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Previous studies demonstrated that passive lightweight exosuits can improve walking biomechanics. However, most of these devices focus on assisting hip flexion. The aim of this study was to investigate the effects of flexion and extension assistance on joint kinetics and muscle activation. We hypothesized that there would be an optimal combination of flexion and extension assistance for measured parameters. (2) Methods: Four patients with PAD and six healthy individuals walked on a treadmill while wearing a passive exosuit with adjustable hip flexion and extension assistance. Lower limbs\u2019 power, moment, and muscle activation were recorded. (3) Results: We found that passive hip assistance effectively reduced hip kinetics in both healthy and PAD participants. We also found different effects between the groups, with the PAD group utilizing the exosuit to reduce plantarflexion kinetics and gastrocnemius activity. (4) Conclusions: These findings suggest that patients with PAD can leverage the exosuit to ameliorate impairment-specific deficits. Future research should explore more real-world applicability of passive exosuits.<\/jats:p>","DOI":"10.3390\/s25113368","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T11:12:57Z","timestamp":1748344377000},"page":"3368","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Passive Hip Flexion and Extension Assistance in Patients with Peripheral Artery Disease and Healthy Individuals"],"prefix":"10.3390","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0554-0121","authenticated-orcid":false,"given":"Hiva","family":"Razavi","sequence":"first","affiliation":[{"name":"Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE 68182, USA"},{"name":"School of Kinesiology, University of Michigan, Ann Arbor, MI 48109, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2934-2624","authenticated-orcid":false,"given":"Sara A.","family":"Myers","sequence":"additional","affiliation":[{"name":"Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE 68182, USA"},{"name":"Department of Surgery and Research Service, Nebraska-Western Iowa Veterans Affairs Medical Center, Omaha, NE 68105, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6873-6346","authenticated-orcid":false,"given":"Iraklis I.","family":"Pipinos","sequence":"additional","affiliation":[{"name":"Department of Surgery and Research Service, Nebraska-Western Iowa Veterans Affairs Medical Center, Omaha, NE 68105, USA"},{"name":"Department of Surgery, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4110-4167","authenticated-orcid":false,"given":"Philippe","family":"Malcolm","sequence":"additional","affiliation":[{"name":"Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE 68182, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2452","DOI":"10.1016\/j.cub.2015.08.016","article-title":"Humans Can Continuously Optimize Energetic Cost during Walking","volume":"25","author":"Selinger","year":"2015","journal-title":"Curr. 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