Reducing Back Exertion and Improving Confidence of Individuals with Low Back Pain with a Back Exosuit

My colleagues and I have a new paper in Pain Medicine.

The Summary

What’s the context?

Low back pain (LBP) limits our ability to perform activities of daily living, especially for tasks involving bending. Back exosuit technology reduces low back discomfort and improves self-efficacy of individuals with LBP during bending and lifting tasks. However, the biomechanical efficacy of these devices in individuals with LBP is unknown. This study sought to determine biomechanical and perceptual effects of a soft active back exosuit designed to assist individuals with LBP sagittal plane bending.

What did we find?

The back exosuit reduced peak back extensor moments by 9% and back extensor muscle amplitudes by 16% when lifting. Participants also reported lower task effort, back discomfort, and concern about bending and lifting with an exosuit compared to without. Exosuit use did not result in abdominal co-activation or limit range of motion compared to lifting without an exosuit.

What does it mean?

This study demonstrates that back exosuits may modulate movement related pain and boost confidence in individuals with LBP. We believe these benefits are secondary to reductions in back extensor effort. The combined psychological-biomechanical effects imply that back exosuits might have therapeutic effects when used to augment physical therapy, exercises, or daily activities. Further research is needed.

The Highlights

Exosuit Device and Study Tasks

Participants with low back pain wore a Verve Motion exosuit during squatting and stooping tasks. The lifted boxes of varying weight from a standardized height while researchers recorded biomechanics and muscle activation.

Reduced back muscle activity with exosuit.

Back extensor muscle activity during both stoop and squat tasks were significantly reduced while wearing the exosuit. The differences were most pronounced in deeper range of motion.

Reduced concern of movement with exosuit.

Participants reported large reductions in their level of concern with activities of daily living after wearing the exosuit device.

The Bottom Line

Overall the findings from this study suggest that a soft active back may reduce back extensor exertion, reduce perceived task effort and pain, and increase lifting confidence with relatively few perceived burdens to individuals with LBP. Although this study was limited to a single-session experiment, it does highlight the potential of utilizing the exosuit technology in a therapeutic setting. As a part of the Back Pain Consortium (BACPAC) Research Program, future work will probe the clinical implications of using the technology longitudinally over multiple sessions of physical therapy.

The Full Text

The full paper is available online through the Harvard BioDesign Lab. You can also reach out to me on ResearchGate.

This research was supported by:
the National Institutes of Health (NIH) through The Helping to End Addiction Long-term Initiative (UH2AR076731)