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Review

A Review of Potential Exoskeletons for the Prevention of Work-Related Musculoskeletal Disorders in Agriculture

by
Sanura Dunu Arachchige
*,
Lasitha Piyathilaka
,
Jung-Hoon Sul
and
D. M. G. Preethichandra
*
School of Engineering and Technology, Central Queensland University, Rockhampton, QLD 4701, Australia
*
Authors to whom correspondence should be addressed.
Sensors 2024, 24(21), 7026; https://doi.org/10.3390/s24217026
Submission received: 9 October 2024 / Revised: 28 October 2024 / Accepted: 29 October 2024 / Published: 31 October 2024
(This article belongs to the Special Issue Sensors and Robotic Systems for Agriculture Applications)
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Abstract

:
Exoskeletons possess a high potential for assisting the human workforce while eliminating or reducing the risk of Work-Related Musculoskeletal Disorders (WMSDs). However, their usage in agricultural work, where there is a plethora of reported WMSD cases, seems limited. Since agricultural tasks are complex and performed in harsh environments, developing novel exoskeleton-based solutions could be challenging. However, commercial exoskeletons are already being used in various other industries, such as logistics, military, medicine, and manufacturing. Thus, it is expected that those existing exoskeleton solutions could be applied to agricultural tasks. Nevertheless, prior to implementation, assessing the feasibility, efficacy, and necessary modifications for these exoskeletons is imperative to supporting agricultural activities prone to WMSDs. In this review, prevalent exoskeletons documented in scientific literature are identified, and their potential relevance to agricultural tasks with elevated WMSD risks is evaluated. The review further highlights and deliberates on exoskeletons that could be applicable in an agricultural context. This comprehensive examination serves as a foundational step towards the conceptualization and development of exoskeleton-based approaches tailored explicitly for agricultural tasks.

1. Introduction

Work-Related Musculoskeletal Disorders (WMSDs) significantly affect the present labor force, especially in labor-intensive industries such as agriculture [1,2,3,4,5]. In previous research, numerous investigations on WMSDs related to agriculture have found the causes, effects, and a few solutions for injury prevention [1,2,6,7,8,9,10,11,12,13,14]. However, the outcomes of these studies are yet to be seen in the agricultural sector. Exoskeleton technology has been assisting human workers for more than a century and has a high potential for reducing or eliminating the risk of WMSDs. The first recorded (patented) exoskeleton was introduced in 1890 [15], and the field has consistently progressed since then to commercially available exoskeletons that are actively used in various industries [16,17,18,19,20,21,22,23,24,25,26,27,28]. Even though there is a handful of exoskeletons in experimental stages, which have a high potential for agricultural tasks [29,30,31,32], surprisingly, there are no industrial-level/real-world applications of exoskeletons in agriculture, where there is a high need for such solutions. It is evident that agricultural industries in developing countries, where small-scale farming is the dominant sector in agricultural production [33], rely heavily on human labor [11,33,34,35,36,37,38,39,40]. On the other hand, developed nations, which are the primary contributors to exoskeleton research, focus more on automation in their large-scale agriculture. Therefore, the trend of exoskeleton research has focused on other industries, such as military, manufacturing, and dependent-care industries, rather than the agricultural sector [16,17,18,19,20,21,22,23,24,25,26,27,28].
Since agricultural tasks involve complex motions and harsh environments, developing an exoskeleton specifically for the agricultural sector would be highly challenging. Hence, it would be prudent to prioritize an investigation into the feasibility of utilizing existing exoskeletons rather than embarking on the development of an entirely new design from the ground up. The first part of this study aims to explore exoskeletons used in various other industries that have the potential to be used in agricultural activities. It is expected that the introduction of exoskeleton technology to agriculture would reduce the WMSD risks involved in agriculture, making the industry efficient and safe. It is important to conduct a comprehensive review of both exoskeleton technologies (active and passive) and the specific needs of agricultural tasks, which is performed in this study. This critical review of the existing exoskeletons enables the evaluation of their effectiveness across various agricultural tasks.
This review will commence with an in-depth exploration of Work-Related Musculoskeletal Disorders (WMSDs). Then, the latest exoskeleton developments found in recent publications are discussed and summarized. Subsequently, the applicable exoskeletons to agriculture are sorted. Finally, challenges, considerations, and ethical factors are discussed.

1.1. Aim

The aim of this review is to identify and suggest available exoskeletons that have the potential to assist agricultural work in reducing or eliminating the risks of work-related musculoskeletal disorders.

1.2. Objectives

The objectives of this study are to,
  • Identify agricultural tasks that cause risks for WMSDs.
  • Identify different exoskeletons in various other industries, which are designed to support tasks similar to agricultural tasks with risks of WMSDs in agriculture.
  • Identify characteristics of exoskeletons that are suitable for agricultural tasks.

2. Materials and Methods

Literature searches were carried out in two categories. Initially, a search was performed to find literature related to work-related musculoskeletal disorders in various recognized databases, including DOAJ, Gale Academic, IEEE Xplore, JSTOR, ProQuest, PubMed, SpringerLink, Science Direct, Wiley, and Taylor & Francis. The keywords for this search were “WMSD” and “Agriculture”. This search criteria included the language (English), peer-reviewed status, publication years (2000–2023), and online availability. Initially, 119 papers were found, which were then screened based on their titles, abstracts, and relevance to agriculture. Then, they were narrowed down to 23 papers by the authors. A thorough reading of these 23 papers was conducted by the authors, who identified countries and regions where the WMSDs were reported, the reasons for WMSDs (activities and tasks), and current solutions. Finally, 22 papers were selected for citation, as illustrated in Figure 1a.
The same procedure was used to find literature related to exoskeletons. The aforementioned databases were searched using the keywords “robotic exoskeletons” and “agriculture”. A total of 287 articles written in English, peer-reviewed, online available, and published between 2008 and 2023 were found. The reason for selecting this 15-year period is based on the identified exoskeleton-related scientific literature production trends [34]) that were identified. After filtering based on their titles and abstracts, 51 papers remained. Following a thorough reading of these 51 papers by the authors to identify exoskeletons that are fabricated and at least tested in a laboratory environment and not specifically designed for rehabilitation, 48 papers were selected for citation in this review, as shown in Figure 1b.

3. WMSDs and Related Agricultural Tasks

WMSDs arise when muscles, tendons, nerves, or joints experience repeated stress and trauma over days, months, or years, leading to tissue damage and injury [35,36,37]. When human workers are involved in repetitive tasks, awkward postures, heavy lifting, prolonged static postures, and/or climbing (trees, ladders, walls, etc.) that strain their musculoskeletal system, they are susceptible to frequent work-related injuries. The aforementioned activities that put workers at risk of work-related injuries are commonly observed in labor-intensive fields such as manufacturing, agriculture, and logistics [38]. While WMSDs in the agricultural sector are very common [39,40,41,42,43], there have been only a handful of solutions proposed by previous research works to mitigate them [15,44]. The most prominent solution found in the literature for reducing the risks associated with agricultural tasks is correcting postures [3,4]. However, changing traditional practices and habits can be challenging and need wide-scale awareness programs. Therefore, novel solutions such as exoskeletons can be sought.
WMSDs can cause both short-term and long-term damage to agricultural workers. In the short term, these will affect their performance and cause discomfort in both daily activities and agricultural tasks [45,46,47]. In the long term, these can cause devastating effects on workers’ bodies, causing them to be permanently injured/disabled and ultimately lose their jobs [37,48,49]. WMSDs can occur in various locations in a human body, either in a single location or multiple locations simultaneously [50]. Scientific literature depicts that the effects of WMSDs could be observed on regions such as the neck, shoulders, upper/lower back, hands/wrists, elbows, hips/thighs, knees, and feet/ankles, which can be identified by human anatomy, as shown in Figure 2. These WMSDs can be caused by a range of factors, including repetitive motions, awkward postures, prolonged work duration, handling heavy physical loads (lifting), bending, climbing, reaching, and twisting [1,2,7,11,12,14,46,50,51,52,53,54,55,56,57,58,59].
Agricultural tasks can be divided into several main categories: ground preparation, planting, weeding, pesticide or insecticide spraying, fertilizing, pruning, harvesting, sorting, and forestry operations [36,37,39,40,45,47,60,61], some of which are depicted in Figure 3. All these tasks involve activities that have a high probability of causing WMSDs. Crops are listed in Table 1 with their associated tasks and the probable causes of WMSDs as identified in the literature. When considering the affected areas of the human body, it is evident that the main activities identified in agriculture affect different body parts with varying degrees of severity [43,62,63,64,65]. This is primarily due to the compound and complex motions involved in agricultural activities [66,67]. Therefore, it is vital to propose practical solutions that can be applied to individual tasks.

4. Exoskeleton Technology

The concept of modern exoskeletons is closely related to robotics, and thus, they are identified as robotic exoskeletons. Researchers have been involved in this field for a considerable amount of time and have developed new technologies. According to Romero et al. [79], “Exoskeletons are cyber-physical systems with human-machine interfaces which allow humans to build human-automation symbiosis work systems”. However, a simpler explanation of exoskeletons is that they are “super suits or systems that expand or augment a person’s physical abilities” [80]. Wearable exoskeletal implementations mainly focus on reducing the disadvantages associated with manual labor, such as the high risk of WMSDs and physical stress on human workers, enabling safe, efficient, and effective task completion [79]. One of the main objectives in designing an exoskeleton is to reduce the risks of WMSDs by taking off part of the physical stress act on human workers.
Exoskeletons keep the human operator in control [81], making them highly suitable for application in complex agricultural tasks. Exoskeletons can be categorized in various ways [82,83]. Firstly, exoskeletons can be classified based on their activation method. They can be active, requiring a separate power source to actuate, or passive, not requiring a separate power source to actuate. Secondly, exoskeletons can be categorized according to the targeted area of the human body they support [82]. These exoskeletons primarily aim to support major joints or muscles in the human body, such as the shoulder, elbow, upper back, lower back, hips, fingers, wrists, elbows, and knees [82,83]. In addition, exoskeletons can selectively support specific human movements, such as standing, walking, bending, or overhead work [82,84]. Over time, the development of exoskeletons has become industry-specific. Therefore, they can also be categorized based on the intended industry they serve. Military, medical, manufacturing, and eldercare are among the notable industries where modern exoskeletons are focused on assisting [83]. However, in this review, rehabilitation, surgical, and medical-related exoskeletons are excluded as the authors believe that their target task and operational environments do not align with the requirements of agriculture.
When considering active exoskeletons, the majority of them utilize motors as their primary actuators [17,30,85,86,87,88,89,90,91,92,93,94,95,96,97,98]. These motors can provide precision control, enabling better assistive motion capabilities, while hydraulic and pneumatic actuators have also been used in certain heavy-duty applications [30,86,90,91,93]. Active exoskeletons are equipped with additional motion sensors and advanced control systems for real-time controls, and thus they can assist humans with a more “natural sensation”. However, this may lead to dependency on it and overconfidence, increasing the risk of injuries [99,100]. Another significant drawback of active exoskeletons is the operational time. As active exoskeletons depend on a power source, usually a battery, their work duration is limited, which is not desired by agricultural operations. Further, additional challenges have been raised in the maintenance of active skeletons owing to their complex mechanism that may not be favorable in relatively harsh agricultural working conditions [101]. Agricultural work commonly takes place in wet environments, such as the cultivation of rice [40,62], which poses electrical hazards for active exoskeletons. High daytime temperatures of open agricultural land can adversely affect the operation of complex active exoskeletons [40,56]. Moreover, financial burdens arising from expensive electronics in active exoskeletons make them unaffordable for underprivileged or financially strained agricultural workers.
On the other hand, passive exoskeletons have a clear potential to assist agricultural tasks in real-world situations, overcoming the disadvantages of active exoskeletons, such as complexity and operational time [102]. These passive exoskeletons primarily employ elastic fabric materials [9,20,21,23,28,103,104,105,106,107,108,109,110,111] or spring damper systems [20,31,32,103,112] as their main passive assistive element. Hence, their main advantages are simple maintenance and operation without limitations on work duration [18,21,24] or risk of electrocution. When considering the maintenance, it can be identified that most of these passive exoskeletons will only require a change to the passive element. Unlike an active exoskeleton, it will not require any specific knowledge or skill, and thus, it would be much easier for agricultural workers to maintain passive exoskeletons. Fabric-based passive exoskeletons are well suited for agricultural tasks as they allow considerable freedom of movement for the wearer, and they are simple and easy to wear (no rigid components [9,23,105,106,107,108]. However, fine-tuning and precision controls could be compromised due to the use of mechanical systems. Also, passive exoskeletons may not support complex motions or facilitate multiple tasks due to their inherent construction limitations, and a lack of a real-time closed-loop control system. Moreover, a rigid exoskeleton (specifically the ones with spring damper systems) might limit the free motion of the wearing worker and add additional weight to them [99].
Exoskeletons designed for other industries or tasks other than agriculture may require significant modifications and extensive testing before applying them to agricultural applications. As an example, exoskeletons developed for military purposes often tend to be too bulky and impractical for simple agricultural tasks [113]. Furthermore, human power amplifying exoskeletons such as the Human Universal Load Carrier (HULC) [30,93] would not be suitable for agricultural activities as these are complex and bulky. Cutting-edge solutions like augmentative controlled robots with the assistance of exoskeletons [94] could be excessive for relatively simple agricultural tasks. Exoskeletons developed for various industries to support related tasks are listed in Table 2.

5. Findings, Challenges, and Considerations

Since the potential causes of WMSDs in agriculture and the various potential exoskeletons have been explored, it is now vital to evaluate the capability of these exoskeletons to assist agricultural workers during the identified labor-intensive tasks. This evaluation can be carried out by considering the specific areas and motions targeted to be supported by the exoskeletons and their impact on the human body during agricultural activities. Most of these exoskeletons were not originally developed for the agricultural industry and are still in the research stage with ongoing efforts to optimize their performance [31,32,89,90,91,92,95,96,105,106,107,109,110,111,112,116,123]. Amongst the identified agricultural tasks, lifting tasks can be directly supported by exoskeletons as the design of several exoskeletons was aimed specifically for this purpose [9,17,20,23,25,30,88,92,94,98,103,105,106,107,108,109,110,111,112,114,122]. It is clear that the best solution for overcoming the risks of WMSDs is to have correct postures [3,4]. As exoskeletons provide a rigid frame, it is possible to use that frame to prevent workers from working in incorrect postures. Repetitive tasks can also take advantage of these exoskeletons as they absorb partial loads from the musculoskeletal system [28,104]. Most importantly, tasks that involve a static posture along with repetitive or random motions should have the most advantages from these investigated exoskeletons. While there may not be clear innovations for tasks involving climbing, reaching, and twisting motions [39,47,52,54,62], an exoskeletal attachment at the end of an agricultural worker’s hand could eliminate the risks associated with reaching and twisting in the wrist.
Several key factors need to be considered to identify suitable exoskeletons for agriculture. Active exoskeletons may not be the best solution, as was discussed in the literature review section. Similarly, hydraulic and pneumatic exoskeletons may be unsuitable as they tend to be bulky and complex for simpler agricultural tasks. Further, active military exoskeletons designed for robustness are not practical for basic agricultural tasks. The exoskeletons at the conceptual level cannot be used until they are fabricated and field-tested properly. Moreover, full-body exoskeletons [40,56,99,100,101] and augmentation-based exo-robots [94] are not suitable for agricultural tasks as they are extremely expensive, impractical, complex, and bulky. After considering the factors discussed above, Table 3 summarizes the potential exoskeletons that can assist in agricultural tasks.
Notably, most of the exoskeletons aimed at supporting upper limbs are able to support agricultural tasks such as hand picking, stick harvesting, pruning, and overhead tasks. It is observed that upper limb exoskeletons are primarily designed to support static postural tasks such as gravity compensation [127]. Agricultural tasks that involve upper limb activities often require repetitive motions. Thus, the applicability of the suggested exoskeletons needs to be assessed for repetitive task assistance. On the other hand, exoskeletons supporting the back, knees, and lower limbs listed in Table 3 can support lifting tasks common in agriculture. When it comes to tasks with back flexion, it could cause a higher degree of postural errors. However, exoskeletons partially absorb tensions in the musculoskeletal system, resulting in a reduced risk of WMSDs [18,21,22,24,31,32,103,114,115,125]. However, the use of exoskeletons to support back flexion requires systematic evaluation as it has not been performed in scientific literature. This is because their assistive method (elastics, spring loads, etc.) might cause more strain on the already exhausted muscles.
Most of the commercially available exoskeletons [9,18,19,21,22,23,24,25,26,27,32,103,105,106,108,114,115,117,120,122,125,128] found in this review can be recommended for agricultural tasks. However, a few of the commercially available exoskeletons lacked detailed information on their operational duration, maintenance, and costs, leading to their exclusion from the final recommendation. The main body parts supported by the filtered exoskeletons in Table 3 are either the back [9,20,23,25,103,105,106,107,108,109,110,114,122,126] or upper limb [18,19,21,22,24,27,29,31,32,103,111,114,115,117,120,125], targeting overhead and lifting tasks [18,19,21,22,24,27,29,31,32,103,111,114,115,117,120,125]. While there are similarities between areas in the human body/specific tasks that exoskeletons are targeted for supporting and areas in the human body/specific tasks in agriculture that are high in potential for causing WMSDs, the complexity of work requirements in agriculture varies significantly. Specifically, overhead-supporting exoskeletons are designed to support the shoulder joint for postures where the hands are held statically at or above shoulder level [18,21,22,103,115,125]. Overhead agricultural tasks often require repetitive shoulder motion [39,47,48,62,63,65,74,129]. Hence, these suggested upper limb-supporting exoskeletons need thorough evaluation before applying in a dynamic agricultural environment. The back supporting exoskeletons, on the other hand, tend to support lifting tasks [9,20,23,25,103,105,106,107,108,109,110,114,122,126], which align with agricultural needs. However, agricultural workers require assistance more on tasks involving bending or leaning forward postures [39,43,52,54,56,62,64,74,75,76]. The suggested, existing exoskeletal solutions have the potential to assist the above-mentioned back flexion tasks. There is still a possibility of having negative impacts because agricultural tasks involve motions such as twisting and holding in various back flexed postures, which exoskeletons are not designed for [7,45,51,53]. Unlike other industries, such as manufacturing and logistics, for which the current exoskeletons are primarily designed, the agricultural field demands support for more dynamic motions in its activities. However, there are a few exoskeletons that can support dynamic movements, such as “Three-layer Fabric Mechanism and Assistive Suit” [98] and some commercial ones [16,18,20,23,24]. Nonetheless, the majority of existing exoskeletons may not satisfy all the support requirements arising from complex and various motions that vary with different crops and regions. Thus, there are ample opportunities for researchers to develop novel solutions that can be of help to different agricultural tasks. It is possible to use existing/commercially available solutions and further develop them to achieve better results [9,21,22,23,25,31,32,94,96,97,98,99,118,119].
In consideration of applicability and suitability, agricultural tasks can be assisted by most of the commercially available passive exoskeletons (Figure 4). These passive exoskeletons are mostly lightweight as they do not have active equipment such as electric motors, batteries, hydraulic actuators, or pneumatic actuators. Therefore, the additional weight on a laborer is minimal; thus long duration of fatigueless operation is possible [9,18,19,21,22,23,24,25,26,27,32,103,105,106,108,114,115,117,120,122,125,128].
Additionally, most of the commercially available passive exoskeletons have flexible or semi-flexible, non-rigid structures [9,18,19,21,22,23,24,25,26,27,32,103,105,106,108,114,115,117,120,122,125,128]. Hence, their user can easily wear and use the exoskeleton without limiting the free motion capability, which is vital for working in agricultural fields. Also, all the commercially developed exoskeletons have a comprehensive user manual in which manufacturers have given all the necessary information on how to use, repair, and service the equipment [16,18,19,20,21,23,24,25,26,27,28]. In many cases, manufacturers are willing to provide the necessary training required for the use of the exoskeleton; thus, it will allow the workers to have a proper understanding of the machine, how to use it, and what to do with it.
While several promising exoskeletons are currently under development in the research stage [29,31,32,107,109,110,111,126,130], the lack of information and real-world testing poses a challenge in recommending these to the agricultural industry. Customizing the current exoskeleton may raise another issue related to the affordability of the exoskeletons for agriculture. The modification of already expensive exoskeletons to meet the needs of agricultural activities may add an additional financial burden to economically disadvantaged countries in which numerous WMSDs and associated cases are reported [11,39,43,48,52,54,57,62,64,65,70,71,73,74,77,129].
The review reveals that the majority of agricultural tasks related WMSDs have been reported from South and South East Asian countries [11,39,43,48,52,54,57,62,64,65,70,71,73,74,77,129], whereas exoskeleton research is driven by countries in East Asian, North American, and European regions for non-agricultural tasks [9,18,19,20,22,23,24,25,27,29,31,32,103,108,111,114,115,117,120,122,125,131]. Ironically, developing countries have faced more WMSDs in their agriculture industry, while developed countries are pioneering exoskeleton development. In this case, this mismatch of WMSD perseverance and exoskeleton development seemingly has not assisted the countries and regions that require proper help.
In the majority of the exoskeleton designs and developments, it appears that a crucial aspect has been neglected as researchers have prioritized mimicking human anatomy [132,133]. Given that exoskeletons are wearable, human-in-the-loop devices, it is imperative to integrate human perspectives considering both the mental and physical aspects [10,134,135]. When considering physical aspects, an exoskeleton should not be heavy, bulky, or limit the worker’s mobility and motion. Also, it must be easy to use without worrying about work durations, electric shocks, and other mobility-related hazards such as excessive joint actuation [5,84,113]. Most importantly, exoskeletons should be able to be worn easily and increase the efficiency of the worker. Therefore, it is worth noting that exoskeletons constructed with fabric/elastic materials are more suitable for agricultural tasks, mainly due to their ability to simplify the work process. They are easy to wear and remove, lightweight, and offer a comfortable fit. On the other hand, the psychological effects of using exoskeletons need to be considered. According to surveys found in the literature [99,133], the perception of workers on exoskeletons is not positive. Workers seem to have doubts about the risks involved while using exoskeletons, specifically risks with misalignments, unintended motion, user errors, skin injuries, vibrations, and electrical faults [99]. On the other hand, it can be observed that workers feel threatened or insecure about their jobs because of exoskeletons [133]. Thus, the introduction process of exoskeletal solutions for any workplace would require a very well-planned process.
According to the literature survey on WMSDs, it is evident that there are numerous reports of agriculture-related WMSDs from different regions of the world. A subset of these studies revealed that harvesting tasks are responsible for the majority (51.9%) of the WMSDs [30,94,97]. Also, according to the findings, tasks involving a stooping posture are repetitive in nature and are the main causes of WMSDs, and most of the time, both of those can be observed in the majority of agricultural tasks. In order to enhance the agricultural industry and the wellbeing of workers, it is of utmost importance to implement efficient intervention measures.
When considering the exoskeletons in Table 3 with high potential for assisting agricultural workers, a few key patterns can be recognized. Most of the commercially available upper limb exoskeletons seem to follow a similar design. A rigid frame with a passive actuator is used to translate upper limb loads to hips to provide assistance to the shoulders. All the exoskeletons have focused on providing a maximum range of motion to the shoulder joints, too. Moreover, manufacturers are actively trying to lower the weight of these exoskeletons to minimize user discomfort. Some of the exoskeletons, such as H-Vex [22,115] and ShoulderX by Suitx [27,117], also provide additional neck support, which is an additional advantage when performing overhead tasks. Most upper limb exoskeletons, including those still in the research phase, consider user fit, too. Each of these upper limb exoskeletons offers some degree of customization to ensure a proper fit for the user. A pole-harvesting support exoskeleton [29], the only agricultural task-focused exoskeleton, appears to be relatively heavy as it is still in the early stage of development.
Back support exoskeletons have similar trends to the upper limb exoskeletons. All the commercial exoskeletons adopted a similar design language (Figure 4 b, c, and d). These are designed to be worn over the shoulders at the back and connect to the thighs. According to the manufacturers, these exoskeletons are able to provide a considerable amount of support while performing lifting tasks, making them high potential for similar agricultural tasks. Fabric-based back exoskeletons, such as the three-layer Fabric Mechanism, Assistive Suit [107], Industrial Passive Waist-assistant Exoskeleton IPWE) [126] and carbon fiber composite link-based VT-Lowe’s Exoskeleton [109,110] do not provide technical specifications to compare with commercially available exoskeletons, although they have performed exceptionally well in experiments.

6. Regulatory and Ethical Considerations

Due to their direct interaction with human laborers, rigorous regulations and ethical considerations are required for using exoskeletons. Some research is dedicated to exploring ethical, social, legal, and safety factors [132,133,135,136,137], whereby the necessity of regulatory frameworks is identified for this field. Since most exoskeletons are still in the research stage, commercial adoption is not wide-spread. Therefore, the development of legal regulations and ethical considerations is pertinent and timely. These ethical considerations should arise from the initial phase of the exoskeleton design, and consent must be sought from all involved parties before human data can be collected. In addition, it is essential to convey that humans retain control over activities during the use of exoskeletons. Existing standards by the International Organization for Standardization (ISO), such as ISO 13482:2014, should be considered when developing and implementing exoskeleton-based solutions in the real world [127].
Currently, there are no legal and/or standardized regulations for exoskeleton developments or use cases. Thus, researchers must actively seek the perspectives of stakeholders and end-users to ensure usability, safety, and acceptability when developing an exoskeleton, thereby upholding the significance of existing human factors. With the commercial application of exoskeletons in agriculture or any other industry, the workplace dynamics may change, and it is required to continuously re-evaluate working conditions such as work time, rest interval, personal protective equipment, workload distribution, maintenance protocols, and hazard management.

7. Future Trends and Supporting Technologies for the Development of Exoskeletons for Agriculture

Developing an exoskeleton is a tedious and long process. Most of the exoskeletons presented in this paper have been through a few iterations to achieve their intended assistive motions and supports. Based on the current development, passive exoskeletons are mostly suited for agricultural tasks. However, this does not imply that active exoskeletons are out of consideration. With the development and advancement of electronics and battery technology, it is possible to develop light power actuators and high-capacity batteries that remove the major hurdle of active exoskeletons, such as limited operational time and their weight.
However, novel low-power, highly efficient, and modular-active actuators are being developed [34,138,139,140,141,142]. Specifically, hydraulic actuators, as described in [138], have a high potential to support static postural tasks seen in agriculture with minimal power consumption. Cluch-based actuation of the spring in a knee exoskeleton, as presented in [140], is another novel invention for exoskeletons. This enables sophisticated support for the user only when needed without the user’s involvement. Soft actuators are another emerging type that can further enhance exoskeletons for agricultural tasks [143]. Soft actuators are generally light and flexible, making exoskeletons equipped with these actuators suitable for complex agricultural movements. Thus, further developments in soft actuators will introduce more variety of exoskeletons in agriculture.
One of the main overlooked areas when considering exoskeletons is the sensors that can be used to either test or control exoskeletons. Although passive exoskeletons, which are ideal for agricultural tasks, are not equipped with built-in control sensors, most passive exoskeletons were developed and tested with Electromyography (EMG) sensors. Accurate EMG signals can reflect the true effects of an exoskeleton on a human body. On the other hand, camera-based motion capture systems play a major role in developing exoskeletons. These systems are able to capture human motion for further analysis. Specifically, these motion capture systems are essential in developing exoskeletons for complex agricultural tasks. Inertial measurement unit (IMU) sensors combined with camera-based motion capture systems provide highly accurate motion data, allowing their user to analyze motions more precisely [34]. Encoders are another important sensor that can be used to control and test exoskeletons. If an active exoskeleton is used for an agricultural task, these sensors will provide precise joint angles so that the actuator can provide the necessary support. Strain and pressure sensors could provide load-related data, making it possible for the exoskeleton to provide necessary supportive forces to the user [34].

8. Conclusions and Outlook

WMSDs in agriculture are a global concern demanding immediate attention. To this date, most global food producers still rely heavily on human labor for their agricultural operations. Consequently, the effects of WMSDs hold a potential risk for the global labor force and food production. Despite the emergence of fully autonomous machinery designed to replace human labor, they are still in the preliminary phase of implementation and, thus, are not yet viable for real-world agricultural tasks. Under these circumstances, exoskeletons have been identified as promising candidates for providing a human-centered, easy-to-use, and practical solution for reducing WMSD-related risks in agriculture. Particularly, this study reveals that fabric-based passive exoskeletons are effective and economical in supporting various agricultural activities that involve shoulder motion, bending, stooping, and kneeling. These types of exoskeletons are designed to support major joints and muscles used in agricultural tasks while reducing the risk of WMSDs without interfering with the dynamic motions of agricultural workers. The existing exoskeletons designed for other industries were reviewed in this study to investigate their suitability for agricultural applications. Most current exoskeletons, which are not specifically developed for agricultural tasks, need to be further evaluated, modified, and field-tested prior to wide-spread adoption. Moreover, agricultural countries that are heavily reliant on human labor should focus more on developing their own assistive solutions. Otherwise, these countries may have to use existing exoskeletons from developed countries, which may be unaffordable. Developing their exoskeletal solutions should allow these countries to develop solutions that can be specific to their agricultural tasks and environments, and hence, more effective implementations can be attained.

Author Contributions

S.D.A.: Conceptualization, investigation, methodology, project administration, Writing—original draft. L.P.: Supervising, conceptualization, project administration, writing—reviewing and editing. J.-H.S.: Supervising, conceptualization, project administration, writing—reviewing and editing. D.M.G.P.: Supervising, conceptualization, project administration, writing—reviewing and editing. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Data Availability Statement

No new data were created or analyzed in this study. Data sharing is not applicable to this article.

Acknowledgments

Authors would like to acknowledge “CQU and Kevin Greenwood Bequest Elevate Stipend Scholarship and International Excellence Award”.

Conflicts of Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Figure 1. (a) WMSD-related literature selection criteria; (b) Exoskeleton-related literature selection criteria.
Figure 1. (a) WMSD-related literature selection criteria; (b) Exoskeleton-related literature selection criteria.
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Figure 2. WMSD-occurring regions categorized anatomically.
Figure 2. WMSD-occurring regions categorized anatomically.
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Figure 3. Typical agricultural tasks: (a) Manual pruning (reproduced under CC By 4) [47]; (b) Manual apple harvesting (reproduced with permission) [67]; (c) Manual mango harvesting with a pole (reproduced under CC By 4) [57]; (d) Manual rice harvesting [68]; (e) Manual rubber harvesting (reproduced under CC By 4) [64].
Figure 3. Typical agricultural tasks: (a) Manual pruning (reproduced under CC By 4) [47]; (b) Manual apple harvesting (reproduced with permission) [67]; (c) Manual mango harvesting with a pole (reproduced under CC By 4) [57]; (d) Manual rice harvesting [68]; (e) Manual rubber harvesting (reproduced under CC By 4) [64].
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Figure 4. Commercially available exoskeletons (a) Levitate Exoskeleton [28,104]; (b) Herowear [20,103]; (c) Laevo V2.57 [9,23,108]; (d) Auxivo Lift Suit [16,105,106]; (e) H-Vex [22,115]; (f) Skelex 360 [24,114] (pictures courtesy of respective manufacturers).
Figure 4. Commercially available exoskeletons (a) Levitate Exoskeleton [28,104]; (b) Herowear [20,103]; (c) Laevo V2.57 [9,23,108]; (d) Auxivo Lift Suit [16,105,106]; (e) H-Vex [22,115]; (f) Skelex 360 [24,114] (pictures courtesy of respective manufacturers).
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Table 1. Main agricultural tasks and WMSD possibilities.
Table 1. Main agricultural tasks and WMSD possibilities.
Agricultural TaskCropProbable WMSD Causes Affected Area of the BodyReference
Ground PreparationRiceAwkward Postures, Heavy Lifting, Repetitive Motion Neck, Shoulder, Spine [39,40]
PotatoRepetitive Motion, Awkward PosturesBack, Upper Limbs[41]
PlantingPineappleProlonged and Repetitive Awkward PosturesBack, Upper Limbs, Lower Limbs[42,43]
RiceAwkward Posture (bend and work), Repetitive MotionKnees, Back, Neck, Wrist[39,62]
PotatoAwkward Posture (bend and work), Repetitive MotionBack, Neck, Knees[41]
Weeding/Pesticide or Insecticide Spraying/Fertilization/PruningPineappleAwkward PosturesBack, Lower Limbs[42]
RiceAwkward Posture (Manual Weeding), Upper Limbs (Shoulder), Lower Limbs, Back, Wrist, Neck[39]
Repetitive Motion (pesticide and weedicide spraying)Upper Limbs (Wrist), Back, Lower Limbs
PeachClimbing, Awkward Posture, Repetitive Motion (Pruning)Back, Upper Limbs (Wrist, Fingers)[47]
Repetitive Motion (Pesticide Spraying)Upper Limbs, Back, and Lower Limbs
GrapeRepetitive Motion, Awkward Posture (Pruning)Upper Limbs (Wrist, Fingers)[69]
HarvestingRiceAwkward Posture (bend and work), Repetitive Motion (trunk twisting, cutting by hands), Heavy Load Lifting (moving the harvest around)Neck, Trunk, Shoulder, Upper and Lower Back, Knees[39,54,62]
RubberAwkward Posture (squatting, kneeling), Prolonged Standing, Heavy Lifting, Long Duration of WorkBack, Lower Limbs[64]
MangoAwkward Posture, Repetitive Motion (harvesting with a pole)Upper Limbs (shoulder), Lower Back, Upper Back[57]
Oil PalmRepetitive Motion, Awkward Posture (harvesting with a pole)Upper Limbs, Lower Back, Upper Back[70,71]
GrapeProlonged Statical Posture, Repetitive MotionUpper Limbs (shoulder, wrist, fingers)[72]
AppleAwkward Posture, RepetitionLumbar, Knee, Shoulder, Neck[57,73]
CoffeeAwkward Posture and Loading Conditions, Prolonged Work DurationBack, Shoulders, Wrist, Fingers[74]
Cauliflower, Broccoli, Iceberg, StrawberryAwkward Posture (bend and work), RepetitionBack, Wrist, Fingers[75]
SugarcaneRepetitive Motion, Heavy and Awkward LiftingBack, Upper Limbs[52]
Lychee-LonganClimbing, Reaching, Repetitive Motion, Upper Limbs (wrist, hand, fingers, shoulder), Neck[76]
PeachClimbing, Static Awkward PosturesUpper Limbs[47]
Sweet PotatoesAwkward Posture (bend and work), Prolonged Work Duration, Repetitive MotionBack, Upper Limbs, Lower Limbs[56]
PineappleAwkward Postures (bend and work), Heavy LiftingLower Back, Knee[43]
SortingMangoRepetitive MotionShoulder, Wrist, Elbow[57]
HazelnutRepetitive Motion, Shoulder, Wrist, Elbow[65]
RiceAwkward Posture (bend forward, knees bent, neck bent), Repetitive Motion (upper limbs)Back, Knees, Upper Limbs[39]
PeachStatic Awkward Postures (squatting, kneeling or sitting low)Knees, Lower Back[47]
Forestry OperationsN/ARepetitive Motion, Heavy Lifting, Awkward PosturesWhole body[76,77,78]
Table 2. Summary of exoskeletons found in literature.
Table 2. Summary of exoskeletons found in literature.
Supporting Area of the BodySpecific Area of SupportName/MadePowerIndustryCountry of OriginYearTasks That Can Be Supported
Upper BodyUpper Limb (Shoulder)Ekso EVO [20,103].Passive (Spring-Based Actuator)Muti-Purpose (Tested on Construction industry)USA2023Overhead Works, Static Shoulder Position Holding Taks.
Hilti Exo-001 [21,103].Passive (Straps)Muti-Purpose (Tested on Construction industry)USA2023Overhead Works, Static Shoulder Position Holding Tasks.
Armored 3DoF Shoulder Exoskeleton [85]Active (Motors)In research stage (Military)Spain2020Shoulder assistance
Model-based Biomechanical Exoskeleton [112]Passive (Springs)In research stageGermany2022Heavy Lifting (Up to shoulder height)
PULE (Passive Upper Limb Exoskeleton) [32]Passive (Gas Spring)In research stage (Agriculture)China2021Arm Lift Task Assistance
TasKi [31]Passive (Spring)In research stage (Agriculture)Japan2019Overhead Work Assistance (Arm lifting and posture holding tasks)
Skelex 360 [24,114]Passive (Springs)Multiple IndustriesThe Netherlands2020Overhead Task Assistance, Static Elevation of Arms Assistance
Pole harvesting support exoskeleton [29]Passive (Springs)In research stageMalaysia2021Upper Limb Motion Assist (in harvesting with a pole)
H-Vex [22,115]Passive (Springs)In research stage Korea2019Overhead Task Assistance
H-Pulse [116]Semi Passive (Springs and Active Support Control)In research stageItaly2020Overhead Task Assistance
ShoulderX by Suitx [27,117]Passive (Springs)Multiple IndustriesUSA2020Overhead Task Assistance
Levitate exoskeleton [28,104]Passive (Custom spring- and pulley-based actuator systems)Multiple IndustriesUSA2017Static Elevation of Arms Assistance, Repetitive Motion Assistance
Upper Limb (Arm)Static upper limb activity supporting exoskeleton [118]Passive (Springs)In research stageSwitzerland2018Upper Limb Static Postures Assistance, Overhead Work Assistance
Parallelogram type Exoskeleton [119]Passive (Spring)In research stageSwitzerland2016Overhead Work Assistance, Hand Raising Task Assistance (Gravity compensation)
Upper Limbs (Shoulder and Elbow)Hapo MS [19,120]Passive (Springs)Multiple IndustriesFrance2023Overhead Task Assistance
Upper Limb (Elbow)Power-Assist Exoskeleton [86]Active (Pneumatic)In research stageChina2014Power Assistance
Upper LimbNo name, design and lab testing only [87]Active (Motos and Gears)In research stageJapan2018Lifting, Posture Support
FingersDouble-Acting Soft Actuator (DASA)-Based Robotic Glove [121]Active (Pneumatic)In research stageChina/Honk Kong2023Finger Extension/Flexion
BackBack (Lower and UpperHero Wear Apex [20,103].Passive (Elastic Straps)Multipurpose (Tested on Construction industry)USA2023Lifting Tasks, Forward Bending Tasks, Push and Pull Taks.
Lower BackLiftSuit v2.0 (Auxivo AG) [16,105,106]Passive (Textile Springs)In research stage Switzerland 2022Heavy Lifting, Forward Leaning Posture Assistance
Three-layer Fabric Mechanism, Assistive Suit [107]Passive (Elastic Fabrics)In research stageJapan2009Posture Support
IPWE (Industrial Passive Waist-assistant Exoskeleton) [107]Passive (Elastic Straps)In research stageChina2020Lifting Assistance
Laevo 2.0 [9,23,108]Passive (Elastic Fabrics)MultipurposeThe Netherlands2019Lifting Assistance
VT-Lowe’s Exoskeleton [109,110]Passive (Carbon Fibre Legs)In research stageUSA2019Lifting Assistance
BACKX by Suitx [25,114,122]Passive (gas springs) MultipurposeUSA2020Lifting Assistance
Dynamic Lifting aid Exoskeleton [88]Active (Motors)In research stage Europe (Ireland, The Netherlands, Italy)2017Lifting Assistance
Back and Upper LimbEz-UP [111]Passive (Deformable and Non-Deformable Belts with Quadrilateral structured Elastic Fabric)In research stage (Lab Testing)Japan2020Lifting, Forward Bent Work Posture Support
Lower BodyLower Limbsexoskeleton for static conditions using Indian anthropometric considerations [123]Passive (Metal links)In research stageIndia2020Static Standing Assistance
MIT lower-body exoskeleton [30]Active (Motor)Military USA2009Heavy Lifting, Load Carrying
Lower Limb Exoskeleton [89]Active (Motors)In research stageJapan2019Walking Assistance
Lowerlimb energy harvesting and transmission exoskeleton (EHTE) [124]Passive (Flat Spiral Springs)In research stageChina2021Walking Assistance
AWGAS (Assistive Wearable Gait Augment Suit) [90]Active Passive (Pneumatic and Gel Muscles)In research stageJapan2018Gait/Walking Assistance, Postural Assistance, Bent (knee) task assistance
KneesEndoskeleton Type Knee Joint Assist [91]Active (Pneumatic)In research stageJapan2021Posture Support (half sitting and crouching)
Knee exoskeleton [92]Active (Motors)In research stageJapan2016Lifting from Crouch Position
Lower Limbs/BackHULC [30,93]Active (Hydraulic)MilitaryUSA2009Heavy Lifting, Load Carrying (Enhance load capacity)
CRAY X [17,94]Active (Motors)ManufacturingGermany2019Lifting heavy loads
Model A/Model Y [94]Active (Motors)Various Industries that handle goodsJapan2019Heavy Lifting, Posture Support
Lower Back/Top of Lower LimbsNo name, Design only [95]Active (Motors)In research stageIndia2022Heavy Lifting
Hip, KneeNon-Exoskeletal Structure [96]Active (Motors)In research stageJapan2014Walking Assistance, Power Assistance
Whole body-Raytheon/Sarcos exoskeleton [30]Active (Motors)MilitaryUSA2009Heavy Lifting
Separate modules for different areasHAL [30,94,97]Active (Motors)Multipurpose Japan2019Lifting, Posture Support
-Tokyo University of Agriculture and Technology—Exoskeleton [30]Active (Motors)Agriculture (Support for elderly workers)Japan2009Posture Support
-Guardian XO and Guardian XO MAX [94,98]Active (Motors)ManufacturingUSA2019Heavy Lifting
AugmentedGuardian GT [94]Active (Motors)ManufacturingUSA2019Multiple tasks and can be remotely operated.
Table 3. Exoskeletons that have the potential to assist in agricultural tasks.
Table 3. Exoskeletons that have the potential to assist in agricultural tasks.
Area of the Human Body (Affected/Supported)AvailabilityExoskeletonFeatures/SpecificationsPossible Agricultural Activities
Upper Limb (Shoulder)Commercially AvailableEkso EVO [18,103,125]
○
Exoskeleton weight—4.3 kg
○
Adjustable support (2.25 kg–6.8 kg)
○
Allows full range of motion (shoulder and back)
○
Grape, Apple, Coffee, Peach Harvesting (by hand)
○
Mango/Oil Palm Harvesting (by stick)
○
Grape Pruning
○
Forestry operations that involve overhead tasks
○
Sorting tasks that involve static shoulder posture (Hazelnut, Mango)
Hilti Exo-001 [21,103]
○
Exoskeleton weight—under 2 kg.
○
Allows full range of motion (shoulder)
○
Best suited for overhead tasks.
H-Vex [22,115]
○
Exoskeleton weight—2.5 kg
○
Additional neck support
○
Allows full range of motion (shoulder)
Skelex 360 [24,114]
○
Exoskeleton weight—2.3 kg
○
Adjustable support (0.5 kg–4 kg)
○
Allows full range of motion (shoulder)
○
One-size-fits-all build
ShoulderX by Suitx [27,117]
○
Exoskeleton weight—2.22 kg
○
Allows full range of motion (shoulder)
○
Adjustable to fit different-sized people
In Research Stage PULE (Passive Upper Limb Exoskeleton) [32]
○
Exoskeleton weight—1.9 kg
○
Allows full range of motion
TasKi [31]
○
Provides pre-defined assistance for overhead tasks for different individuals.
○
Consists of pre-use procedure to fine-tune the support and exoskeleton
Upper Limb (Shoulder and Elbow)Commercially AvailableHapo MS [19,120]
○
Exoskeleton weight—1.3 kg
○
Adjustable support (3 kg or 2 kg)
○
Range of motion with assistance—up to 135in height and up to 180in horizontal
○
One size fit all
Upper LimbIn the Research Stage but developed specifically for harvesting tasks with a pole/stick.Pole harvesting support exoskeleton [29]
○
Exoskeleton weight—3.8 kg
○
Supports shoulder flexion in the sagittal plane between 45and 135°.
○
Custom built for harvesting with a pole.
○
Oil palm/Mango harvesting.
Upper Limb/BackIn Research StageEz-UP [111]
○
Exoskeleton weight—0.75 kg.
○
Provide support for the back and upper limbs simultaneously.
○
Fabric-based.
○
Easy to wear.
○
Can support tasks that involve bending and lifting loads.
○
Rice manual planting, weeding, harvesting and sorting.
○
Pineapple planting and harvesting.
○
Potato planting.
○
Sweet potato harvesting.
○
Rubber harvesting.
○
Cauliflower harvesting.
○
Broccoli harvesting.
○
Iceberg harvesting.
○
Strawberry harvesting.
○
Sugarcane harvesting.
○
Peach sorting.
○
Forestry work that requires bending and lifting.
Back (Lower and Upper)Commercially AvailableHero Wear Apex [20,103]
○
Exoskeleton weight—1.5 kg
○
Provide support at the back over 23 kg.
○
Comes in over 50 different fit combinations.
○
Textile-based and breathable.
○
Can manually activate and deactivate support
Commercially AvailableLaevo 2.0 [9,23,108]
○
Exoskeleton weight—3 kg
○
Supports hip joint providing 30 Nm max torque at 40bending.
○
Additionally, improves the posture while bending
○
Can manually activate and deactivate support
Commercially AvailableBACKX (IX Back) by Suitx [25,114,122]
○
25 kg maximum support in lumbar area.
○
One size fits all.
○
Support ergonomically correct postures.
Commercially AvailableLiftSuit v2.0 (Auxivo AG) [16,105,106]
○
Exoskeleton weight—0.9 kg
○
Exoskeleton is made out of textile and artificial muscles
○
21% reduction in peak muscle activity while lifting 6 kg.
In Research StageThree-layer Fabric Mechanism, Assistive Suit [107]-
In Research StageIPWE (Industrial Passive Waist-assistant Exoskeleton) [126]-
In Research StageVT-Lowe’s Exoskeleton [109,110]-
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Arachchige, S.D.; Piyathilaka, L.; Sul, J.-H.; Preethichandra, D.M.G. A Review of Potential Exoskeletons for the Prevention of Work-Related Musculoskeletal Disorders in Agriculture. Sensors 2024, 24, 7026. https://doi.org/10.3390/s24217026

AMA Style

Arachchige SD, Piyathilaka L, Sul J-H, Preethichandra DMG. A Review of Potential Exoskeletons for the Prevention of Work-Related Musculoskeletal Disorders in Agriculture. Sensors. 2024; 24(21):7026. https://doi.org/10.3390/s24217026

Chicago/Turabian Style

Arachchige, Sanura Dunu, Lasitha Piyathilaka, Jung-Hoon Sul, and D. M. G. Preethichandra. 2024. "A Review of Potential Exoskeletons for the Prevention of Work-Related Musculoskeletal Disorders in Agriculture" Sensors 24, no. 21: 7026. https://doi.org/10.3390/s24217026

APA Style

Arachchige, S. D., Piyathilaka, L., Sul, J.-H., & Preethichandra, D. M. G. (2024). A Review of Potential Exoskeletons for the Prevention of Work-Related Musculoskeletal Disorders in Agriculture. Sensors, 24(21), 7026. https://doi.org/10.3390/s24217026

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