5 Exoskeleton and Exosuit Highlights from 2021 that Provide Insight on What to Expect This Year

By: | January 23, 2022

Matthew Marino is the Director of Ergonomics and Human Performance with HeroWear, LLC. Matt is an expert in exoskeleton and wearable technology design, testing, and implementation. By combining this expertise with his experience in ergonomics, human performance optimization, and rehabilitation, Matt is interested in leveraging cutting edge technology, science and methods to solve difficult problems, optimize performance, and help people pursue healthy, high-quality lives. He can be reached at [email protected].

It’s been another year for the record books.

The pandemic has altered human lives in many ways, including many workplaces. Essential workers have been forced to step up their game. Hard-working people are increasingly tired and sore. They do the best they can to hit their production demands, but many can’t keep up, others call in sick, and some just quit.

Workers are less willing to do work at the expense of their bodies and minds. The labor shortage is impacting companies and already-high turnover rates have increased across numerous industries.

To break this vicious cycle, people and companies are turning to wearable assistive technology like exoskeletons and exosuits (exos) to reduce strain, fatigue, burn out and other injuries that commonly plague workers doing physically demanding jobs.

The way people work is evolving. Exos have transitioned from Hollywood sci-fi fantasies into practical products for the real world, and they’re beginning to improve the lives of workers across the globe. Here are five exo-related highlights from 2021. 

1) The Exo Industry Matured 

While exos are not new, the exo industry is still at a very young stage.

Today’s wearable assistive technologies are designed for the same problems that inventors have been trying to solve for over 130 years.

Fortunately, it’s the 21st century and technology has finally caught up to workers’ needs. The power of computers, modern day manufacturing methods, and advanced materials make it possible to produce comfortable and assistive exos at scale, with features that the inventors of the past would have greatly envied.

Product improvement cycles that used to take years now only take months, and the results are exos that can meet the needs of workers in a wide variety of fields doing different types of tasks. 

 In late 2021 the Exoskeleton Report published an updated directory and industry statistics with 118 exo companies producing 172 different exo products across the globe. 

A little less than half (51) of these companies are making products for workplace applications. Keeping track of the companies and products was no small feat, but it was an important undertaking for tracking a maturing industry, and I am proud to assist in these efforts.  

This year also saw the global prosthetic, orthotic, and exo producer Ottobock acquire California-based SuitX. While this isn’t the first exo company acquisition, it’s a significant event. This is a sign that an industry dominated by small companies might begin to evolve, and another indication that the exo industry is maturing.

State of the art exos of today, and those of tomorrow are evolving the way people work, play, and live. It’s only a matter of time before exo technology touches everyone’s life in some way.  

2) Practical Exo Assessment Methods Emerged 

Since exos first arrived in workplaces with good intentions over 5 years ago, they’ve challenged the professionals responsible for overseeing their use.

The ergonomics and safety community, managers, leaders, and insurers have struggled to evaluate what these devices can do to benefit the workers who need them.

Many early adopters have carefully approached using exos. They’ve spent countless hours and dollars developing standards, hiring universities to perform research, and thoughtfully planning their implementation strategy.

But for exo technology to reach all the people that need them, exo evaluation must take minutes, not months.  

Back-assist exo assessment got more practical in 2021 with the publication of the first user-friendly exo-specific ergonomic assessment tool, which I was proud to help deliver.

It’s called the Exo-Lifting Fatigue Failure Tool (Exo-LiFFT), and it’s adapted from the Lifting Fatigue Failure Tool (LiFFT). LiFFT is an easy to use, scientifically validated ergonomic assessment tool that was developed by researchers at Auburn University and published in 2017.

The development of Exo-LiFFT involved collaboration between the LiFFT developers at Auburn University, researchers at Vanderbilt University, ergonomics professionals, physical therapists and exo experts.  

Practitioners can now use the same LiFFT method they’ve used for years, with an adjustment for how much torque a back-assist exo provides to estimate how much the risk for lower back injury can be reduced with the use of the device.

Simply capture a few measurements, enter them into an online calculator, and the tool estimates cumulative damage and risk for lower back injury based on epidemiological research.

Exo-LiFFT is a new tool for the ergonomics and safety toolbox to help practitioners focus their efforts on what really matters; equipping the right workers with the right solutions that improve their quality of life.  

3) Exo Standards Progress 

The ASTM F48 Committee on Exoskeletons and Exosuits, and other standards groups across the globe continue to make progress toward developing standards, test methods, and certifications for exo technology.

As a member of F48, at the time of this article I tallied 13 published ASTM standards and 24 drafts working their way through various stages of the development and balloting process covering numerous important areas of exo terminology, design, manufacturing, security, IT, performance, maintenance, disposal, innovation, research, ergonomics, human factors, safety and risk management.  

 A brand new ASTM subcommittee (F48.06 Risk Management) led by Woody Dwyer, CPE began work in 2021, and is continuing to seek participation from insurance, risk control, and legal professionals interested in contributing to the development of these important exo standards.  

 In addition to numerous safety and ergonomics standards, I helped lead the development of a standard practice for using exoskeletons for return to work (RTW) is currently making its way through the ballot process.

This standard is based on prior work done by the Washington State Department of Labor and Industries Exoskeleton Advisory Committee, a group formed and led by Rick Goggins, CPE. 

The ASTM International Exo Technology Center of Excellence (ET CoE) wrapped up a very productive year in support of standards development. The ET CoE’s annual report provides a great summary of the center’s many notable accomplishments from 2021.

These include the creation of several partnerships with groups such as the National Safety Council, LiUNA, the Human Factors and Ergonomics Society, and ongoing collaboration with the National Institute of Occupational Safety and Health (NIOSH) and the United States Army.

The ET CoE funded numerous research projects with leading universities such as Virginia Tech, Vanderbilt University, University of Michigan, Texas Tech University, and UMass Lowell which advance exo science and delivered valuable test methods and standards.  

4) Real-World Implementation Is the New Focus 

The final frontier of exo adoption is implementation. Rolling out exos across a large organization requires leadership, change management, good planning, and solid execution.

An overwhelming amount of scientific research suggests that exos have great potential to help people and reduce the risk for certain types of injuries in the workplace, especially lower back and shoulder injuries.

But like PPE, there are considerations around fit, comfort, training, and implementation that need to be managed.

Unlike PPE, and more akin to tools, there’s also more variability across individuals when it comes to how helpful exos can be, which requires a different management approach.

At this point, scientists, who for years have been focused on controlled laboratory studies, are publishing articles on the importance of taking exos out of the lab.

Testing exos in the workplace is the only way to help workers and companies get exposure to these devices, identify the best jobs and tasks, gain practical insights on their effectiveness, and better understand what it takes to implement them across an organization.  

Pilot tests are an important early step in a company’s implementation process, but endless testing with no implementation plan is a recipe for pilot paralysis. The earliest adopters of exos have taken their learnings over the past 5+ years and turned them into exo implementation programs that are repeatable, and scalable.

Over the past year more companies have realized that there’s a whole lot more that needs to go into equipping their workforce with exos than what labs can research, and they’ve shifted their focus toward real-world implementation. 

5) Risk Control and Insurance Companies Piloted Exos with Policyholders 

According to the International Association for the Study of Pain, lower back pain has been the leading cause of years lived with disability since 1990, and the burden it places on people and companies around the world has been increasing ever since.

Risk control and insurance companies are acutely aware of the costs associated with lower back pain, and other types of work-related injuries. Safety and ergonomics interventions have helped reduce injury rates and lost time, but automation and engineering controls have limits.

Frequently, these types of changes are not feasible for a variety of reasons, or they will take years of budgeting and planning to execute, leaving workers to bend, lift, reach and do physically demanding work for the foreseeable future.  

 Innovative risk control and insurance companies are looking for new solutions their policyholders can begin using now to reduce the risk for preventable work injuries, and in 2021 some of the leaders in this space conducted exo pilots in collaboration with their policyholders in industries such as manufacturing, logistics, retail, construction, and agriculture.  

 A great example of this were “learning launches” spearheaded by SAIF Corporation. HeroWear and I assisted SAIF in equipping about 40 workers with back-assist exosuits at 4 policyholders for real-world pilot experiences.

The results were recently summarized in a recorded webinar and video. SAIF shared that user acceptance of exos in these pilots depended heavily on the jobs and tasks they were used for, the presence of conflicting PPE, tools, or equipment, the fit and comfort of the devices, the work environment, and a good safety and ergonomics program (and culture) with the presence of dedicated exo implementation support staff.

The results indicated that the workers in these pilots experienced a 73% reduction in lower back discomfort, and a 30% reduction in effort at work while using the exos. 80% of the workers felt the exo could prevent lower back injuries.

The exos helped with bending and lifting at work, and the workers also appreciated being able to bring their exos home for things like stacking firewood and doing yard work. When was the last time you heard of an employee asking to take home a new piece of PPE? 

 Exos are gaining traction in the workplace, and they are even starting to become available for people to use for everyday things around the house, or out in the yard. Risk control and insurance companies, their policyholders, and workers who do physically demanding jobs stand to benefit from emerging technologies like exos.

Beyond 2021, the exo industry will continue to mature and products will continue to improve. Practical exo assessment methods and standards will continue to emerge.

Implementation of exos in the real world will continue to be a major focus, so risk control and insurance companies and their policyholders will continue to lead the way toward a future where exos help people go home from work with less pain and fatigue, and more energy to enjoy a high quality life. &

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