Saskia Baltrusch

243 Chapter 9 potential end-users and taking those into account in the next steps of the project, whether it be in designing the device, conducting studies to investigate the concerns that came up, or identifying the necessity of and requirements for an adequate implementation strategy. What is the most promising target group? The focus of this thesis was put on industry as a main potential field of application, due to the negative feedback received from healthcare professionals about implementing an exoskeleton in rehabilitation. In industry the benefits of using an exoskeleton are seen by both, employees and managers, as shown in Chapter 8. Still, employees who do not suffer from low-back pain, do not see the need to wear an exoskeleton as a preventive strategy, whereas the management stresses the importance of using an exoskeleton to prevent the occurrence of low-back pain. However, the results from Chapter 8 show that especially people with low-back pain are more open to wear an exoskeleton at work, simply to avoid the pain. This is in line with a systematic review that has shown that pain relief is an important aspect that patients expect from treatment for back pain [9]. Also Chapter 5 suggested that the SPEXOR exoskeleton might be more applicable for secondary prevention, as employees with low-back pain showed bigger effects when wearing the exoskeleton, compared to employees without low-back pain. In conclusion, the most promising target group might be employees suffering from low-back pain. Using a passive trunk exoskeleton to prevent low-back pain should, however, not be neglected, as it is important for the health of the individual employee as well as for the industry. Implications for future exoskeleton design The results reported in this thesis demonstrate the effectiveness of the design of the SPEXOR exoskeleton to reduce mechanical loading on the low-back. This is in line with biomechanical testing of the SPEXOR exoskeleton. When wearing the SPEXOR exoskeleton compression forces on the spine are reduced by 13-21% during static bending and by 11-19% during lifting [10]. Based on compressive strength data of cadaveric specimens, a reduction of 14% in compression 9