Advancing exoskeleton research in construction: Systematic review

Wearable exoskeletons have the potential to reduce work-related musculoskeletal disorders (WMSDs) and improve safety and productivity in construction; however, evidence on real-world effectiveness and implementation challenges remains limited. This paper presents a systematic review based on qualitative content analysis of 67 peer-reviewed publications, including 52 experimental evaluations and 15 survey or conceptual papers, following PRISMA 2020 guidelines. Most research relies on short-term laboratory studies using back-support or upper-body devices, involving predominantly male students, isolated task segments, and limited methodological reporting. Although reductions in muscle activation are frequently reported, issues with comfort, mobility restrictions, and PPE compatibility persist, and field validation remains limited. Methodological inconsistencies and limited demographic diversity further constrain generalizability. To address these gaps, eight research directions are organized into three tiers: foundational, system integration, and transformative. The paper positions exoskeletons as human-centered automation tools and proposes a roadmap to guide safe, scalable, and evidence-based adoption in construction.