Neuromuscular and Movement Control Strategies With Soft Passive Low Back Exoskeleton Use During EMS-Specific Physical Agility Tests

Emergency Medical Technicians (EMTs) are at high risk of work-related low back injuries due to the physical demands of patient rescue and transfer operations. Despite training in proper lifting techniques and ergonomic interventions, there remains a gap in technology that can assist EMTs without hindering their movement or attention. Soft-passivelow- back exoskeletons (LBEs) are a potential solution. Previous research on LBEs has shown reduced muscular demands in the lower back, but studies have been limited to static holding or sagittal plane lifting. Our study investigates the use of a soft LBE in a dynamic work environment with physically and mentally demanding tasks, similar to those performed by EMTs. We evaluated the neuromuscular, kinematic, and subjective differences between control and exoskeleton conditions. Results indicated lowered muscular demands and improved kinematics however these benefits were task-specific. Interestingly, there was a mismatch between subjective perception of workload and effort during and after the tasks where EMTs were not able to recognize the benefits during the tasks.