## 4 Discussion
### Insights on Occupational Exoskeletons Based on the Supported Body Areas  
Based on the available information regarding upper limb support exoskeletons, there are several suggestions for the use of occupational exoskeletons in this context. Given the safety outcomes observed in the literature, it is crucial to address the weakening of trunk muscles and the potential for reduced blood flow in the arm's human-machine interface. The observed positive health outcomes, such as decreased mechanical energy, altered joint torques, and reduced muscle activity during lifting and static conditions, highlight the potential for exoskeletons to alleviate physical strain and promote better musculoskeletal health. Therefore, their use should be encouraged in tasks where repetitive or strenuous upper limb movements are involved. Overall, the use of upper limb support exoskeletons in occupational settings should be carefully implemented, with attention to safety, health benefits, task-specific performance improvements, and user comfort. Similarly, occupational exoskeletons for shoulder support appear to offer potential benefits for worker health and productivity. The studies reviewed indicate that these exoskeletons can reduce muscle load and fatigue, improve postural function, and enhance work performance. However, safety considerations for shoulder exoskeletons have not been extensively studied, so caution should be exercised when implementing these devices in the workplace. In terms of practical applications, it may be beneficial to consider implementing these exoskeletons in jobs that require repetitive or sustained overhead work, such as assembly line work or construction. It may also be useful to conduct further research to evaluate the long-term effects of using these exoskeletons, as well as to optimize their design and functionality for specific work tasks. Benefits of lower limb exoskeletons include decreased load using passive exoskeletons, increased performance in repetitive lifting tasks for healthy adults, and improved range of motion promoting stability and comfort. These exoskeletons have demonstrated potential for improving user health, reducing muscle fatigue, and enhancing performance. Further research and development are warranted to optimize the design, comfort, and usability of lower limb exoskeletons for specific occupational tasks, ensuring a safe and effective integration in the workplace. Occupational exoskeletons for whole body support have shown potential in improving user health by reducing muscle fatigue and metabolic demand. Based on the information provided, it is suggested to consider the application of occupational exoskeletons for whole body support in tasks that involve extended periods of physically demanding work or repetitive movements. Further research and development efforts are necessary to evaluate the impact of whole-body exoskeletons on performance metrics and to ensure their compatibility with various occupational tasks. Additionally, it is recommended to conduct user evaluations to assess the usability, comfort, and acceptance of these exoskeletons in real-world work environments. Regarding back support exoskeletons, the negative results outlined in the investigated studies can be attributed to the adverse effects of using exoskeletons with high external forces on walking energy and fall risk. Exoskeletons that effectively reduce loads on the spine while minimizing constraints on natural movements have demonstrated potential for improving user health and productivity. The improvements observed were attributed to significant reductions in loads on passive tissues of the curved spine, without significantly increasing loads on the hip, knee, and ankle joints. Additionally, reductions in average peak and muscle activation of back and leg muscles were observed during MMH.