State-of-the-art controllers for active back exosuits rely on body kinematics and state machines. These controllers do not continuously target the lumbosacral compression forces or adapt to unknown external loads. The use of additional contact or load detection could make such controllers more adaptive
however, it can be impractical for daily use. Here, we developed a novel neuro-mechanical model-based controller (NMBC) that uses a personalized electromyography (EMG)-driven musculoskeletal (MSK) model to estimate lumbosacral joint loading. NMBC provided adaptive, subject- and load-specific assistive forces proportional to estimates of the active part of biological joint moments through a soft back support exosuit. Without