{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T19:45:53Z","timestamp":1790797553372,"version":"4.1.0"},"reference-count":50,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T00:00:00Z","timestamp":1675987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"F\u00e9DeV"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>(1) Background: Healthcare workers are highly affected by work-related musculoskeletal disorders, particularly in the lower back, neck and shoulders, as their occupational tasks expose them to biomechanical constraints. One solution to prevent these musculoskeletal disorders may be the use of a passive exoskeleton as it aims to reduce muscle solicitation. However, few studies have been carried out directly in this field to assess the impact of the use of a passive upper limb exoskeleton on this population. (2) Methods: Seven healthcare workers, equipped with electromyographic sensors, performed a tool cleaning task with and without a passive upper limb exoskeleton (Hapo MS, Ergosant\u00e9 Technologie, France). Six muscles of the upper limbs were analysed, i.e., anterior deltoid, biceps brachii, pectoralis major, latissimus dorsi, triceps brachii and longissimus thoracis. A subjective analysis of the usability of the equipment, the perception of effort and discomfort, was also carried out using the System Usability Scale and the Borg scale. (3) Results: The longissimus thoracis was the most used muscle during this task. We observed a significant decrease in the muscular solicitation of the anterior deltoid and latissimus dorsi when wearing the exoskeleton. Other muscles were not significantly impacted by the device. (4) Conclusions: the passive exoskeleton used in this study allowed the reduction in muscular load on the anterior deltoid and latissimus dorsi without negative effects on other muscles. Other field studies with exoskeletons are now necessary, particularly in hospitals, to increase our knowledge and improve the acceptability of this system for the prevention of musculoskeletal disorders.<\/jats:p>","DOI":"10.3390\/ijerph20043153","type":"journal-article","created":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T02:42:33Z","timestamp":1676256153000},"page":"3153","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Evaluation of a Passive Upper Limb Exoskeleton in Healthcare Workers during a Surgical Instrument Cleaning Task"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9748-9911","authenticated-orcid":false,"given":"Bastien","family":"Arnoux","sequence":"first","affiliation":[{"name":"CIAMS, Universit\u00e9 Paris-Saclay, 91405 Orsay, France"},{"name":"CIAMS, Universit\u00e9 d\u2019Orl\u00e9ans, 45067 Orl\u00e9ans, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4060-3386","authenticated-orcid":false,"given":"Ana\u00efs","family":"Farr","sequence":"additional","affiliation":[{"name":"CIAMS, Universit\u00e9 Paris-Saclay, 91405 Orsay, France"},{"name":"CIAMS, Universit\u00e9 d\u2019Orl\u00e9ans, 45067 Orl\u00e9ans, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3561-9041","authenticated-orcid":false,"given":"Vincent","family":"Boccara","sequence":"additional","affiliation":[{"name":"LIMSI CNRS, Universit\u00e9 Paris Sud XI, CEDEX, 91403 Orsay, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7267-0236","authenticated-orcid":false,"given":"Nicolas","family":"Vignais","sequence":"additional","affiliation":[{"name":"CIAMS, Universit\u00e9 Paris-Saclay, 91405 Orsay, France"},{"name":"CIAMS, Universit\u00e9 d\u2019Orl\u00e9ans, 45067 Orl\u00e9ans, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,10]]},"reference":[{"key":"ref_1","unstructured":"NIOSH (1997). Musculoskeletal Disorders and Workplace Factors. A Critical Review of Epidemiologic Evidence for Work-Related Musculoskeletal Disorders of the Neck, Upper Extremity, and Low Back."},{"key":"ref_2","unstructured":"Maladie, A. (2020). Rapport Annuel 2020 de l\u2019Assurance Maladie\u2014Risques Professionnels\u2014\u00c9l\u00e9ments Statistiques et Financiers, Assurance Maladie. Technical Report."},{"key":"ref_3","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":"Theurel","year":"2018","journal-title":"Appl. Ergon."},{"key":"ref_4","first-page":"208","article-title":"Chronic musculoskeletal pain and arthritis: Impact, attitudes and perceptions","volume":"101","author":"Veale","year":"2008","journal-title":"Ir. Med. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/j.berh.2015.08.002","article-title":"Economic impact of musculoskeletal disorders (MSDs) on work in Europe","volume":"29","author":"Bevan","year":"2015","journal-title":"Best Pract. Res. Clin. Rheumatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1016\/j.apergo.2008.09.012","article-title":"Perioperating nurses and technicians\u2019 perceptions of ergonomic risk factors in the surgical environment","volume":"40","author":"Sheikhzadeh","year":"2009","journal-title":"Appl. Ergon."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Cotrim, T.P., Serranheira, F., Sousa, P., Hignett, S., Albolino, S., and Tartaglia, R. (2019). Advances in Intelligent Systems and Computing, Proceedings of the Health and Social Care Systems of the Future: Demographic Changes, Digital Age and Human Factors, Lisbon, Portugal, 3\u20135 July 2019, Springer International Publishing.","DOI":"10.1007\/978-3-030-24067-7"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"103715","DOI":"10.1016\/j.ijnurstu.2020.103715","article-title":"Musculoskeletal disorders in aged care workers: A systematic review of contributing factors and interventions","volume":"110","author":"Caponecchia","year":"2020","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"26","DOI":"10.4236\/odem.2017.51003","article-title":"Low Back Pain among Nurses: Prevalence, and Occupational Risk Factors","volume":"5","author":"Boughattas","year":"2017","journal-title":"Occup. Dis. Environ. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1002\/ajim.10048","article-title":"Musculoskeletal problems of the neck, shoulder, and back and functional consequences in nurses","volume":"41","author":"Trinkoff","year":"2002","journal-title":"Am. J. Ind. Med."},{"key":"ref_11","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_12","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.apergo.2015.12.003","article-title":"The effects of a passive exoskeleton on muscle activity, discomfort and endurance time in forward bending work","volume":"54","author":"Bosch","year":"2016","journal-title":"Appl. Ergon."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1007\/s12541-012-0197-x","article-title":"The technical trend of the exoskeleton robot system for human power assistance","volume":"13","author":"Lee","year":"2012","journal-title":"Int. J. Precis. Eng. Manuf."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.apergo.2018.08.004","article-title":"Influences of different exoskeleton designs and tool mass on physical demands and performance in a simulated overhead drilling task","volume":"74","author":"Alabdulkarim","year":"2019","journal-title":"Appl. Ergon."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.apergo.2018.02.009","article-title":"Evaluation of a passive exoskeleton for static upper limb activities","volume":"70","author":"Huysamen","year":"2018","journal-title":"Appl. Ergon."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1864","DOI":"10.1080\/00140139.2014.952682","article-title":"Ergonomic evaluation of a wearable assistive device for overhead work","volume":"57","author":"Rashedi","year":"2014","journal-title":"Ergonomics"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"103718","DOI":"10.1016\/j.apergo.2022.103718","article-title":"Shoulder muscle activity and perceived comfort of industry workers using a commercial upper limb exoskeleton for simulated tasks","volume":"101","author":"Pinho","year":"2022","journal-title":"Appl. Ergon."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1080\/24725838.2018.1551255","article-title":"A Follow-Up Study of the Effects of An Arm Support Exoskeleton on Physical Demands and Task Performance During Simulated Overhead Work","volume":"7","author":"Kim","year":"2019","journal-title":"IISE Trans. Occup. Ergon. Hum. Factors"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1080\/24725838.2019.1665596","article-title":"Electromyographic Assessment of a Shoulder Support Exoskeleton during on-Site Job Tasks","volume":"7","author":"Gillette","year":"2019","journal-title":"IISE Trans. Occup. Ergon. Hum. Factors"},{"key":"ref_20","unstructured":"Gillette, J., and Stephenson, M. (2018, January 8\u201311). EMG Analysis of an Upper Body Exoskeleton during Automotive Assembly. Proceedings of the American Society of Biomechanics Annual Meeting, Rochester, MN, USA."},{"key":"ref_21","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_22","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1080\/24725838.2019.1637799","article-title":"Experimental Evaluation of a Shoulder-Support Exoskeleton for Overhead Work: Influences of Peak Torque Amplitude, Task, and Tool Mass","volume":"7","author":"Poon","year":"2019","journal-title":"IISE Trans. Occup. Ergon. Hum. Factors"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Wang, H.M., Le, D.K.L., and Lin, W.C. (2021). Evaluation of a Passive Upper-Limb Exoskeleton Applied to Assist Farming Activities in Fruit Orchards. Appl. Sci., 11.","DOI":"10.3390\/app11020757"},{"key":"ref_24","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\u2014\u201cExpected\u201d effects on discomfort, shoulder muscle activity, and work task performance","volume":"70","author":"Kim","year":"2018","journal-title":"Appl. Ergon."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1080\/00140139.2020.1868581","article-title":"The effectivity of a passive arm support exoskeleton in reducing muscle activation and perceived exertion during plastering activities","volume":"64","author":"Krause","year":"2021","journal-title":"Ergonomics"},{"key":"ref_26","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_27","doi-asserted-by":"crossref","first-page":"102478","DOI":"10.1016\/j.jelekin.2020.102478","article-title":"Effects of a passive upper extremity exoskeleton for overhead tasks","volume":"55","author":"Yin","year":"2020","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1109\/MRA.2019.2954105","article-title":"An Experimental Evaluation of the Proto-MATE: A Novel Ergonomic Upper-Limb Exoskeleton to Reduce Workers\u2019 Physical Strain","volume":"27","author":"Pacifico","year":"2020","journal-title":"IEEE Robot. Autom. Mag."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1080\/24725838.2018.1563010","article-title":"A Field Evaluation of Arm-Support Exoskeletons for Overhead Work Applications in Automotive Assembly","volume":"7","author":"Smets","year":"2019","journal-title":"IISE Trans. Occup. Ergon. Hum. Factors"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1080\/00140139.2021.1963490","article-title":"A physiological and biomechanical investigation of three passive upper-extremity exoskeletons during simulated overhead work","volume":"65","author":"Weston","year":"2022","journal-title":"Ergonomics"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1007\/s00464-017-5667-x","article-title":"Solving the surgeon ergonomic crisis with surgical exosuit","volume":"32","author":"Liu","year":"2018","journal-title":"Surg. Endosc."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1016\/j.promfg.2017.07.252","article-title":"Investigation into the Applicability of a Passive Upper-limb Exoskeleton in Automotive Industry","volume":"11","author":"Spada","year":"2017","journal-title":"Procedia Manuf."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.procir.2018.04.028","article-title":"Experimental study of the physical impact of a passive exoskeleton on manual sanding operations","volume":"70","author":"Moyon","year":"2018","journal-title":"Procedia CIRP"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1109\/TNSRE.2020.3041906","article-title":"Passive Shoulder Exoskeletons: More Effective in the Lab Than in the Field?","volume":"29","author":"Ghillebert","year":"2021","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Zallio, M. (2021). Advances in Intelligent Systems and Computing, Proceedings of the Advances in Human Factors in Robots, Drones and Unmanned Systems, Springer International Publishing.","DOI":"10.1007\/978-3-030-51758-8"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"103120","DOI":"10.1016\/j.apergo.2020.103120","article-title":"Ergonomics assessment of passive upper-limb exoskeletons in an automotive assembly plant","volume":"87","author":"Iranzo","year":"2020","journal-title":"Appl. Ergon."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Le Tellier, B., Albouy, T., and Lebel, K. (2021). Objective and Subjective Evaluation of a Passive Exoskeleton for Upper Limbs. Preprints, 2021110512.","DOI":"10.20944\/preprints202111.0512.v1"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/S1050-6411(00)00027-4","article-title":"Development of recommendations for SEMG sensors and sensor placement procedures","volume":"10","author":"Hermens","year":"2000","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_39","unstructured":"Borg, G. (1998). Borg\u2019s Perceived Exertion and Pain Scales, Human Kinetics."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1080\/10447318.2021.1898828","article-title":"Psychometric Evaluation of the F-SUS: Creation and Validation of the French Version of the System Usability Scale","volume":"37","author":"Gronier","year":"2021","journal-title":"Int. J. Hum. Comput. Interact."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1080\/10447310802205776","article-title":"An Empirical Evaluation of the System Usability Scale","volume":"24","author":"Bangor","year":"2008","journal-title":"Int. J. Hum. Comput. Interact."},{"key":"ref_42","unstructured":"Koskas, D. (2021). Graduation Thesis\u2014Physical Ergonomic Analysis with Embedded Sensors to Prevent Musculoskeletal Disorders among Hospital Staff. [Master\u2019s Thesis, Sorbonne Universit\u00e9]. Technical Report."},{"key":"ref_43","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 25years of research","volume":"20","author":"Burden","year":"2010","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.jelekin.2003.10.005","article-title":"Less is more: High pass filtering, to remove up to 99% of the surface EMG signal power, improves EMG-based biceps brachii muscle force estimates","volume":"14","author":"Potvin","year":"2004","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.jshs.2016.01.019","article-title":"p < 0.05, < 0.01, < 0.001, < 0.0001, < 0.00001, < 0.000001, or < 0.0000001 \u2026","volume":"5","author":"Zhu","year":"2016","journal-title":"J. Sport Health Sci."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1941","DOI":"10.1109\/TNSRE.2022.3189666","article-title":"Development and Experimental Validation of a Passive Exoskeletal Vest","volume":"30","author":"Du","year":"2022","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"ref_47","first-page":"45","article-title":"Acceptation des exosquelettes par les op\u00e9rateurs: \u00e9tude exploratoire","volume":"157","author":"Wioland","year":"2019","journal-title":"R\u00e9f\u00e9rences En Sant\u00e9 Au Trav."},{"key":"ref_48","unstructured":"INRS (2022). Acquisition et Int\u00e9gration d\u2019un Exosquelette en Entreprise, Institut National de Recherche et de S\u00e9curit\u00e9 Pour la Pr\u00e9vention des Accidents du Travail et des Maladies Professionnelles."},{"key":"ref_49","first-page":"1000228","article-title":"Ergonomic Testing for the Design of an Innovative Mail Delivery Vehicle: A Physical Mock-up Case Study","volume":"8","author":"Roger","year":"2018","journal-title":"Int. J. Ergon."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.apergo.2018.02.024","article-title":"Assessing the influence of a passive, upper extremity exoskeletal vest for tasks requiring arm elevation: Part II\u2014\u201cUnexpected\u201d effects on shoulder motion, balance, and spine loading","volume":"70","author":"Kim","year":"2018","journal-title":"Appl. Ergon."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/4\/3153\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:30:42Z","timestamp":1760121042000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/4\/3153"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,10]]},"references-count":50,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["ijerph20043153"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20043153","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,10]]}}}