Adaptation to a Whole-Body Powered Exoskeleton: Human-Exoskeleton Coordination During Load-Handling Tasks

Whole-body powered exoskeletons can augment human performance and reduce physical strain in occupational settings, but little is known about how users adapt to these complex devices during practical work scenarios. We compared novice and experienced users during simulated, occupationally relevant load-handling tasks. Six novice users completed exoskeleton familiarization and stationary load-handling tasks in three sessions while five experienced users performed the tasks once. Task performance, biomechanical demands, and perceived workload were compared in each novice session vs. the experienced group. Novice performance improved substantially across sessions, with task completion time reduced by nearly 50% and movement jerk by 30%. However, performance gaps still persisted in session three, compared to the experienced users. Novices also used consistently lower angular velocities (up to 52% lower) and adopted greater hip flexion throughout the sessions. In contrast, differences in shoulder flexion, muscle activity, perceived exertion, and workload diminished more rapidly, with novices approaching experienced levels by session three. Novice users adapted to using a powered exoskeleton over multiple sessions, especially in movement patterns and muscle activation, but differences in task completion time, jerk index, and angular velocities indicated that novices did not attain the skilled coordination and efficiency of experienced users after three sessions. Our results highlight the likely need for extended familiarization and training for the current powered exoskeleton design and provide baseline data for the novice learning curve in occupational settings.