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Focusing on the physical interaction between people and machines within safety constraints in versatile situations, this paper proposes a new, efficient actuation approach, continuous-state coupled elastic actuation (CCEA), to provide oncoming human-machine systems with an intrinsic programmable stiffness capacity to shape output force corresponding to the deviation between human motions and set positions of the system. As one of all the possible CCEA systems, a prototype of a 2-DOF coupled elastic actuator is designed to provide a compromise between performance and safety. Using a pair of antagonistic four-bar linkages, the inherent stiffness of the system can be adjusted dynamically. Compared to the state-of-the-art variable stiffness actuators, the CCEA system is unique in that it can achieve near zero mechanical stiffness in an efficient way. In addition, a human-robot interaction model is built to investigate the controlled bandwidth and safety of the CCEA system. For the application of assistive exercises, this study also proposes two kinds of controls for assistive exercises. Finally, a CCEA exoskeleton is built for elbow rehabilitation. Both simulations and experiments are conducted to show some desired properties of the proposed CCEA system.