{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:43:31Z","timestamp":1790963011602,"version":"4.1.0"},"reference-count":43,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T00:00:00Z","timestamp":1728259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Brussels Institute of Advanced Studies","award":["BrIAS2024"],"award-info":[{"award-number":["BrIAS2024"]}]},{"name":"Federal Public Service for Policy and Support","award":["BrIAS2024"],"award-info":[{"award-number":["BrIAS2024"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomimetics"],"abstract":"<jats:p>(1) Exoskeletons offer potential benefits for overhead working tasks, but gender effects or differences are unclear. This study aimed to compare the performance as well as subjective body strain and comfort of men and women using an upper-body exoskeleton. (2) n = 20 female and n = 16 male participants performed an overhead drilling task with and without a passive upper-body exoskeleton in a randomized cross-over study. The task performance of different movement phases, perceived exertion, and ease of use were measured to compare gender differences. One- and two-way analyses were used to compare genders in the different conditions. The body mass index (BMI) was included as a covariate. (3) Gender differences in task performance were found for error integrals (p &lt; 0.001) with higher values in male participants. Moreover, there was a significant interaction effect for gender x exoskeleton use. While females showed performance decrements in aiming with exoskeleton use, the males\u2019 performance increased (p = 0.025). No other gender differences were observed. (4) Gender differences in task performance using an upper-body industrial exoskeleton were less detectable than expected, indicating that body composition and anthropometrics might be valuable indicators for performance including assisting devices. Moreover, future studies should also integrate the examination of muscle activity to gain more insights into potential gender movement control patterns.<\/jats:p>","DOI":"10.3390\/biomimetics9100601","type":"journal-article","created":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T07:30:18Z","timestamp":1728286218000},"page":"601","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Gender Differences in Performing an Overhead Drilling Task Using an Exoskeleton\u2014A Cross-Sectional Study"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1082-9141","authenticated-orcid":false,"given":"Bettina","family":"Wollesen","sequence":"first","affiliation":[{"name":"Department of Human Movement Science, Universit\u00e4t Hamburg, 20148 Hamburg, Germany"},{"name":"Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sports University Cologne, 50933 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Gr\u00e4f","sequence":"additional","affiliation":[{"name":"Department of Human Movement Science, Universit\u00e4t Hamburg, 20148 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8351-9702","authenticated-orcid":false,"given":"Sander","family":"De Bock","sequence":"additional","affiliation":[{"name":"Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eligia","family":"Alfio","sequence":"additional","affiliation":[{"name":"Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050 Brussels, Belgium"},{"name":"Human Robotics Research Center, 1050 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Alejandra","family":"D\u00edaz","sequence":"additional","affiliation":[{"name":"Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050 Brussels, Belgium"},{"name":"Human Robotics Research Center, 1050 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6901-7199","authenticated-orcid":false,"given":"Kevin","family":"De Pauw","sequence":"additional","affiliation":[{"name":"Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1177\/1541931213601733","article-title":"Industrial exoskeletons: Are we ready for prime time yet?","volume":"61","author":"Reid","year":"2017","journal-title":"Proc. Hum. Factors Ergon. Soc. Annu. Meet."},{"key":"ref_2","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":"McFarland","year":"2019","journal-title":"IISE Trans. Occup. Ergon. Hum. Factors"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1080\/24725838.2019.1638331","article-title":"Occupational Exoskeletons: Overview of Their Benefits and Limitations in Preventing Work-Related Musculoskeletal Disorders","volume":"7","author":"Theurel","year":"2019","journal-title":"IISE Trans. Occup. Ergon. Hum. Factors"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e11","DOI":"10.1017\/wtc.2021.11","article-title":"Occupational exoskeletons: A roadmap toward large-scale adoption. Methodology and challenges of bringing exoskeletons to workplaces","volume":"2","author":"Crea","year":"2021","journal-title":"Wearable Technol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1794","DOI":"10.1177\/21695067231192559","article-title":"Individual Differences in Body Mass, Biological Sex, and Physical Fitness Affecting Human-Exoskeleton Interactions","volume":"67","author":"Leibman","year":"2023","journal-title":"Proc. Hum. Factors Ergon. Soc. Annu. Meet."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1007\/BF00235103","article-title":"Gender differences in strength and muscle fiber characteristics","volume":"66","author":"Miller","year":"1993","journal-title":"Eur. J. Appl. Physiol. Occup. Physiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1113\/jphysiol.1983.sp014658","article-title":"Strength and cross-sectional area of human skeletal muscle","volume":"338","author":"Maughan","year":"1983","journal-title":"J. Physiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1080\/14038190801999679","article-title":"Gender differences and reliability of selected physical performance tests in young women and men","volume":"11","author":"Sahlberg","year":"2009","journal-title":"Adv. Physiother."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"104015","DOI":"10.1016\/j.apergo.2023.104015","article-title":"Three passive arm-support exoskeletons have inconsistent effects on muscle activity, posture, and perceived exertion during diverse simulated pseudo-static overhead nutrunning tasks","volume":"110","author":"Ojelade","year":"2023","journal-title":"Appl. Ergon."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"103903","DOI":"10.1016\/j.apergo.2022.103903","article-title":"Passive shoulder exoskeleton support partially mitigates fatigue-induced effects in overhead work","volume":"106","author":"Ampe","year":"2023","journal-title":"Appl. Ergon."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2357","DOI":"10.1007\/s00421-016-3487-7","article-title":"Gender differences in fatigability and muscle activity responses to a short-cycle repetitive task","volume":"116","author":"Srinivasan","year":"2016","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1152\/jappl.2000.89.1.81","article-title":"Skeletal muscle mass and distribution in 468 men and women aged 18\u201388 yr","volume":"89","author":"Janssen","year":"2000","journal-title":"J. Appl. Physiol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Lamers, E.P., Soltys, J.C., Scherpereel, K.L., Yang, A.J., and Zelik, K.E. (2020). Low-profile elastic exosuit reduces back muscle fatigue. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-72531-4"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1067\/mse.2001.115270","article-title":"The effects of age, sex, and shoulder dominance on range of motion of the shoulder","volume":"10","author":"Barnes","year":"2001","journal-title":"J. Shoulder Elb. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1177\/0363546508316281","article-title":"Electromyographic analysis of specific exercises for scapular control in early phases of shoulder rehabilitation","volume":"36","author":"Kibler","year":"2008","journal-title":"Am. J. Sports Med."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Schmalz, T., Sch\u00e4ndlinger, J., Schuler, M., Bornmann, J., Schirrmeister, B., Kannenberg, A., and Ernst, M. (2019). Biomechanical and metabolic effectiveness of an industrial exoskeleton for overhead work. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16234792"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1080\/00140139.2011.586061","article-title":"A critical review on physical factors and functional characteristics that may explain a sex\/gender difference in work-related neck\/shoulder disorders","volume":"55","year":"2012","journal-title":"Ergonomics"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Ashta, G., Finco, S., Battini, D., and Persona, A. (2023). Passive Exoskeletons to Enhance Workforce Sustainability: Literature Review and Future Research Agenda. Sustainability, 15.","DOI":"10.3390\/su15097339"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Gr\u00e4f, J., Grospretre, S., Argubi-Wollesen, A., and Wollesen, B. (2024). Impact of a passive upper-body exoskeleton on muscular activity and precision in overhead single and dual tasks: An explorative randomized crossover study. Front. Neurol., 15.","DOI":"10.3389\/fneur.2024.1405473"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"104042","DOI":"10.1016\/j.apergo.2023.104042","article-title":"Side-effects and adverse events of a shoulder-and back-support exoskeleton in workers: A systematic review","volume":"111","author":"Kranenborg","year":"2023","journal-title":"Appl. Ergon."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"104199","DOI":"10.1016\/j.apergo.2023.104199","article-title":"Perceived benefits, barriers, perceptions, and readiness to use exoskeletons in the construction industry: Differences by demographic characteristics","volume":"116","author":"Gutierrez","year":"2024","journal-title":"Appl. Ergon."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Cardoso, A., Colim, A., and Sousa, N. (2020). The effects of a passive exoskeleton on muscle activity and discomfort in industrial tasks. Occupational and Environmental Safety and Health II, Springer.","DOI":"10.1007\/978-3-030-41486-3_26"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.1080\/00140139.2015.1043356","article-title":"Task variation during simulated, repetitive, low-intensity work\u2013influence on manifestation of shoulder muscle fatigue, perceived discomfort and upper-body postures","volume":"58","author":"Luger","year":"2015","journal-title":"Ergonomics"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1177\/00187208211007267","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","volume":"65","author":"Luger","year":"2023","journal-title":"Hum. Factors"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1080\/00140130601133800","article-title":"Fatigue during prolonged intermittent overhead work: Reliability of measures and effects of working height","volume":"50","author":"Sood","year":"2007","journal-title":"Ergonomics"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.apergo.2018.02.025","article-title":"Assessing the influence of a passive, upper extremity exoskeletal vest for tasks requiring arm elevation: Part I\u2013\u201cExpected\u201d effects on discomfort, shoulder muscle activity, and work task performance","volume":"70","author":"Kim","year":"2018","journal-title":"Appl. Ergon."},{"key":"ref_27","unstructured":"Borg, G. (1998). Borg\u2019s Perceived Exertion and Pain Scales, Human Kinetics."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1249\/00005768-198205000-00012","article-title":"Psychophysical bases of perceived exertion","volume":"14","author":"Borg","year":"1982","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/S0001-6918(01)00055-5","article-title":"A comparison of AME and CR100 for scaling perceived exertion","volume":"109","author":"Borg","year":"2002","journal-title":"Acta Psychol."},{"key":"ref_30","first-page":"15","article-title":"A new generation of scaling methods: Level-anchored ratio scaling","volume":"28","author":"Borg","year":"2001","journal-title":"Psychologica"},{"key":"ref_31","first-page":"4","article-title":"SUS: A \u201cquick and dirty\u201d Usability Scale","volume":"189","author":"Brooke","year":"1996","journal-title":"Usability Eval. Ind.\/Taylor Fr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1109\/TMRB.2021.3110679","article-title":"Design and evaluation of a passive cable-driven occupational shoulder exoskeleton","volume":"3","author":"Rossini","year":"2021","journal-title":"IEEE Trans. Med. Robot. Bionics"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"103149","DOI":"10.1016\/j.humov.2023.103149","article-title":"The effects of hand dominance, fatigue, and sex on muscle activation during a repetitive overhead fatiguing task","volume":"92","author":"Renda","year":"2023","journal-title":"Hum. Mov. Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1111\/apha.12234","article-title":"Sex differences in human fatigability: Mechanisms and insight to physiological responses","volume":"210","author":"Hunter","year":"2014","journal-title":"Acta Physiol."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Schwartz, M., Desbrosses, K., Theurel, J., and Mornieux, G. (2023). Biomechanical consequences of using passive and active back-support exoskeletons during different manual handling tasks. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20156468"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Liutsko, L., Mui\u00f1os, R., Tous Ral, J.M., and Contreras, M.J. (2020). Fine motor precision tasks: Sex differences in performance with and without visual guidance across different age groups. Behav. Sci., 10.","DOI":"10.3390\/bs10010036"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Raghuraman, R.N., Barbieri, D.F., Aviles, J., and Srinivasan, D. (2024). Age and gender differences in the perception and use of soft vs. rigid exoskeletons for manual material handling. Ergonomics, 1\u201318.","DOI":"10.1080\/00140139.2024.2338268"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.apergo.2018.12.003","article-title":"Effect of assistive devices on hand and arm posture during activities of daily living","volume":"76","author":"Vergara","year":"2019","journal-title":"Appl. Ergon."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1109\/TMECH.2007.901934","article-title":"Upper-limb powered exoskeleton design","volume":"12","author":"Perry","year":"2007","journal-title":"IEEE\/ASME Trans. Mechatron."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1097\/JES.0b013e3181aa63e2","article-title":"Sex differences and mechanisms of task-specific muscle fatigue","volume":"37","author":"Hunter","year":"2009","journal-title":"Exerc. Sport Sci. Rev."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1080\/00140139.2020.1774080","article-title":"Usability, user experience and accessibility: Towards an integrative model","volume":"63","author":"Sauer","year":"2020","journal-title":"Ergonomics"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/j.apergo.2009.09.002","article-title":"The influence of design aesthetics in usability testing: Effects on user performance and perceived usability","volume":"41","author":"Sonderegger","year":"2010","journal-title":"Appl. Ergon."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e10","DOI":"10.1017\/wtc.2021.10","article-title":"Exoskeleton acceptance and its relationship to self-efficacy enhancement, perceived usefulness, and physical relief: A field study among logistics workers","volume":"2","author":"Siedl","year":"2021","journal-title":"Wearable Technol."}],"container-title":["Biomimetics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2313-7673\/9\/10\/601\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:11:58Z","timestamp":1760112718000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2313-7673\/9\/10\/601"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,7]]},"references-count":43,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2024,10]]}},"alternative-id":["biomimetics9100601"],"URL":"https:\/\/doi.org\/10.3390\/biomimetics9100601","relation":{},"ISSN":["2313-7673"],"issn-type":[{"value":"2313-7673","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,7]]}}}