Although the principle of exoskeletons is over 100 years old, their popularity has just begun to rise in the last two decades. Their fields of application reach from medical indications to military use to occupational utilization (Agrawal et al.
2017; Gull et al.
2020; Theurel and Desbrosses
2019). However, only in the last five to ten years they have become relevant in the working industry. The main driver of occupational exoskeletons is the prevention of musculoskeletal disorders and complaints to decrease work absence (Crea et al.
2021). Further, occupational exoskeletons improve the ergonomics and thereby the productivity of a manual workplace which is highly interesting for human-centricity (EU Commission
2021). The preventive efficacy is not yet evident (Steinhilber et al.
2020). Nevertheless, a recent longitudinal study proved that shoulder exoskeletons significantly decreased work-related shoulder health issues for selected overhead work tasks (Kim et al.
2022). Additionally, first studies claim that occupational exoskeletons can decrease cognitive load during work (Schroeter et al.
2020; Zhu et al.
2021). The implementation and evaluation of occupational exoskeletons can be complex and versatile, dependent on the scope and focus of the aimed application. Hoffmann et al. (
2019) propose four dimensions to be considered for successful implementation and evaluation. Based on the exoskeletons’ specifics, human capabilities, tasks and application context, a successful implementation is realized. A good understanding of the occupational situation for the problematic workplace is crucial for successful implementation. Therefore, work ergonomists apply ergonomic assessment methods in advance to identify suitable workstations. Furthermore, exoskeleton adapted assessment methods still exist and can be applied to objectify the ergonomic impact of an exoskeleton (Fondazione Ergo-MTM Italia
2022). Methods in the field of digital ergonomics support systematic and efficient evaluation and implementation by considering all relevant aspects in the digital work model. In general, for a successful long-term implementation, it is important to involve all relevant stakeholders with condensed information fitted to their specific interests (Crea et al.
2021). Among other things (device usability, costs, perceived relief and discomfort etc.) it is important for most stakeholders, that an effective and safe utilization of exoskeletons in the workplace is guaranteed (Crea et al.
2021). Biomechanics of the human-exoskeleton interaction influence the redistribution of load and unloading of body areas and are thereby crucial to the devices’ safety and effectiveness. Aside from long- and short-term experimental studies, musculoskeletal models could come in handy for simulation-aided exoskeleton development, optimization and evaluation and can be an important tool to quantify the effect of work-related loading and exoskeletons. Sophisticated biomechanical models help to objectify the biomechanical influences of person, exoskeleton and task specifics (Schmalz et al.
2022). Musculoskeletal models are digital human body models with the ability to calculate internal and external loads such as muscle forces, joint reaction forces, spine forces or ground reaction forces solely by the input of a given motion. These models allow the calculation of e.g., spine loads during lifting. By introducing a mechanical model of an exoskeleton into such models, an objective comparison of use cases with and without exoskeletons can be done. Furthermore, interface forces, such as the contact forces between the exoskeleton and the human body can be investigated which is highly recommended for an objective comparison of different systems (Massardi et al.
2022). This enables the biomechanical assessment of real-life work tasks to a very detailed level. Since it is quite simple to create colourful pictures and graphs of any biomechanical loading with these models and it is quite hard to achieve reliable and robust results, the following sections shall provide an overview of the AnyBody Modeling System and its possibilities in biomechanically assessing occupational exoskeletons. The sections will provide a brief introduction to the state of the art of exoskeletons and musculoskeletal models as well as insights into the practical use of such models and the implications that come with them. The article aims to deliver an impression of the general subjects of exoskeletons and musculoskeletal modelling as well as the possibilities of different data acquisition methods. Furthermore, the basics of combined exoskeleton and musculoskeletal modelling are presented and discussed. The third objective is to provide a small overview of existing work regarding the design and efficiency of exoskeletons using musculoskeletal models.