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SPEXOR passive spinal exoskeleton decreases metabolic cost during symmetric repetitive lifting

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Besides mechanical loading of the back, physiological strain is an important risk factor for low-back pain. Recently a passive exoskeleton (SPEXOR) has been developed to reduce loading on the low back. We aimed to assess the effect of this device on metabolic cost of repetitive lifting. To explain potential effects, we assessed kinematics, mechanical joint work, and back muscle activity.


We recruited ten male employees, working in the luggage handling department of an airline company and having ample experience with lifting tasks at work. Metabolic cost, kinematics, mechanical joint work and muscle activity were measured during a 5-min repetitive lifting task. Participants had to lift and lower a box of 10 kg from ankle height with and without the exoskeleton.


Metabolic cost was significantly reduced by 18% when wearing the exoskeleton. Kinematics did not change significantly, while muscle activity decreased by up to 16%. The exoskeleton took over 18–25% of joint work at the hip and L5S1 joints. However, due to large variation in individual responses, we did not find a significant reduction of joint work around the individual joints.


Wearing the SPEXOR exoskeleton decreased metabolic cost and might, therefore, reduce fatigue development and contribute to prevention of low-back pain during repetitive lifting tasks. Reduced metabolic cost can be explained by the exoskeleton substituting part of muscle work at the hip and L5S1 joints and consequently decreasing required back muscle activity.

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adopted from Näf et al., 2018)

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Bending non-demand return


Centre of mass




Ground reaction force


Low-back pain


Maximal voluntary contraction


Personal lifting assistive device


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The authors would like to acknowledge the support of Michel Kaldenhoven from KLM, who made this testing possible.


The work presented in this paper was supported by the European Union’s Horizon 2020 research and innovation program under Grant Agreement no. 687662-SPEXOR.

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Correspondence to S. J. Baltrusch.

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Communicated by Bénédicte Schepens.

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Baltrusch, S.J., van Dieën, J.H., Koopman, A.S. et al. SPEXOR passive spinal exoskeleton decreases metabolic cost during symmetric repetitive lifting. Eur J Appl Physiol 120, 401–412 (2020).

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