Saskia Baltrusch

204 Chapter 8 Abstract Purpose: Determinants of successfully introducing passive exoskeletons in the working environment to decrease mechanical loading on the back, are acceptability of the device to management and employees and self-efficacy of employees when using the device. Therefore, the aim of this study was to assess self-efficacy of employees with low-back pain when using an exoskeleton and the acceptability of such a device to these employees and their managers. Methods: We used a mixed method approach. We quantitatively assessed the change in self-efficacy of 19 employees with low-back pain when performing daily activity tasks with the exoskeleton, using the modified spinal function sort (M-SFS). Qualitatively, we conducted a focus group with employees and a double interview with two managers to add more insight and understandings into changes in self-efficacy and to discuss challenges of implementing an exoskeleton in the working environment. Results : Self-efficacy significantly increased when using the exoskeleton. In the focus group employees acknowledged the flexibility of the exoskeleton being advantageous to current static external lifting devices, which confirmed the increase of self-efficacy in both static and dynamic tasks. Individual data showed that the increase in self-efficacy was largest for participants, being greatly restricted by their low-back pain. In the focus group, employees confirmed that they are mostly open to wearing the exoskeleton if they suffer from low-back pain. Conclusion : If potential challenges are considered in the implementation strategy, acceptability of and self-efficacy in using the passive trunk exoskeleton would be further improved, potentially contributing to reduced risk of low-back pain.