Saskia Baltrusch

225 Chapter 8 Participants discussed potential factors that can negatively affect the acceptability and usability of an exoskeleton in the working environment. Main concerns from the managers were that employees might not use the exoskeleton, as they might not want to be seen with it in a working environment that is dominated by male personalities. If the design of the exoskeleton does not match their personal taste, employees will most likely not accept it. Previous research has described visibility of assistive devices as a disclosure of disability status [37]. The authors suggest to make assistive devices socially invisible by choosing a design that matches the social environment. The managers indeed discussed to design the exoskeleton in the colour of the work clothes to make it more invisible. Luggage handlers reported they would not mind to be seen with the exoskeleton. Although not entirely consistent, these findings suggest that visibility should be considered when introducing an exoskeleton in the working environment in order to improve acceptability. Even though the data cannot automatically be generalized to other working environments, we demonstrated potential benefits and challenges from the employees’ and the management perspective when introducing an exoskeleton in a working environment. Self-efficacy base scores were relatively high. Further research is needed to assess whether participants who show greater restrictions due to their low-back pain indeed show greater increase in self-efficacy when wearing a passive trunk exoskeleton. 5 Conclusion Wearing a passive spinal exoskeleton increases self-efficacy in workers with low- back pain, having a bigger effect in people with low self-efficacy. The focus group and the interview confirmed the willingness of the employees and managers to use an exoskeleton at their workplace, especially in a versatile and dynamic working environment. Managers see potential in using the exoskeleton as a preventive measure, whereas employees would only use it if suffering from low-back pain. If potential challenges, such as visibility and potential refusal are considered in the implementation strategy and acceptability can be improved by following design requirements, acceptance of a passive trunk exoskeleton would be further improved, potentially contributing to reduced risk of low-back pain. 8