# Skilled Workers' Perspectives on Utilizing a Passive Shoulder Exoskeleton in Construction
## 4 Discussion
(2018) found that the EksoVest Prototype (Ekso Bionics, San Rafael, CA, USA) reduced maximum shoulder abduction by \(\sim\)10%, and 36% of plasteres who trialed the Skelex 360 found it to obstruct their movements [12; 14]. Ourparticipants suggested that exoskeletons should not restrict essential movements to their tasks because this could lead to productivity decrements. 3. **Ability to adjust the level of arm support without doffing. ** Some participants found that the exoskeleton interfered with non-overhead work. Since the exoskeleton was designed to support overhead work, it was not surprising that participants found the exoskeleton unhelpful for performing tasks below shoulder height, such as general cleanup, downward drilling, and measuring and cutting. A few participants reported needing to 'fight against' the exoskeleton during these tasks, which was more fatiguing. Workers suggested they should be able to adjust the level of arm support to match the task they are performing while wearing the exoskeleton. 4. **Compact and close-fitting design to allow for working in small spaces. ** Participants found it challenging to work in tight spaces, such as installing lights in closets or showers, framing around ducts and vents, or installing range hoods while wearing the exoskeleton. They also noted that it was inconvenient to doff the exoskeleton when switching to seated tasks (i.e., moving materials with a forklift or skid steer). Similarly, plasters in the study by [PERSON] et al. (2023) found the Skelex 360 to be a hindrance when working in smaller spaces, such as staircases and toilets [14]. Future exoskeletons should be designed to minimize obtrusiveness. 5. **Breathable materials for extended use. ** A few participants reported skin irritations where the exoskeleton's arm cuffs were secured. This was particularly evident amongst those working in warmer environments, such as outdoors during the summer or in heated worksites. Skin irritations associated with exoskeleton use have been recognized by public health agencies [32]. The participants recommended that materials used for the exoskeleton should be breathable. 6. **Mechanism to prevent debris from entering the arm cuffs. ** Workers who were cutting or drilling overhead shared that debris fell between the arm cuffs and their arms, and they had to repeatedly doff and don the arm cuff to shake out the debris. Despite the opportunities for improvement, our findings suggest that there is merit for implementing exoskeletons in construction, as over 70% of the participants found that the EXO-01 had no hindrance to their overall work performance and productivity, with over 35% reporting that the exoskeleton even enhanced their performance and productivity. Given the industry-specific benefits and drawbacks identified, we find that exoskeletons, at their current state, are most useful when the overhead task is performed for a sustained period without the need to be in tight spaces or working below shoulder height. We generated a list of tasks for which construction workers found the exoskeleton to be beneficial and not beneficial. We suggest that the use case for the exoskeleton be similar to a harness. Workers put on a harness when they will be working at heights--the harness is not worn all the time. Similarly, when workers know that they will be performing overhead work in an open area, without the need for much below-shoulder work, they would don the exoskeleton. To our knowledge, there are two other naturalistic field studies evaluating arm support exoskeletons in construction work [14; 33]. Perspectives from experienced workers offer invaluable insights into the applicability and adoptability of novel technologies. For example, findings from our study provided various use cases for engineers to consider when developing future exoskeletons for construction use. Additionally, it brings awareness to employers about the likelihood of their workers using the technology had it been provided.