  Passive shoulder exoskeletons have been widely introduced in the industry to
aid upper extremity movements during repetitive overhead work. As an ergonomic
intervention, it is important to understand how users adapt to these devices
over time and if these induce external stress while working. The study
evaluated the use of an exoskeleton over a period of 3 days by assessing the
neural, physiological, and perceptual responses of twenty-four participants by
comparing a physical task against the same task with an additional cognitive
workload. Over days adaptation to task irrespective of task and group were
identified. Electromyography (EMG) analysis of shoulder and back muscles
reveals lower muscle activity in the exoskeleton group irrespective of task.
Functional connectivity analysis using functional near infrared spectroscopy
(fNIRS) reveals that exoskeletons benefit users by reducing task demands in the
motor planning and execution regions. Sex-based differences were also
identified in these neuromuscular assessments.
