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R. Soc. Interface."],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:p>Soft tissue at the human\u2013exoskeleton interface can deform under load to absorb, return and dissipate the mechanical energy generated by the exoskeleton. These soft tissue effects are often not accounted for and may mislead researchers on the actual joint assistance an exoskeleton provides. We assessed the effects of soft tissue by quantifying the performance and energy distribution of a knee exoskeleton under different assistance strategies using a synthetic lower limb phantom. The phantom emulated knee kinematics and soft tissue deformation at the exoskeleton interface. We loaded the exoskeleton on the phantom under six different spring stiffness conditions. Motion capture marker and load cell data from the phantom\u2013exoskeleton assembly allowed us to estimate the moments, stiffness and energy contributions of the exoskeleton and physical interface. We found that soft tissue caused interface power to increase and exoskeleton power to decrease with increasing spring stiffness. Despite similar joint kinematics, our findings show that increasing exoskeleton assistance did not notably change power transfer to the targeted joint, as soft tissue compressed under high forces. Our methodology improves exoskeleton design process by estimating energy distribution and transfer for exoskeletons while accounting for the effects of soft tissue deformation before human testing.<\/jats:p>","DOI":"10.1098\/rsif.2024.0539","type":"journal-article","created":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T00:05:52Z","timestamp":1733270752000},"update-policy":"https:\/\/doi.org\/10.1098\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Soft tissue can absorb surprising amounts of energy during knee exoskeleton use"],"prefix":"10.1098","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7057-7161","authenticated-orcid":true,"given":"W. 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