Background: Occupational exos (comprising both rigid exoskeletons and soft exosuits) are emerging technologies designed to reduce the risk of work-related musculoskeletal disorders. Existing occupational exos are standalone accessories worn on top of a user's clothing.Purpose: Our objective was to determine whether back-assist exosuit capabilities could be integrated into regular clothing in an effective and usable manner, which could make musculoskeletal relief accessible to more workers.Methods: We redesigned an accessory exosuit so it could integrate into a standard-issue U.S. Army uniform. The uniform-integrated exosuit prototype was low-profile (protruding <30 mm from the body), lightweight (adding 800 grams to the uniform), and could be donned/doffed like normal clothing. We demonstrated the effectiveness and usability of the prototype in lab testing (N=5) and in a case study (N=1) with a U.S. Army Soldier.Results: In lab testing, the exosuit provided 18-27 Nm of torque about the low back during lifting. Assistance could be engaged or disengaged one-handed in about half a second, and the exosuit did not restrict a user’s natural range of motion or cause discomfort. The case study Soldier who performed operationally relevant tasks reported that he was satisfied with the weight, comfort, range of motion, and lifting assistance of the prototype.Conclusions: This work demonstrated proof-of-concept that integrating back-assist exosuit capabilities into standard workwear can be effective and usable. We added lifting assistance with little change to the form factor, weight, range of motion, or comfort of the standard uniform. This new sub-class of exosuit could be beneficial to workers who alternate between bending, lifting, and sitting (e.g., driving) tasks, or to those in customer- or patient-facing jobs where it is important for wearable technology to be discreet.
