Evaluation of the support provided by a soft passive exoskeleton in individuals with back pain

Physically straining occupations involving repetitive lifting and forward leaning increase risk of back pain. In response, back exoskeletons have been developed to alleviate strain on back muscles and potentially prevent such pain. In people experiencing back pain, these may also help decrease the pain-related activity limitations during work or leisure. This experimental study evaluated the effects of a soft passive back exoskeleton on muscle activity, acute pain, kinesiophobia, and movement kinematics. Individuals experiencing mild to moderate back pain (n=35) performed forward leaning and lifting tasks, both with and without the support of the back exoskeleton. Electromyography data were collected for trunk and hip muscles, alongside hip and spine kinematics, reported pain levels and concerns regarding daily activities. Back exoskeleton support reduced back muscle activity during forward leaning by up to 35% (p_Exo<0.001) and during lifting tasks by up to 24% (p_Exo<0.001). Participants reported reduced lumbar pain (p<0.01) and decreased kinesiophobia (p<0.001) across all tasks when supported by the exoskeleton. Minimal influence on movement kinematics was observed and there were no observable changes in abdominal co-activation compared to tasks performed without exoskeleton support. These results indicate that the LiftSuit, a passive back exoskeleton, can effectively reduce back muscle activity, acute pain, and kinesiophobia among individuals with back pain during forward leaning and repetitive lifting tasks. These findings suggest that passive back exoskeletons may be beneficial during physically demanding tasks in workers experiencing mild to moderate back pain.