Using musculoskeletal models to estimate the effects of exoskeletons on spine loads during dynamic lifting tasks:...

Occupational back-support exoskeletons (BSEs) can reduce physical demands during lifting by providing assistive torques, but their effects on spine loading are poorly understood. In this study, we used two common musculoskeletal models developed in OpenSim and the AnyBody Modeling System to estimate intervertebral joint forces (IJF) during asymmetric and symmetric lifting tasks with and without BSEs. Data from an earlier study were used, involving 18 participants who performed repetitive lowering/lifting in three task conditions and with three different BSEs (along with a control condition using no BSE). We simulated the tasks with both models and estimated axial compression and anteroposterior shear forces at the L4/L5 joint and derived peak values (95th percentile) as outcome measures. OpenSim estimated significantly larger axial compression and anteroposterior shear forces than AMS. Both models estimated reductions in spine loading when using either of the BSEs, though OpenSim estimated greater reductions than AMS. Strong positive, linear relationships (r > 0.95) between the two model estimates were found for axial compression, while much weaker and even negative relationships were observed for shear forces, especially under asymmetric conditions. The differences in model estimates were likely due to variations in model assumptions and passive tissue representations. Future research should explore more detailed human-exoskeleton interaction models, evaluate the impact of modelling assumptions on IJF estimates, and assess the agreement of these findings with in vivo measurements such as electromyography.