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Review
. 2023 Apr;7(4):456-472.
doi: 10.1038/s41551-022-00984-1. Epub 2022 Dec 22.

Opportunities and challenges in the development of exoskeletons for locomotor assistance

Christopher Siviy #  1 , Lauren M Baker #  1 , Brendan T Quinlivan  1 , Franchino Porciuncula  1   2 , Krithika Swaminathan  1 , Louis N Awad  2 , Conor J Walsh  3
Affiliations
Review

Opportunities and challenges in the development of exoskeletons for locomotor assistance

Christopher Siviy et al. Nat Biomed Eng. 2023 Apr.

Abstract

Exoskeletons can augment the performance of unimpaired users and restore movement in individuals with gait impairments. Knowledge of how users interact with wearable devices and of the physiology of locomotion have informed the design of rigid and soft exoskeletons that can specifically target a single joint or a single activity. In this Review, we highlight the main advances of the past two decades in exoskeleton technology and in the development of lower-extremity exoskeletons for locomotor assistance, discuss research needs for such wearable robots and the clinical requirements for exoskeleton-assisted gait rehabilitation, and outline the main clinical challenges and opportunities for exoskeleton technology.

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Conflict of interest statement

Competing interests

Harvard University has entered into a licensing-and-collaboration agreement with ReWalk Robotics. C.J.W., C.S. and B.T.Q. are co-inventors on licensed patents and are paid consultants for ReWalk Robotics. L.N.A. is a paid consultant for MedRhythms. The other authors declare no competing interests.

Figures

Fig. 1 |
Fig. 1 |. Examples of autonomous exoskeletons.
a, Weight-bearing applications in unimpaired users. b, Joint-targeting applications in unimpaired users. c, Weight-bearing applications in clinical populations. d, Joint-targeting applications in clinical populations.
Fig. 2 |
Fig. 2 |. Timeline of exoskeleton design and function.
Key developments in exoskeletons for gait assistance from 2000 to present. Green boxes and illustrations denote weight-bearing exoskeletons meant for unimpaired populations, yellow denotes weight-bearing exoskeletons for clinical applications, blue denotes joint-targeting devices for unimpaired populations, and pink denotes joint-targeting devices for clinical populations.
Fig. 3 |
Fig. 3 |. AF versus metabolic improvement of wearable exoskeletons.
The shapes indicate the condition to which metabolic improvement was compared. The dashed grey line is the identity line. Only bilateral exoskeleton and exosuit level-ground walking experiments (for which data to calculate AF are available) are compared.
See this image and copyright information in PMC

References

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    1. Scholder CA Movement-cure apparatus. US patent 675,678 (1901).
    1. Büdingen T Movement-cure apparatus. US patent 964,898 (1910).
    1. Cobb GL Walking motion. US patent 2,010,482 (1935).
    1. Pietro F Device for the automatic control of the articulation of the knee applicable to a prosthesis of the thigh. US patent 2,305,291 (1937).

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