"pone.0287588.ref018","article-title":"Industrial Robot: An International Journal Robotic exoskeletons: a review of recent progress.","volume":"42","author":"R. Bogue","year":"2015","journal-title":"Ind Robot An Int J"},{"issue":"3\u20134","key":"pone.0287588.ref019","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1080\/24725838.2021.1954565","article-title":"Model-Based Comparison of Passive and Active Assistance Designs in an Occupational Upper Limb Exoskeleton for Overhead Lifting.","volume":"9","author":"X Zhou","year":"2021","journal-title":"IISE Trans Occup Ergon Hum Factors."},{"issue":"3","key":"pone.0287588.ref020","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1177\/0018720819890966","article-title":"Biomechanical Evaluation of Passive Back-Support Exoskeletons in a Precision Manual Assembly Task: \u201cExpected\u201d Effects on Trunk Muscle Activity, Perceived Exertion, and Task Performance.","volume":"62","author":"S Madinei","year":"2020","journal-title":"Hum Factors"},{"issue":"April","key":"pone.0287588.ref021","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.apergo.2018.04.007","article-title":"The effect of a passive trunk exoskeleton on functional performance in healthy individuals.","volume":"72","author":"SJ Baltrusch","year":"2018","journal-title":"Appl Ergon"},{"issue":"April","key":"pone.0287588.ref022","article-title":"Reliability of a battery of tests for functional evaluation of trunk exoskeletons","volume":"86","author":"\u017d Kozinc","year":"2020","journal-title":"Appl Ergon"},{"issue":"September 2021","key":"pone.0287588.ref023","article-title":"Benchmarking occupational exoskeletons: An evidence mapping systematic review","volume":"98","author":"S De Bock","year":"2022","journal-title":"Appl Ergon"},{"issue":"3\u20134","key":"pone.0287588.ref024","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1080\/24725838.2019.1684399","article-title":"Considerations for Industrial Use: A Systematic Review of the Impact of Active and Passive Upper Limb Exoskeletons on Physical Exposures.","volume":"7","author":"T McFarland","year":"2019","journal-title":"IISE Trans Occup Ergon Hum Factors"},{"issue":"2","key":"pone.0287588.ref025","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.jelekin.2007.08.006","article-title":"The effect of an on-body personal lift assist device (PLAD) on fatigue during a repetitive lifting task.","volume":"19","author":"CA Lotz","year":"2009","journal-title":"J Electromyogr Kinesiol"},{"issue":"5","key":"pone.0287588.ref026","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1016\/j.apergo.2009.01.006","article-title":"Effectiveness of an on-body lifting aid at reducing low back physical demands during an automotive assembly task: Assessment of EMG response and user acceptability.","volume":"40","author":"RB Graham","year":"2009","journal-title":"Appl Ergon"},{"issue":"1","key":"pone.0287588.ref027","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.ergon.2008.05.008","article-title":"Testing the efficacy of an ergonomic lifting aid at diminishing muscular fatigue in women over a prolonged period of lifting.","volume":"39","author":"AA Godwin","year":"2009","journal-title":"Int J Ind Ergon"},{"key":"pone.0287588.ref028","article-title":"Using a Passive Back Exoskeleton During a Simulated Sorting Task: Influence on Muscle Activity, Posture, and Heart Rate","author":"M B\u00e4r","year":"2022","journal-title":"Hum Factors"},{"key":"pone.0287588.ref029","article-title":"Using a Back Exoskeleton During Industrial and Functional Tasks\u2014Effects on Muscle Activity, Posture, Performance, Usability, and Wearer Discomfort in a Laboratory Trial","author":"T Luger","year":"2021","journal-title":"Hum Factors"},{"issue":"6","key":"pone.0287588.ref030","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1080\/00140139.2020.1870162","article-title":"Effects of industrial back-support exoskeletons on body loading and user experience: an updated systematic review.","volume":"64","author":"T Kermavnar","year":"2021","journal-title":"Ergonomics"},{"issue":"3","key":"pone.0287588.ref031","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1177\/0018720819897669","article-title":"Effects of Two Passive Back-Support Exoskeletons on Muscle Activity, Energy Expenditure, and Subjective Assessments During Repetitive Lifting","volume":"62","author":"MM Alemi","year":"2020","journal-title":"Hum Factors"},{"key":"pone.0287588.ref032","author":"Auxivo","year":"2021","journal-title":"CarrySuit \u00ae Specification"},{"key":"pone.0287588.ref033","article-title":"SENIAM. European Recommendations for Surface ElectroMyoGraphy.","author":"HJ Hermens","year":"1999","journal-title":"Enschede, the Netherlands: Roessingh Research and Development;"},{"issue":"21","key":"pone.0287588.ref034","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3390\/s21217322","article-title":"Electrode size and placement for surface emg bipolar detection from the brachioradialis muscle: A scoping review.","volume":"21","author":"A Merlo","year":"2021","journal-title":"Sensors"},{"issue":"7","key":"pone.0287588.ref035","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1007\/s00421-019-04142-5","article-title":"RR interval signal quality of a heart rate monitor and an ECG Holter at rest and during exercise","volume":"119","author":"R Gilgen-Ammann","year":"2019","journal-title":"Eur J Appl Physiol"},{"issue":"3","key":"pone.0287588.ref036","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/0003-6870(87)90010-X","article-title":"Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms.","volume":"18","author":"I Kuorinka","year":"1987","journal-title":"Appl Ergon"},{"issue":"7","key":"pone.0287588.ref037","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1177\/0018720815590293","article-title":"Long-term muscle fatigue after standing work","volume":"57","author":"M Garcia","year":"2015","journal-title":"Hum Factors"},{"issue":"2","key":"pone.0287588.ref038","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1080\/00140139.2019.1677949","article-title":"Physiological and neuromotor changes induced by two different stand-walk-sit work rotations.","volume":"63","author":"M Garcia","year":"2020","journal-title":"Ergonomics"},{"issue":"1","key":"pone.0287588.ref039","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-020-72531-4","article-title":"Low-profile elastic exosuit reduces back muscle fatigue.","volume":"10","author":"EP Lamers","year":"2020","journal-title":"Sci Rep"},{"key":"pone.0287588.ref040","doi-asserted-by":"crossref","DOI":"10.1002\/9781119082934","volume-title":"Surface Electromyography: Physiology, Engineering, and Applications","author":"R Merletti","year":"2016"},{"issue":"2","key":"pone.0287588.ref041","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1123\/jab.13.2.135","article-title":"The Use of Surface Electromyography in Biomechanics","volume":"13","author":"CJ De Luca","year":"1997","journal-title":"J Appl Biomech"},{"issue":"6","key":"pone.0287588.ref042","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1016\/j.jelekin.2010.07.004","article-title":"How should we normalize electromyograms obtained from healthy participants? What we have learned from over 25 years of research.","volume":"20","author":"A. Burden","year":"2010","journal-title":"J Electromyogr Kinesiol"},{"key":"pone.0287588.ref043","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.jelekin.2017.07.001","article-title":"Precision based guidelines for sub-maximal normalisation task selection for trunk extensor EMG.","volume":"37","author":"JA Jackson","year":"2017","journal-title":"J Electromyogr Kinesiol"},{"issue":"5","key":"pone.0287588.ref044","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1080\/00140139.2020.1725145","article-title":"Physiological changes during prolonged standing and walking considering age, gender and standing work experience.","volume":"63","author":"R Wall","year":"2020","journal-title":"Ergonomics"},{"issue":"3","key":"pone.0287588.ref045","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1080\/00140139.2015.1080861","article-title":"Commissaris DACM. Comparison of the postural and physiological effects of two dynamic workstations to conventional sitting and standing workstations","volume":"59","author":"J Botter","year":"2016","journal-title":"Ergonomics"},{"issue":"14","key":"pone.0287588.ref046","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1080\/00140130600811620","article-title":"Changes in upper extremity biomechanics across different mouse positions in a computer workstation","volume":"49","author":"JT Dennerlein","year":"2006","journal-title":"Ergonomics"},{"issue":"3","key":"pone.0287588.ref047","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/BF00635988","article-title":"The static load component in muscle work","volume":"57","author":"B. Jonsson","year":"1988","journal-title":"Eur J Appl Physiol Occup Physiol"},{"key":"pone.0287588.ref048","article-title":"An ad hoc method for computing pseudo effect size for mixed models","author":"K. G. Tippey","year":"2016","journal-title":"In South Central SAS Users Group"},{"issue":"NOV","key":"pone.0287588.ref049","first-page":"1","article-title":"reporting effect sizes to facilitate cumulative science: A practical primer for t-tests and ANOVAs","volume":"4","author":"Lakens D. Calculating","year":"2013","journal-title":"Front Psychol"},{"issue":"12 December","key":"pone.0287588.ref050","first-page":"1","article-title":"Does treadmill workstation use affect user\u2019s kinematic gait symmetry?","volume":"16","author":"PG Arauz","year":"2021","journal-title":"PLoS One"},{"issue":"1","key":"pone.0287588.ref051","doi-asserted-by":"crossref","first-page":"89","DOI":"10.2478\/hukin-2021-0002","article-title":"Synergistic activation patterns of hand muscles in left- And right-hand dominant individuals","volume":"76","author":"D Liang","year":"2021","journal-title":"J Hum Kinet"},{"issue":"2","key":"pone.0287588.ref052","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1589\/jpts.28.585","article-title":"Comparison of trunk muscle activities in lifting and lowering tasks at various heights","volume":"28","author":"H Lee","year":"2016","journal-title":"J Phys Ther Sci"},{"issue":"2","key":"pone.0287588.ref053","first-page":"245","article-title":"Trunk muscle activities during lifting in upright and stooped postures","volume":"12","author":"M Subramaniyam","year":"2019","journal-title":"Int J Eng Res Technol"},{"issue":"4","key":"pone.0287588.ref054","volume":"22","author":"T Varrecchia","year":"2022","journal-title":"Trunk Muscle Coactivation in People with and without Low Back Pain during Fatiguing Frequency-Dependent Lifting Activities. Sensors"},{"issue":"10","key":"pone.0287588.ref055","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1007\/s00256-013-1667-7","article-title":"The deltoid, a forgotten muscle of the shoulder","volume":"42","author":"T Moser","year":"2013","journal-title":"Skeletal Radiol"},{"issue":"12","key":"pone.0287588.ref056","doi-asserted-by":"crossref","first-page":"2469","DOI":"10.1007\/s00421-014-2974-y","article-title":"Fatigue development in the finger flexor muscle differs between keyboard and mouse use","volume":"114","author":"JH Kim","year":"2014","journal-title":"Eur J Appl Physiol"},{"issue":"8","key":"pone.0287588.ref057","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1177\/0018720816669444","article-title":"Long-Lasting Changes in Muscle Twitch Force during Simulated Work while Standing or Walking","volume":"58","author":"M-G Garcia","year":"2016","journal-title":"Hum Factors"},{"issue":"6","key":"pone.0287588.ref058","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1097\/WCO.0b013e328315a293","article-title":"Understanding sensorimotor adaptation and learning for rehabilitation","volume":"21","author":"AJ Bastian","year":"2008","journal-title":"Curr Opin Neurol"},{"issue":"June 2017","key":"pone.0287588.ref059","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.apergo.2017.10.008","article-title":"Physiological consequences of using an upper limb exoskeleton during manual handling tasks.","volume":"67","author":"J Theurel","year":"2018","journal-title":"Appl Ergon"},{"issue":"9 SUPPL","key":"pone.0287588.ref060","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1097\/00005768-200009001-00005","article-title":"Evaluation of heart rate as a method for assessing moderate intensity physical activity","volume":"32","author":"SJ Strath","year":"2000","journal-title":"Med Sci Sports Exerc"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0287588","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T13:29:30Z","timestamp":1702646970000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0287588"}},"subtitle":[],"editor":[{"given":"Ryan T.","family":"Roemmich","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,6,23]]},"references-count":60,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,6,23]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0287588","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,23]]}}}