Saskia Baltrusch

11 Chapter 1 The SPEXOR project: An iterative design process Exoskeletons as a new approach for low-back pain prevention and rehabilitation was the starting point of the SPEXOR project, a collaboration between institutions from 5 different countries, including the Netherlands represented by the Vrije Universiteit Amsterdam and the Rehabilitation Center Heliomare. The aim of this project was to design and test an assistive device to prevent low-back pain in able-bodied workers and to support workers with low-back pain who are re- integrating in the vocational setting. To address limitations of current assistive devices and to gain insight into design requirements, the first step in the project was to look through literature on previous attempts. One passive exoskeleton that has been reported in literature and that is also commercially available in the Netherlands, is the Laevo device. The manufacturer advertises that using this exoskeleton leads to: “Less back pain, more energy and ultimate freedom of movement.” (Website Laevo, January 2020) As a first step in the SPEXOR development process it was decided to use this exoskeleton for initial benchmark testing, to assess whether the above statement is true and whether the Laevo exoskeleton shows limitations that need to be addressed in the new SPEXOR prototype. Second, design requirements were established, based on the benchmark results. As a third step, an iterative design process, involving measurements and redesign, were performed to evaluate and improve the design of the SPEXOR exoskeleton. An iterative design process in medical device development has shown to improve usability and user acceptance [19, 20]. This thesis focuses on these three steps. User-centred approach: a research gap in exoskeleton technology To develop an exoskeleton that can be adapted to the end-users’ needs and truly meet the demands of the environment in which it is used, the starting point of the design process should be the potential end-user. 1