Design and evaluation of the OmniSuit: A passive occupational exoskeleton for back and shoulder support.

Many physically straining occupations involve lifting movements over the full-vertical range of motion, which over time may lead to the development of musculoskeletal injuries. To address this, occupational exoskeletons can be designed to provide meaningful support to the back and shoulders during lifting movements. This paper introduces the main functional design features of the OmniSuit, a novel passive occupational exoskeleton. We present the technical and biomechanical considerations for the expected support level, as well as an evaluation of the physiological benefit and usability of the exoskeleton in a sample of 31 healthy volunteers performing physically demanding tasks in a laboratory setting. The OmniSuit exoskeleton significantly reduced Deltoid, Trapezius and Erector Spinae muscle activity between 4.1%MVC and 15.7%MVC when lifting a 2.5kg weight above shoulder level (p<0.001), corresponding to a reduction of up to 49.1% compared to without exoskeleton. A position-dependent reduction of Erector Spinae muscle activity was observed (p<0.001), with reductions ranging between 4.6%MVC and 14.0%MVC during leaning and squatting, corresponding to a reduction up to 41.5% compared to without exoskeleton. The measured muscular support and the predicted support torque based on the biomechanical model were found to show a similar profile for those phases of the movement which are most straining to the shoulder and back muscles. Participants reported experiencing good device usability and minimal discomfort (<1/10) in the shoulder and back during task execution with exoskeleton support. These first results validate that the considered biomechanical model helped design an ergonomic and efficient exoskeleton, and confirm the potential of such wearable assistive devices to provide support over multiple joints during physically demanding tasks.

Shape change in the saddle region of the equine back during trot and walk.

Equine back pain is prevalent among ridden horses and is often attributed to poor saddle fit. An alternative explanation is that saddle fits are technically good but fit to the wrong configuration. Saddles are fit for the standing horse, but much of the time ridden is instead spent locomoting when the back experiences the greatest peak forces. We used an array of cameras to reconstruct the surface of the back and its movement during trot, walk and standing for five horses. We verified the setup's accuracy by reconstructing a laser-scanned life-sized model horse. Our reconstructions demonstrate that saddles sit within a large, relatively low-mobile region of the back. However, saddles do sit adjacent to the highly mobile withers, which demands care in positioning and design around this important region. Critically, we identified that saddle curvature between standing and moving horses is substantially different, where trotting and walking horses have flatter backs than their standing configurations. Saddles designed around the locomoting configuration of horses may improve horse welfare by being better fit and decreasing the focal pressures applied by saddles.

Vibration reduction of human body biodynamic response in sitting posture under vibration environment by seat backrest support.

Four-degree-of-freedom (4-DOF) human-chair coupling models are constructed to characterize the different contact modes between the head, chest back, waist back and backrest. The seat-to-head transfer ratio (STHT) is used as an evaluation metric for vibration reduction effectiveness. The simulated vibration reduction ratio of the model is close to the experimental results, which proves the validity of the model. The peak STHT is obviously reduced (P < 0.05, T-test) with seat-backrest support. The experiments show that supporting the head ( a 1 , P < 0.05, Wilcoxon matched-pairs signed ranks) has the best vibration reduction effect (21%), supporting the chest back ( a 2 , P < 0.05) has a reduced effect (11%), and supporting the waist back ( a 3 , P < 0.05) has the weakest effect (4%). When the upper torso is in full contact with the backrest, the peak STHT curve and resonance frequency are positively correlated with the contact stiffness of the seat surface and negatively correlated with the contact damping. In order to reduce the seat-to-head transfer ratio, the lowest STHT peak and lowest total energy judgments were proposed as the selection methods for the selection of the contact stiffness and damping of the backrest in two environments (periodic and non-periodic excitation), respectively.

Impact of a passive upper-body exoskeleton on muscle activity, heart rate and discomfort during a carrying task.

OBJECTIVE: The goal of this study was to compare erector spinae muscle fatigue, upper limb muscle activity, body areas discomfort, and heart rate during a 10-min carrying task with and without a passive upper-body exoskeleton (CarrySuitⓇ) while considering sex influences. BACKGROUND: Passive exoskeletons are commercially available to assist lifting or carrying task. However, evidence of their impact on muscle activity, fatigue, heart rate and discomfort are scarce and/or do not concur during carrying tasks. METHOD: Thirty participants (16 females and 14 male) performed a 10-min, 15kg load-carrying task with and without the exoskeleton in two non-consecutive days. Heart rate, and erector spinae, deltoid, biceps and brachioradialis muscle activity were recorded during the carrying tasks. In addition, erector spinae electromyography during an isometric hold test and discomfort ratings were measured before and after the task. RESULTS: While without the exoskeleton upper limb muscle activity increased or remained constant during the carrying task and showing high peak activation for both males and females, a significant activity reduction was observed with the exoskeleton. Low back peak activation, heart rate and discomfort were lower with than without the exoskeleton. In males muscle activation was significantly asymmetric without the exoskeleton and more symmetric with the exoskeleton. CONCLUSION: The tested passive exoskeleton appears to alleviate the physical workload and impact of carrying heavy loads on the upper limbs and lower back for both males and females.

sEMG-Triggered Fast Assistance Strategy for a Pneumatic Back Support Exoskeleton.

To prevent lower back pain (LBP) in the industrial workplace, various powered back support exoskeletons (BSEs) have been developed. However, conventional kinematics-triggered assistance (KA) strategies induce latency, degrading assistance efficiency. Therefore, we proposed and experimentally evaluated a surface electromyography (sEMG)-triggered assistance (EA) strategy. Nine healthy subjects participated in the lifting experiments: 1) external loads test, 2) extra latency test, and 3) repetitive lifting test. In the external loads test, subject performed lifting with four different external loads (0 kg, 7.5 kg, 15 kg, and 22.5 kg). The assistance was triggered earlier by EA compared to KA from 114 ms to 202 ms, 163 ms to 269 ms for squat and stoop lifting respectively, as external loads increased from 0 kg to 22.5 kg. In the extra latency test, the effects of extra latency (manual switch, 0 ms, 100 ms and 200 ms) in EA on muscle activities were investigated. Muscle activities were minimized in the fast assistance (0 ms and 100 ms) condition and increased with extra latency. In the repetitive lifting test, the EA strategy significantly reduced L1 muscle fatigue by 70.4% in stoop lifting, compared to KA strategy. Based on the experimental results, we concluded that fast assistance triggered by sEMG improved assistance efficiency in BSE and was particularly beneficial in heavy external loads situations. The proposed assistive strategy can be used to prevent LBP by reducing back muscle fatigue and is easily applicable to various industrial exoskeleton applications.

Low back muscle action potential conduction velocity estimated using high-density electromyography.

While a decreasing spectral content of surface electromyography reflects low back muscle fatigue development, reliability of these decreases may be insufficient. Decreasing frequency content is largely determined by decreasing average motor unit action potential conduction velocities (CV), which is considered a more direct measure of muscle fatigue development. However, for the low back muscles it has been proven difficult to identify propagating potentials and consequently estimate the CV. The aim of this study was to estimate the low back muscle CV from high-density multi-channel electromyography by using peak-delay and cross-correlation methods. Fourteen healthy male participants without a history of low-back pain performed a 30 degrees lumbar flexion trial until exhaustion while standing. For 10 out of the 14 participants (118 out of 560 sites) realistic CV estimates were obtained using both methods, the majority likely over the iliocostalis lumborum muscle. Between-method CV differences appeared to be small. Close to the spine a considerable number of sites (79) yielded systematically overestimated low back muscle CV values. Estimating low back muscle CV may allow additional insight into low back muscle fatigue development and potentially improve its monitoring using (high-density) surface electromyography.

Short-term effects of the Auxivo LiftSuit during lifting and static leaning.

Back support exosuits can support workers in physically demanding jobs by reducing muscle load, which could reduce risk of work-related musculoskeletal disorders. This paper presents a two-session evaluation of a commercial exosuit, the Auxivo LiftSuit 1.1. In session 1, 17 participants performed single repetitions of lifting and static leaning tasks with and without the LiftSuit. In session 2, 10 participants performed 50 box lifting repetitions with and without the LiftSuit. In session 1, the exosuit was considered mildly to moderately helpful, and reduced erector spinae and middle trapezius electromyograms. In session 2, the exosuit was not considered helpful, but reduced the middle trapezius electromyogram and trunk and thigh ranges of motion. These effects are likely due to placement of elastic elements and excessive stiffness at the hips. Overall, the LiftSuit appears suboptimal for long-term use, though elastic elements on the upper back may reduce muscle activation in future exosuit designs.

A novel approach to thermographic images analysis of equine thoracolumbar region: the effect of effort and rider's body weight on structural image complexity.

BACKGROUND: The horses' backs are particularly exposed to overload and injuries due to direct contact with the saddle and the influence of e.g. the rider's body weight. The maximal load for a horse's back during riding has been suggested not to exceed 20% of the horses' body weight. The common prevalence of back problems in riding horses prompted the popularization of thermography of the thoracolumbar region. However, the analysis methods of thermographic images used so far do not distinguish loaded horses with body weight varying between 10 and 20%. RESULTS: The superficial body temperature (SBT) of the thoracolumbar region of the horse's back was imaged using a non-contact thermographic camera before and after riding under riders with LBW (low body weight, 10%) and HBW (high body weight, 15%). Images were analyzed using six methods: five recent SBT analyses and the novel approach based on Gray Level Co-Occurrence Matrix (GLCM) and Gray Level Run Length Matrix (GLRLM). Temperatures of the horse's thoracolumbar region were higher (p < 0.0001) after then before the training, and did not differ depending on the rider's body weight (p > 0.05), regardless of used SBT analysis method. Effort-dependent differences (p < 0.05) were noted for six features of GLCM and GLRLM analysis. The values of selected GLCM and GLRLM features also differed (p < 0.05) between the LBW and HBW groups. CONCLUSION: The GLCM and GLRLM analyses allowed the differentiation of horses subjected to a load of 10 and 15% of their body weights while horseback riding in contrast to the previously used SBT analysis methods. Both types of analyzing methods allow to differentiation thermal images obtained before and after riding. The textural analysis, including selected features of GLCM or GLRLM, seems to be promising tools in considering the quantitative assessment of thermographic images of horses' thoracolumbar region.

Within-session test-retest reliability of pressure pain threshold and mechanical temporal summation in healthy subjects.

OBJECTIVE: To determine the absolute and relative intra-rater within-session test-retest reliability of pressure pain threshold (PPT) and mechanical temporal summation of pain (TSP) at the low back and the forearm in healthy participants and to test the influence of the number and sequence of measurements on reliability metrics. METHODS: In 24 participants, three PPT and TSP measures were assessed at four sites (2 at the low back, 2 at the forearm) in two blocks of measurements separated by 20 minutes. The standard error of measurement, the minimal detectable change (MDC) and the intraclass correlation coefficient (ICC) were investigated for five different sequences of measurements (e.g. measurement 1, 1-2, 1-2-3). RESULTS: The MDC for the group (MDCgr) for PPT ranged from 28.71 to 50.56 kPa across the sites tested, whereas MDCgr for TSP varied from 0.33 to 0.57 out of 10 (numeric scale). Almost all ICC showed an excellent relative reliability (between 0.80 and 0.97), except when only the first measurement was considered (moderate). Although minimal differences in absolute PPT reliability were present between the different sequences, in general, using only the first measurement increase measurement error. Three TSP measures reduced the measurement error. DISCUSSION: We established that two measurements of PPT and three of TSP reduced the measurement error and demonstrated an excellent relative reliability. Our results could be used in future pain research to confirm the presence of true hypo/hyperalgesia for paradigms such as conditioned pain modulation or exercise-induced hypoalgesia, indicated by a change exceeding the measurement variability.

Effect on autonomic nervous activity of applying hot towels for 10 s to the back during bed baths.

BACKGROUND: Bed baths are a daily nursing activity to maintain patients' hygiene. Those may provide not only comfort but also relaxation. Notably, applying a hot towel to the skin for 10 s (AHT10s) during bed baths helped to reduce the risk of skin tears and provided comfort and warmth in previous studies. However, it is still unclear whether autonomic nervous system is affected by bed baths. Thus, this study investigated the effect on the autonomic nervous activity of applying hot towels for 10 s to the back during bed baths. METHODS: This crossover study had 50 participants (25 men and women each; average age 22.2 ± 1.6 years; average body mass index 21.4 ± 2.2 kg/m2) who took bed baths with and without (control condition: CON) AHT10s on their back. Skin temperature, heart rate variability (HRV), and blood pressure (BP) were measured. Subjective evaluations and the State-Trait Anxiety Inventory in Japanese were also performed. RESULTS: A significant interaction of time and bed bath type on skin surface temperature was observed (p < .001). Regarding the means of skin surface temperature at each measurement time point, those for AHT10s were significantly higher than those for CON. Although the total state-anxiety score significantly decreased in both the bed bath types after intervention, the mean values of comfort and warmth were higher for bed baths with AHT10s than for CON (p < .05) during bed baths; AHT10s was significantly higher in warmth than CON after 15 min (p = .032). The interaction and main effects of time on HRV and BP and that of bed bath type were not significant. CONCLUSION: Bed baths that involved AHT10s caused participants to maintain a higher skin temperature and warmer feeling than under the wiping-only condition; they also provided comfort during the interventions. However, the bed baths with AHT10s did not allow participants to reach a relaxed state; moreover, there was no change in autonomic nerve activity. This may be due to participants' increased anxiety from skin exposure and the intervention being limited to one part of the body.

Perception of vibrotactile distance on the back.

Vibrotactile displays worn on the back can be used as sensory substitution device. Often vibrotactile stimulation is chosen because vibration motors are easy to incorporate and relatively cheap. When designing such displays knowledge about vibrotactile perception on the back is crucial. In the current study we investigated distance perception. Biases in distance perception can explain spatial distortions that occur when, for instance, tracing a shape using vibration. We investigated the effect of orientation (horizontal vs vertical), the effect of positioning with respect to the spine and the effect of switching vibration motors on sequentially versus simultaneously. Our study includes four conditions. The condition which had a horizontal orientation with both vibration motors switching on sequentially on the same side of the spine was chosen is the baseline condition. The other three conditions were compared to this baseline condition. We found that distances felt longer in the vertical direction than in the horizontal direction. Furthermore, distances were perceived to be longer when vibration motors were distributed on both sides of the spine compared to when they were on the same side. Finally, distances felt shorter when vibration motors were switched on simultaneously compared to sequentially. In the simultaneous case a distance of 4 cm was not clearly perceived differently than a distance of 12 cm. When designing vibrotactile displays these anisotropies in perceived distance need to be taken into account because otherwise the intended shape will not match the perceived shape. Also, dynamically presented distances are more clearly perceived than static distances. This finding supports recommendations made in previous studies that dynamic patterns are easier to perceive than static patterns.

Air-assisted devices reduce biomechanical loading in the low back and upper extremities during patient turning tasks.

This laboratory study evaluated different assistive devices for reducing biomechanical loading during patient turning tasks. Twenty caregivers (18 females and 2 males) performed standardized patient turning tasks with two simulated patients (body mass: 74 kg and 102 kg). The turning tasks were performed in two turning directions (toward vs. away relative to caregivers) using five device conditions: draw sheet, friction-reducing turning sheet, air-assisted transfer device, air-assisted turning device, and no assistive device. Low back and upper extremity muscle activity, trunk and shoulder postures, low back moment, and self-reported usability ratings were evaluated. While all assistive devices reduced trunk flexion, both air-assisted transfer and turning devices reduced the trunk flexion (p's < 0.001) and muscle activity (p's < 0.001) in the erector spinae and triceps compared to no assistive device condition. These results suggest that the air-assisted devices have potential as an effective intervention to considerably reduce physical risk factors associated with caregivers' musculoskeletal disorders in low back and upper extremities.

A thorough investigation on pushing activities in industry: The impact of the variation in the speed of motion and load conditions on initial and sustained forces.

Pushing and pulling wheeled objects represent a significant part of manual material handling activities in industry. Medical investigations and epidemiological studies proved the correlation between such activities and the occurrence of lumbago, low back pain and adverse effects on the shoulders. The ISO 11228-2:2007 provides the recommended limits for pushing and pulling. Such values are the results of psychophysical studies realized under prescribed speed conditions referring to a slow walk. However, observation of real industrial and service sector environments reveals that workers are required to perform pushing activities at higher speed of motion. The aim of this study was to investigate the impact of the variation in the speed of motion and load conditions on push forces. 96 subjects performed a total of 2592 trials consisting of pushing an industrial trolley for warehouse applications, at different speed values and load conditions. Results confirm the presence of correlation between the increasing speed of motion and push forces. The findings have practical value for researchers, occupational physicians and ergonomics practitioners.

Effects of Two Passive Back-Support Exoskeletons on Muscle Activity, Energy Expenditure, and Subjective Assessments During Repetitive Lifting.

OBJECTIVE: The aim of this study was to explore the efficacy of two different passive back-support exoskeleton (BSE) designs during repetitive lifting in different postures. BACKGROUND: Although BSEs have been proposed as a potential intervention for reducing physical demands, limited information is available about the impacts of different exoskeleton designs in diverse work scenarios. METHOD: Eighteen participants (gender-balanced) performed lab-based simulations of repetitive lifting tasks. These tasks were performed in 12 different conditions, involving two BSEs and a control condition, two levels of lifting symmetry (symmetric and asymmetric), and two postures (standing and kneeling). Outcome measures described muscle activity and energy expenditure, along with perceived discomfort, balance, and usability. RESULTS: Using both BSEs significantly reduced peak activity of the trunk extensor muscles (by ~10%-28%) and energy expenditure (by ~4%-13%) in all conditions tested. Such reductions, though, were task dependent and differed between the two BSEs. In most of the tested conditions, using BSEs positively affected subjective responses regarding perceived exertion and usability. CONCLUSION: Our results suggest that the beneficial effects of a BSE are task specific and depend on the specific BSE design approach. More work is needed, though, to better characterize this task specificity and to determine the generalizability of BSE effects on objective and subjective outcomes for a wider range of conditions and users. APPLICATION: Our results provide new evidence to guide the selection and application of passive BSE designs in diverse lifting tasks.

Range of motion and between-measurement variation of spinal kinematics in sound horses at trot on the straight line and on the lunge.

Clinical assessment of spinal motion in horses is part of many routine clinical exams but remains highly subjective. A prerequisite for the quantification of spinal motion is the assessment of the expected normal range of motion and variability of back kinematics. The aim of this study was to objectively quantify spinal kinematics and between -measurement, -surface and -day variation in owner-sound horses. In an observational study, twelve owner-sound horses were trotted 12 times on four different paths (hard/soft straight line, soft lunge left and right). Measurements were divided over three days, with five repetitions on day one and two, and two repetitions on day three (recheck) which occurred 28-55 days later. Optical motion capture was used to collect kinematic data. Elements of the outcome were: 1) Ranges of Motion (ROM) with confidence intervals per path and surface, 2) a variability model to calculate between-measurement variation and test the effect of time, surface and path, 3) intraclass correlation coefficients (ICC) to determine repeatability. ROM was lowest on the hard straight line. Cervical lateral bending was doubled on the left compared to the right lunge. Mean variation for the flexion-extension and lateral bending of the whole back were 0.8 and 1 degrees. Pelvic motion showed a variation of 1.0 (pitch), 0.7 (yaw) and 1.3 (roll) degrees. For these five parameters, a tendency for more variation on the hard surface and reduced variation with increased repetitions was observed. More variation was seen on the recheck (p<0.001). ICC values for pelvic rotations were between 0.76 and 0.93, for the whole back flexion-extension and lateral bending between 0.51 and 0.91. Between-horse variation was substantially higher than within-horse variation. In conclusion, ROM and variation in spinal biomechanics are horse-specific and small, necessitating individual analysis and making subjective and objective clinical assessment of spinal kinematics challenging.

Real-time feedback to reduce low-back load in lifting and lowering.

Low-back pain (LBP) is a common health problem. Literature indicates an exposure-response relation between work-related lifting and LBP. Therefore, this study investigated effects of three kinds of real-time feedback on low-back load, quantified as lumbar moments, during lifting. We recruited 97 healthy male and female participants without a recent history of LBP and without prior biomechanical knowledge on lifting. Participants were assigned to groups based on the time of enrollment, filling the four groups in the following order: moment feedback, trunk inclination angle feedback, lumbar flexion feedback, and a control group not receiving feedback. Feedback was given by a sound when a threshold level of the input variable was exceeded. Participants were unaware of the input variable for the feedback, but were instructed to try to avoid the audio feedback by changing their lifting strategy. The groups with feedback were able to reduce the audio feedback and thus changed the input variable towards a more desired level. Lumbar moments significantly decreased over trials in the inclination and moment feedback groups, remained similar in the lumbar flexion group and increased in the control group. Between group comparisons revealed that low-back load was significantly lower in the moment and inclination groups compared to the control group. Additionally, moments were lower in the inclination group than in the lumbar flexion group. Real-time feedback on moments or trunk inclination is a promising tool to reduce low-back load during lifting and lowering.

Effects of task and environmental constraints on axial kinematic synergies during the tennis service in expert players.

The aims of this study were to examine the effects of task and environmental constraints on axial synergies and to find an association between synergies and arm acceleration as a performance variable. Participants of this study were 10 expert tennis players (age: 34.4 ± 7.46) who voluntarily took part and executed 60 serves under two different conditions: no-opponent and opponent. An inertial motion unit (IMU) capture system was used to calculate the 3D angular joint motions in the neck, back and lumbar segments. The results of the principal component analysis showed that the redundancy in the axial segments is decomposed into 2 main synergies that are responsible for the loading (backward swing) and firing phase (forward swing). The total variance and loading synergy variance were significantly lower in the topspin service than other service types. The emerged firing synergy was strongly associated with the arm acceleration regardless of service type. In conclusion, the effective strategy to utilise the axial motions in the trunk is through creating functional synergies that have a flexible role based on the type of service and conditions. The topspin service showed less coordination variability relative to other types of service and serving in the opponent condition required participants to change the nature of synergy among the axial segments. These findings support the design of practice that emphasises the importance of more realistic contexts with special attention given to the order of different service types.

Inter-individual variability in load carriage economy and comparisons between different load conditions.

Equivocal findings exist for the economy associated with load carried close to the body's centre of mass. Individual variation could explain some of the equivocal findings. This research aimed to examine the extent of individual variation in loaded walking economy. Eighteen females carried load on the back, head and split between the front and back. Individual variation in relative load carriage economy (ELI) was primarily assessed using standard deviation, coefficients of variation (CV) and intraclass correlation coefficients (ICC). There was large inter-individual variation in ELI values with highest mean CV's of 16%, 12% and 10% for head-, back- and combined front and back-loading. Mean ELI values were not significantly different between methods. The large amount of individual variation found here suggests future load carriage research should account for individual variation, particularly when considering sample size and when making inferences on the economy associated with different types of load carriage using group mean data.

Effects of a passive back exoskeleton on the mechanical loading of the low-back during symmetric lifting.

Low-back pain is the number one cause of disability in the world, with mechanical loading as one of the major risk factors. Exoskeletons have been introduced in the workplace to reduce low back loading. During static forward bending, exoskeletons have been shown to reduce back muscle activity by 10% to 40%. However, effects during dynamic lifting are not well documented. Relative support of the exoskeleton might be smaller in lifting compared to static bending due to higher peak loads. In addition, exoskeletons might also result in changes in lifting behavior, which in turn could affect low back loading. The present study investigated the effect of a passive exoskeleton on peak compression forces, moments, muscle activity and kinematics during symmetric lifting. Two types (LOW and HIGH) of the device, which generate peak support moments at large and moderate flexion angles, respectively, were tested during lifts from knee and ankle height from a near and far horizontal position, with a load of 10 kg. Both types of the trunk exoskeleton tested here reduced the peak L5S1 compression force by around 5-10% for lifts from the FAR position from both KNEE and ANKLE height. Subjects did adjust their lifting style when wearing the device with a 17% reduced peak trunk angular velocity and 5 degrees increased lumbar flexion, especially during ANKLE height lifts. In conclusion, the exoskeleton had a minor and varying effect on the peak L5S1 compression force with only significant differences in the FAR lifts.

Interaction between eye and body movements to perform visual tasks in upright stance.

Synergistic interactions between visual and postural behaviors were observed in a previous study during a precise visual task (search for a specific target in a picture) performed upright as steady as possible. The goal of the present study was to confirm and extend these novel findings in a more ecological condition with no steadiness requirement. Twelve healthy young adults performed two visual tasks, i.e. a precise task and a control task (free-viewing). Center of pressure, lower back, neck, head and eye movements were recorded during each task. The subjective cognitive workload was assessed after each task (NASA-TLX questionnaire). Pearson correlations and cross-correlations between eyes (time-series, characteristics of fixation) and center of pressure/body movements were used to test the synergistic model. As expected, significant negative Pearson correlations between eye and head-neck movement variables were only observed in searching. They indicated that larger precise gaze shifts were correlated with lower head and neck movements. One cross-correlation coefficient (between COP on the AP axis and eyes in the up/down direction) was also significantly higher, i.e. stronger, in searching than in free-viewing. These synergistic interactions likely required greater cognitive demand as indicated by the greater NASA-TLX score in searching. Moreover, the previous Pearson correlations were no longer significant after controlling for the NASA-TLX global score (thanks to partial correlations). This study provides new evidence of the existence of a synergistic process between visual and postural behaviors during visual search tasks.