Co-designing an AI-based ergonomic risk assessment system with rehabilitation professionals: A review on participatory framework

BackgroundWork-related musculoskeletal disorders remain a major source of disability and productivity loss across healthcare and rehabilitation workforces. Although ergonomic risk assessment is central to prevention strategies, traditional assessment approaches are often constrained by time pressures, workload demands, and variability in clinical interpretation. Recent advances in artificial intelligence offer new opportunities to support ergonomic risk assessment through automated and data-driven methods; however, many AI-based workplace tools fail to achieve sustained real-world adoption.ObjectiveThis paper proposes a participatory co-design framework to guide the development and implementation of artificial intelligence-based ergonomic risk assessment systems in rehabilitation and workplace settings.MethodsDrawing on principles from participatory ergonomics, occupational health, and ethical artificial intelligence, this conceptual paper outlines a structured co-design process that actively involves rehabilitation professionals and other stakeholders across all stages of system development. The framework integrates stakeholder engagement, iterative design, ethical and governance considerations, and alignment with workplace realities.ResultsThe proposed framework emphasises worker-centred design, transparency of AI-supported decision outputs, integration with rehabilitation workflows, and support for professional judgment. It provides practical guidance for translating AI-enabled ergonomic assessment technologies into realworld rehabilitation and occupational contexts.ConclusionParticipatory co-design offers a critical pathway for aligning AI innovation with professional practice, ethical standards, and sustainable adoption in ergonomic risk assessment at work.