Saskia Baltrusch

10 Chapter 1 Also, robots have been introduced in the work environment. However, given the different sizes and shapes of the suitcases, the robot cannot be used at its full capacity when loading carts and mistakes have to be corrected manually. Exoskeletons as a new approach The example of the airline company shows the challenge of translating research results into implementation strategies in practice. It further demonstrates that adaptations of the work environment have their limitations to protect employees against low-back pain. A potential approach to overcome these limitations might be a wearable on-body device that supports the user in any work environment. In that case, adaptations to the work site are not needed, which might simplify implementation. A wearable device could be used in a variety of working tasks and could be adapted to the end-users needs. Indeed, given the advances in technology, body-worn assistive devices, also called exoskeletons, have gained interest from industry. Examples for devices that are currently used in pilots in a few automotive industries are the MATE exoskeleton from the Italian company IUVO and the Paexo exoskeleton from the German company Ottobock. Both exoskeletons support workers when performing overhead work by unloading the arms. Trunk exoskeletons support the user in tasks that involve high loading of the back and have the potential to considerably reduce factors associated with work-related low-back pain [16]. Yet, challenging issues, such as discomfort, weight of the device, alignment with human kinematics and versatility, i.e using an exoskeleton for less stereotypical tasks, still need to be solved. The application of exoskeletons had started in medical and rehabilitation context, mostly to support patients with a spinal cord injury [17]. Exoskeletons designed to support low-back pain patients in the rehabilitation setting have not been developed. However, considering that in the European Union, yearly more than 40% of the workers suffer from low-back pain or neck and shoulder pain [18], it becomes apparent that there is a need for prevention. When already suffering from low-back pain, an exoskeleton could facilitate recovery if used within the rehabilitation setting. Still, it remains to be investigated whether trunk exoskeletons are suited for rehabilitation purposes.