ASTM F3579-24

• Abstract:

  SIGNIFICANCE AND USE; 4.1 The current state of research provides limited evidence to directly support the use of exoskeletons by injured workers for Return to Work (RTW). However, there is research to support using certain exoskeletons to reduce strain and fatigue, as well as improve productivity and work quality. Reductions in strain and fatigue can reduce the risk for injury. To date, the best conclusion is that there is a potential opportunity for exoskeletons to help injured workers RTW, but precise outcomes may be unpredictable at this time. Professional management by a multidisciplinary team (see 5.8) of the following process is recommended. This practice is intended to serve as an example of a potential process that can be used when an exoskeleton is indicated for appropriate workers seeking to RTW. The first step is to consider the criteria in Section 5. If the criteria are met, use the procedure in Section 6 for managing the use of exoskeletons by injured workers for RTW.; SCOPE; 1.1 The purpose of this practice is to discuss the potential benefits and risks of exoskeletons when used by workers during the Return to Work (RTW) process following an injury or illness, and to provide guidance to anyone considering their use during the modified/transitional duty period. The primary objectives of any exoskeleton used in a RTW capacity are to facilitate the natural healing process, prevent an exacerbation of an existing injury or illness, prevent further injuries or illnesses from developing, reduce the number of modified/transitional duty days, reduce the number of visits to healthcare providers for medical treatments, and assist the worker with return to full duty without restrictions. The exoskeleton must not aggravate the original injury or illness, nor cause a secondary injury or illness. Successful RTW constitutes an injured worker’s ability to tolerate all of the demands of his/her job without reinjury, perform essential job functions, or return to work as per the decisions and directions of the worker’s physician and employer. In some cases, workers may continue to use the exoskeletons after full duty RTW for risk reduction, injury prevention, or to continue to perform essential job functions. Exoskeleton usage that continues beyond full duty RTW for these purposes is beyond the scope of this particular standard practice. ; 1.2 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety, health, and environmental practices and determine the applicability of regulatory limitations prior to use. ; 1.3 This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.

• Status: Published
• Publication Date: 14-Feb-2024
• Technical Committee: F48 - Exoskeletons and Exosuits
• Drafting Committee: F48.02 - Human Factors and Ergonomics

Overview

ASTM F3579-24: Standard Practice for Considering and Deploying Exoskeletons for Return to Work provides guidance for evaluating and implementing exoskeletons to assist injured or ill workers during the return-to-work (RTW) process. Developed by ASTM Committee F48 on Exoskeletons and Exosuits, this international standard addresses the potential benefits and risks of exoskeleton deployment and outlines a structured approach for organizations and professionals considering their use during modified or transitional duty periods.

By following this practice, stakeholders-including employers, healthcare professionals, case managers, and exoskeleton managers-can better assess when exoskeletons may enhance RTW outcomes, reduce strain and fatigue, minimize risk of reinjury, and support functional recovery.

Key Topics

• Assessment of Exoskeleton Suitability: The standard recommends reviewing scientific evidence related to exoskeleton use, considering specific injuries, work tasks, and worker motivation.
• Multidisciplinary RTW Team: Successful deployment requires collaboration between physicians, rehabilitation and ergonomics professionals, employers, claims managers, and exoskeleton managers.
• Eligibility Criteria: Factors such as type of injury, job demands, worker willingness, and medical clearance must be evaluated before implementing an exoskeleton.
• Training and Education: Comprehensive instruction for workers and involved parties is essential, including safe operation, care, and expectations for exoskeleton use.
• Data Collection and Monitoring: Functional outcomes should be measured and tracked by trained professionals to monitor progress, align with goals, and inform decision-making.
• Risk Assessment: Continuous workplace hazard assessments are necessary to identify and manage any risks associated with exoskeleton use.
• Graduated RTW Planning: Structured plans must be developed to gradually progress workers from modified to full duty, ensuring all stakeholders are informed and engaged.
• Informed Consent and Documentation: Clear communication about benefits and risks, along with documented informed consent, is required.

Applications

ASTM F3579-24 is intended for use by a wide range of professionals and organizations seeking to incorporate exoskeletons into RTW programs:

• Occupational Health and Safety: Employers can utilize this standard to structure RTW programs that integrate exoskeletons, aiming to reduce downtime, prevent further injury, and promote workforce health.
• Workers’ Compensation Programs: Claims managers and insurers can apply this guidance to support functional recovery, decrease costs associated with extended work absences, and minimize the risk of secondary injuries.
• Rehabilitation and Medical Professionals: Therapists and physicians can coordinate with ergonomics experts and exoskeleton managers to design RTW plans that align with medical best practices and individual worker needs.
• Exoskeleton Manufacturers and Distributors: Guidance on assessment, training, and ongoing support can inform product development and customer integration strategies.

Benefits of adopting this standardized approach include:

• Facilitated healing and functional recovery
• Reduced modified duty days and medical visits
• Lower rates of reinjury and prevalence of secondary conditions
• Improved worker confidence and productivity

Related Standards

For comprehensive deployment and management of exoskeletons in occupational settings, the following related ASTM standards should be considered:

• ASTM F3323 - Terminology for Exoskeletons and Exosuits
• ASTM F3392 - Practice for Exoskeleton Wearing, Care, and Maintenance Instructions
• ASTM F3444M - Practice for Training Exoskeleton Users
• ASTM F3527 - Guide for Assessing Risks Related to Implementation of Exoskeletons in Task-Specific Environments

These standards, in conjunction with ASTM F3579-24, provide foundational terminology, risk management, training protocols, and maintenance procedures to ensure effective and safe exoskeleton deployment in RTW initiatives.

Keywords: exoskeletons, return to work, rehabilitation, modified duty, occupational safety, work injury, functional recovery, workplace ergonomics.

This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the
Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.
Designation: F3579 − 24
Standard Practice for
Considering and Deploying Exoskeletons for Return to
Work
This standard is issued under the fixed designation F3579; the number immediately following the designation indicates the year of
original adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. A
superscript epsilon (´) indicates an editorial change since the last revision or reapproval.
1. Scope 2. Referenced Documents
2.1 ASTM Standards:
1.1 The purpose of this practice is to discuss the potential
F3323 Terminology for Exoskeletons and Exosuits
benefits and risks of exoskeletons when used by workers
F3392 Practice for Exoskeleton Wearing, Care, and Mainte-
during the Return to Work (RTW) process following an injury
nance Instructions
or illness, and to provide guidance to anyone considering their
F3444M Practice for Training Exoskeleton Users
use during the modified/transitional duty period. The primary
F3527 Guide for Assessing Risks Related to Implementation
objectives of any exoskeleton used in a RTW capacity are to
of Exoskeletons in Task-Specific Environments
facilitate the natural healing process, prevent an exacerbation
of an existing injury or illness, prevent further injuries or
3. Terminology
illnesses from developing, reduce the number of modified/
transitional duty days, reduce the number of visits to healthcare
3.1 Refer to Terminology F3323-20.
providers for medical treatments, and assist the worker with
return to full duty without restrictions. The exoskeleton must 4. Significance and Use
not aggravate the original injury or illness, nor cause a
4.1 The current state of research provides limited evidence
secondary injury or illness. Successful RTW constitutes an
to directly support the use of exoskeletons by injured workers
injured worker’s ability to tolerate all of the demands of his/her
for Return to Work (RTW). However, there is research to
job without reinjury, perform essential job functions, or return
support using certain exoskeletons to reduce strain and fatigue,
to work as per the decisions and directions of the worker’s
as well as improve productivity and work quality. Reductions
physician and employer. In some cases, workers may continue
in strain and fatigue can reduce the risk for injury. To date, the
to use the exoskeletons after full duty RTW for risk reduction,
best conclusion is that there is a potential opportunity for
injury prevention, or to continue to perform essential job
exoskeletons to help injured workers RTW, but precise out-
functions. Exoskeleton usage that continues beyond full duty
comes may be unpredictable at this time. Professional man-
RTW for these purposes is beyond the scope of this particular
agement by a multidisciplinary team (see 5.8) of the following
standard practice.
process is recommended. This practice is intended to serve as
an example of a potential process that can be used when an
1.2 This standard does not purport to address all of the
exoskeleton is indicated for appropriate workers seeking to
safety concerns, if any, associated with its use. It is the
RTW. The first step is to consider the criteria in Section 5. If the
responsibility of the user of this standard to establish appro-
criteria are met, use the procedure in Section 6 for managing
priate safety, health, and environmental practices and deter-
the use of exoskeletons by injured workers for RTW.
mine the applicability of regulatory limitations prior to use.
1.3 This international standard was developed in accor-
5. Criteria to Consider Prior to Exoskeleton Deployment
dance with internationally recognized principles on standard-
for RTW
ization established in the Decision on Principles for the
Development of International Standards, Guides and Recom- 5.1 Review and consider all the available scientific evidence
on the use of exoskeletons to support rehabilitation and return
mendations issued by the World Trade Organization Technical
Barriers to Trade (TBT) Committee. to work. Since the research on exoskeletons is not easily
generalizable, consider the available evidence on the specific
This practice is under the jurisdiction of ASTM Committee F48 on Exoskel-
etons and Exosuits and is the direct responsibility of Subcommittee F48.02 on For referenced ASTM standards, visit the ASTM website, www.astm.org, or
Human Factors and Ergonomics. contact ASTM Customer Service at [e-mail]. For Annual Book of ASTM
Current edition approved Feb. 15, 2024. Published March 2024. DOI: 10.1520/ Standards volume information, refer to the standard’s Document Summary page on
F3579-24. the ASTM website.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
F3579 − 24
exoskeleton being considered, and how it may or may not 5.12 The rehabilitation professionals involved are aware of
benefit the specific worker, injury or illness, and job. the worker using the exoskeleton, provide appropriate treat-
ment consistent with best practices and standards of care, and
5.2 A worker is motivated to return to work following an
track patient progress toward goals.
injury or illness.
5.13 An ergonomic assessment should be performed for the
5.3 It is possible to identify an exoskeleton that can support
worker’s job to determine that there are no other ways to
the worker and that is compatible with the job to which the 3
reduce or eliminate the risk of injury, and an ergonomics
worker is seeking to return.
professional confirms that the worker performs a job that is
appropriate for the use of an exoskeleton. For example, the
5.4 The injury or illness affects an area of the body that can
worker performs overhead work that can be supported by a
be augmented, supported, assisted, off-loaded, or otherwise
shoulder-assist exoskeleton, or a bending and lifting job that
benefited by the exoskeleton being considered.
can be supported by a back-assist exoskeleton.
5.5 The worker is interested in and willing to wear an
5.14 The exoskeleton manager confirms that the worker
exoskeleton voluntarily, the exoskeleton is required to be used
performs a job that is appropriate for the use of an exoskeleton,
by the employer, or it is prescribed by a physician.
oversees exoskeleton training, and manages the use and care of
5.6 There are employer, physician, health, safety and ergo-
the exoskeleton (Practice F3392-20).
nomics groups, workers compensation organizations, or claims
5.15 There is a graduated RTW plan for progressing the
management support, or combinations thereof, for the use of
worker from modified/transitional duty to full duty.
exoskeletons in the RTW process. The support of these
individuals and groups is critical and may require outreach, 5.16 See Fig. 1 for a summary of Section 5.
communication, coordination, and specific education on exo-
skeletons and their potential to assist injured or ill workers with 6. Procedure for Deploying Exoskeletons for Return to
Work
return to work. Educational resources and guidance may be
needed for all stakeholders, however they are beyond the scope
6.1 This is the recommended procedure for deploying exo-
of this practice.
skeletons for RTW.
5.7 There is a budget for purchasing and managing the use
6.2 A worker has an injury or illness that impacts an area of
of the exoskeleton.
the body that can benefit from an exoskeleton. The injured
worker wants to RTW to his/her original job or a transitional
5.8 There is a multidisciplinary RTW team including, but
duty job, or both. The job has risk factors that can be safely
not limited to, physicians, rehabilitation professionals, claims
addressed and reduced by an exoskeleton.
adjusters, case managers, operations managers, human re-
source managers, workers compensation managers, ergonom-
6.3 A multidisciplinary RTW team should oversee injury or
ics professionals, and exoskeleton managers involved in the illness claims and the RTW process. They should be familiar
case who have been educated on the use of exoskeletons and
with and receive training on exoskeletons, their intended uses,
who support their use in the RTW process (see 5.6). Decisions their potential benefits, and their potential pitfalls.
should be made according to Evidence Based Practice (EBP).
6.4 The involved parties shall identify a potential claim,
EBP involves integrating the best available evidence with
case, or client, or combinations thereof, for potential use of an
professionals’ clinical knowledge and expertise, while consid-
exoskeleton device to assist with RTW. This can be done
ering patients’ unique needs and personal preferences.
during regularly scheduled claims meetings.
5.9 The multidisciplinary RTW team should determine the
6.5 The involved parties should agree on the appropriate-
objective criteria (if any) that workers will be required to meet
ness of using an exoskeleton to support RTW for a specific
in order to qualify for using an exoskeleton for RTW.
worker, injury/illness, healing status, and job. Ideally, the
injured worker should attend this meeting so that he/she is
5.10 There is a plan for training the involved parties
involved in the discussions and decision-making.
including the worker, his or her manager, support staff, and
RTW team on the safe and proper use of the exoskeleton
6.6 The involved parties should determine if the worker
(Practice F3444M-20). This should include expectations for
meets their objective criteria (if any) for using an exoskeleton
RTW and any considerations that apply because of the exo-
for RTW.
skeleton’s use, such as increasing or decreasing, or both, use of
6.7 If the worker meets objective criteria for exoskeleton
the exoskeleton over the course of the modified/transitional
use for RTW and an exoskeleton is determined to be
duty period. The decision to increase or decrease, or both,
appropriate, the exoskeleton manager involve
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