Passive back support exoskeletons do not effectively reduce physical demands during simulated floor tiling

Back-support exoskeletons (BSEs) have the potential to reduce physical demands during many occupational tasks, but their effectiveness in flooring work remains underexplored. Eighteen participants performed simulated floor tiling work under three intervention conditions (HeroWear Apex™ = HW, Laevo Flex™ = LV, and no device = ND), across two tile sizes (small vs. large), and two task types (tiling vs. grouting). HW use increased back muscle activation by ∼13–44 % compared to ND, while LV led to minimal changes. Some participants reported concerns with both BSEs, including movement restrictions, discomfort, and skin irritation. Significant interaction effects of intervention and tile size on muscle activity and subjective outcomes suggest the importance of considering task-specificity in BSE evaluations. Overall, the BSEs examined here did not effectively reduce physical demands during simulated floor tiling. Although we assessed BSE effects on tiling, our findings could also guide future implementation of exoskeletons in other similar construction tasks.