A Theory-Informed Framework for Implementing Passive Back-Support Exoskeletons in Construction

Abstract

Passive exoskeletons hold significant promise for reducing work-related musculoskeletal disorders in construction, yet clear, theory-informed guidance on how organizations should adopt and sustain them remains limited. This study presents Exo-Implant, a multi-stage implementation framework grounded in Normalization Process Theory and tailored to the operational, organizational, and cultural characteristics of construction workplaces. The framework was developed through literature review, expert validation, and iterative refinement using construction-specific adoption factors. Its evaluation employed a scenario-based case study with professionals from a construction firm, integrating a usability questionnaire with a facilitated focus-group analysis to assess practicality, clarity, and perceived value. Results indicated that participants viewed Exo-Implant as useful, trustworthy, and role-relevant, though moderately complex to navigate due to the number of interconnected steps and information flows. Identified facilitators included early feasibility assessment, stakeholder engagement, and clear procedures for training, operational planning, and iterative learning. Key barriers centered on plan complexity, limited embedded prompts or examples, insufficient detail on repair-tracking and usage monitoring, and the variability of cost–benefit evaluation practices across firms. This study contributes by providing a transferable, construction-specific implementation framework; extending Normalization Process Theory with industry-specific insights into organizational readiness, workforce engagement, and continuous learning; and offering guidance for researchers and practitioners seeking to implement exoskeleton adoption in construction and other labor-intensive sectors. Exo-Implant demonstrates how theory-informed, context-sensitive strategies can bridge the persistent gap between exoskeleton promise and real-world organizational practice.