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Impact of Exoskeleton Use on Perceived Effort and Pain During Resident Handling in Nursing Home Care Staff
Sponsor: LNA SANTE
Summary
The EXO 2 study assessed whether daily use of an exoskeleton - a wearable mechanical support device - could reduce physical effort and pain in nursing home care staff who regularly perform resident handling tasks such as bed baths and diaper changes. Care staff in nursing homes (EHPADs) are among the most affected workers by musculoskeletal disorders (MSDs), which are the leading cause of occupational illness and sick leave in the French healthcare sector. Handling of residents in lying positions (decubitus), such as turning, washing, or changing residents in bed, is one of the most physically demanding tasks and a major source of lower and upper back strain. The HAPO Version 4 exoskeleton is a wearable device worn around the torso that provides mechanical support to the upper body and back during forward-bending tasks. This study is part of a research program that progressively evaluated and improved the HAPO exoskeleton through four earlier phases with LNA Santé care staff. The main questions this study aimed to answer were: Does wearing the HAPO exoskeleton daily reduce the perceived effort (physical fatigue) felt in the upper body during resident handling? Does the exoskeleton reduce upper body pain (neck, shoulders, arms, back, hips) over time? How well do care staff integrate the exoskeleton into their daily work routine? Does exoskeleton use reduce workplace accidents and sick leave related to handling? What participants did: First 2 weeks (baseline): worked normally without the exoskeleton, completing a daily logbook to record pain and workload Following 11 weeks (intervention): wore the exoskeleton daily during all bed baths and resident changes in decubitus, continuing the daily logbook Completed weekly assessments of perceived effort and satisfaction with the device Were assessed at the end of the study (Day 91) with a final evaluation The study took place across 5 LNA Santé nursing homes in France and included 35 volunteer care staff members.
Official title: Impact of Daily Exoskeleton Use (HAPO Version 4) on Perceived Exertion and Musculoskeletal Health in Nursing Home Care Staff Performing Resident Handling in Decubitus: A Prospective Multicenter Observational Study (EXO 2)
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
OBSERVATIONAL
Enrollment
35
Start Date
2025-01-23
Completion Date
2025-07-01
Last Updated
2026-08-11
Healthy Volunteers
Yes
Interventions
Passive back-assist exoskeleton (HAPO Version 4)
The HAPO Version 4 is a passive (non-motorized), CE-marked, wearable exoskeleton worn around the torso, designed to provide mechanical support to the dorsal and lumbar spine during forward-bending tasks. It is individually fitted to each participant's morphology. Care staff wore the device daily during all bed baths and diaper changes performed with residents in decubitus position, throughout their working shifts (day and night), from Day 15 to Day 91 (11 weeks). Usage was voluntary on a daily basis. Exoskeleton use did not replace existing patient-handling equipment. The device was supplied and maintained by Ergo Santé (France
Locations (5)
Villa Océane
Belz, France
Résidence Marconi
Chatou, France
Les Jardins d'Olonne
Les Sables-d'Olonne, France
Résidence Creisker
Pornichet, France
Les Jardins de Leysotte
Villenave-d'Ornon, France