Moderate exosuit use reduces the incidence of back discomfort in logistic warehouse workers: a randomised controlled trial with an exploratory dose-stratified analysis

Evidence on whether exosuits reduce workplace injuries is mixed. We studied whether exosuits can reduce back discomfort among warehouse workers. Ninety-seven participants were randomised to a control or exosuit group; for exploratory analysis, exosuit participants were stratified as moderate or low users. Surveys at baseline and four follow-ups assessed workplace discomfort, perceived back effort, usability, and adverse events. Intention-to-treat analysis showed that exosuit users had no difference in back discomfort intensity and incidence than the control group. However, exosuit users did have reductions in overall body discomfort. Exploratory analyses showed that moderate users had a 2–3-fold lower incidence of back discomfort than the control group, with 20% reductions in perceived back effort and no increased discomfort at other joints. Consistent exosuit use reduced the likelihood of experiencing low back discomfort. However, disparity between intention-to-treat and dose-stratified analyses suggests effectiveness is dose- and job-fit-dependent, supporting targeted implementation. ClinicalTrials.gov, NCT05802914.