{
  "abstract": "One important purpose of back support exoskeletons (BSEs) is to reduce the stress to the lumbar spine and alleviate the low back pain. However, most previous studies introducing BSEs have argued for their effectiveness based only on easily measurable physiological outcomes such as muscle activation. Motivated by this gap, we examined whether the muscle activation of the back muscle during load handling with a passive BSE can faithfully reflect the estimated L5–S1 joint reaction forces and subjective perceptions. Experiments involving 12 healthy young adults revealed that the BSE significantly reduced average thoracic erector spinae muscle activation during both lifting and lowering the load, and lumbar erector spinae muscle activation during lowering. The BSE also reduced integrated thoracic erector spinae muscle activation during lowering. L5–S1 joint reaction forces were also significantly reduced by the BSE (p < 0.001). Participants reported a lower rate of perceived exertion (p < 0.05). However, the lack of associations among all metrics suggests that inferring one measure from another remains limited when evaluating the efficacy of a BSE.",
  "abstract_shown": true,
  "affiliations": [
    "Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea.",
    "The Lampe Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina, United States of America.",
    "The Lampe Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.",
    "Department of Physical Education, Seoul National University, Seoul, Republic of Korea.",
    "Department of Mechanical and Industrial Engineering, University of Massachusetts Lowell, Lowell, Massachusetts, United States of America.",
    "Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea.",
    "Angel Robotics Co, Ltd, Seoul, Republic of Korea.",
    "Institute of Sport Science, Seoul National University, Seoul, Republic of Korea.",
    "SNU Robotics Institute, Seoul National University, Seoul, Republic of Korea."
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Hyeonhee Jung"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Jangwhan Ahn",
      "orcid": "0009-0008-1491-5515"
    },
    {
      "affs": [
        3
      ],
      "name": "Eunsik Choi",
      "orcid": "0009-0004-1118-4607"
    },
    {
      "affs": [
        4
      ],
      "name": "Jeongin Moon",
      "orcid": "0000-0002-1190-8837"
    },
    {
      "affs": [
        5,
        6
      ],
      "name": "Kyoungchul Kong"
    },
    {
      "affs": [
        3,
        7,
        8
      ],
      "name": "Jooeun Ahn",
      "orcid": "0000-0002-7964-5148"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0wbby56wn2j1a.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0361338",
  "fulltext_url": "https://europepmc.org/articles/PMC13704840",
  "id": "0wbby56wn2j1a",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0361338",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2204|Prosthetics and Rehabilitation Robotics"
    ],
    [
      "plos",
      "/Biology and life sciences/Anatomy/Musculoskeletal system/Skeleton/Skeletal joints"
    ],
    [
      "plos",
      "/Biology and life sciences/Biomechanics"
    ],
    [
      "plos",
      "/Biology and life sciences/Biomechanics/Musculoskeletal mechanics"
    ],
    [
      "plos",
      "/Biology and life sciences/Physiology/Muscle physiology/Musculoskeletal mechanics"
    ],
    [
      "plos",
      "/Biology and life sciences/Zoology/Animal physiology/Exoskeleton"
    ],
    [
      "plos",
      "/Medicine and health sciences/Anatomy/Musculoskeletal system/Skeleton/Skeletal joints"
    ],
    [
      "plos",
      "/Physical sciences/Physics/Classical mechanics/Kinematics"
    ],
    [
      "plos",
      "/Physical sciences/Physics/Classical mechanics/Motion/Torque"
    ],
    [
      "plos",
      "/Research and analysis methods/Bioassays and physiological analysis/Electrophysiological techniques/Muscle electrophysiology/Electromyography"
    ],
    [
      "plos",
      "/Research and analysis methods/Bioassays and physiological analysis/Muscle analysis"
    ]
  ],
  "openalex": "W7223663548",
  "pdf_url": "https://europepmc.org/articles/PMC13704840?pdf=render",
  "pmcid": "PMC13704840",
  "pmid": "42932286",
  "published": "2026-10-26",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/0wbby56wn2j1a.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:17Z",
      "native_id": "10.1371/journal.pone.0361338",
      "source": "plos",
      "url": "https://doi.org/10.1371/journal.pone.0361338"
    },
    {
      "first_seen": "2026-10-30T12:21:51Z",
      "native_id": "MED:42932286",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42932286"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "plos:anatomy",
      "subfield": "physiology"
    }
  ],
  "title": "Dissociation between muscle activation, spinal joint load, and subjective perception in passive back support exoskeleton use",
  "title_text": "Dissociation between muscle activation, spinal joint load, and subjective perception in passive back support exoskeleton use",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:51Z",
  "url": "https://research.draconitic.com/paper/0wbby56wn2j1a",
  "venue": "PLOS One",
  "versions": []
}