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Training Persons with Spinal Cord Injury to Ambulate Using a Powered Exoskeleton
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Wearing an Arm Support Exoskeleton Does Not Affect Balance but May Decrease Dynamic Stability During a Step-Down

Federico Arippa1, Alan Barr2,3, Brandon Phillips2

  • 1Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy.

Human Factors
|April 11, 2026
PubMed
Summary
This summary is machine-generated.

Arm support exoskeletons (ASEs) do not significantly impair dynamic balance during tasks like step-downs. However, they may alter stabilization strategies, particularly for individuals with lower body mass and height, warranting careful evaluation.

Keywords:
dynamic balanceoccupational exoskeletonspostural stabilityswayworker safety

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Area of Science:

  • Biomechanics and Human Factors
  • Occupational Safety and Health
  • Robotics and Wearable Technology

Background:

  • Arm support exoskeletons (ASEs) aim to reduce muscle strain in labor-intensive jobs.
  • Potential benefits include decreased fatigue, discomfort, and injury risk.
  • Concerns exist regarding the impact of ASEs on worker safety, specifically dynamic balance.

Purpose of the Study:

  • To investigate the effects of wearing ASEs on dynamic balance during dynamic tasks.
  • To assess changes in postural sway and dynamic postural stability index (DPSI) with ASE use.
  • To identify potential sex-based differences and anthropometric influences on balance performance with ASEs.

Main Methods:

  • Twenty-three healthy volunteers (7 female) performed a single-leg, step-down maneuver.
  • Dynamic balance was assessed with and without three different ASEs.
  • Measurements included postural sway parameters and the dynamic postural stability index (DPSI).

Main Results:

  • No substantial differences in sway were observed across conditions, with one minor exception.
  • The dynamic postural stability index (DPSI) significantly increased with all ASEs compared to no-ASE.
  • Females exhibited greater sway and DPSI; height and body mass were negatively correlated with balance metrics.

Conclusions:

  • ASEs do not appear to impair dynamic balance during moderately demanding tasks like step-down maneuvers.
  • ASEs may influence stabilization strategies, particularly for individuals with lower body mass and height.
  • Findings suggest cautious integration of ASEs in industrial settings, with specific attention to individual anthropometrics and task demands.