Soft exosuits have emerged as potent assistive tools for walking support and rehabilitation training. However, most existing soft exosuit systems rely on preset assistance modes, which may not accurately align with individual physiological states and movement requirements, leading to variable user experiences and efficacy. While existing human-in-the-loop (HIL) research predominantly focuses on optimizing metabolic cost and torque difference parameters, there is a notable absence of real-time monitoring methods that closely reflect the human body’s physiological state and strategies that dynamically indicate walking efficiency. Motivated by this, we developed a novel personalized power-assist system. This system optimizes the power-assist output of the hip joint by monitoring the user’s physiological and motion signals in real time, including heart rate (HR), blood oxygen saturation (SpO2), and inertial measurement unit (IMU) data, to assist hip flexion based on feedback. The findings from a metabolic expenditure trial demonstrate that the innovative soft exosuit, which is based on a Physiological State Monitoring Control (PSMC) system, achieves a reduction of 7.81% in metabolic ex
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