Saskia Baltrusch

14 Chapter 1 and effectiveness of the device. Therefore, I used both quantitative and qualitative research. Such a mixed method approach combines the strengths of both research methods. On the one hand, the quantitative approach is deductive and allows for generalization of a tested theory. On the other hand, the qualitative approach is inductive and focuses on the fact that the social world is only accessible to us via respondents’ interpretations, yielding a theory that is driven by the participant [26]. Employing both practices can therefore provide stronger evidence for a conclusion, by integrating the results and drawing inferences [27]. According to Creswell (2003) [28], research is not about choosing either a quantitative vs. qualitative approach, but a researcher should focus on how research practice lies between the two. Therefore, by incorporating the strengths of both methodologies in this thesis, I aim to add insight and understandings into the potential of using an exoskeleton for low-back pain prevention and vocational reintegration that might be missed when using only a single method. Outline of the thesis Recapitulating, effacing risk factors for occupational low-back pain in the work environment remains a challenge. Given the fact, that external (off-body) assistive devices have their limitations in terms of flexibility and applicability, an on-body wearable device (exoskeleton) might be promising to prevent low- back pain. For adequate development and implementation of an exoskeleton, the user’s perspective needs to be included in the design process, requiring qualitative research. Therefore, this thesis applies a user-centred approach, by combining quantitative and qualitative research methods. Quantitatively, I assess how the SPEXOR exoskeleton affects functionality in daily practice. This involves not only the potential benefits of this device, such as reducing the load on the low back, but also potential limitations. A body worn device that reduces mechanical loading on the back during lifting, might obstruct performance in other work-related tasks through discomfort, hindrance in movement, or affecting the efficiency of movement. This would decrease user acceptance and the likelihood that the exoskeleton will be used at work. Thus, I assessed comfort and functional performance when wearing the SPEXOR exoskeleton to detect the level of hindrance given by the device during a variety of work-related tasks. In addition, aerobic loading was measured to demonstrate whether the exoskeleton affects movement efficiency. Lower movement efficiency can lead