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Review
. 2025 Jul;47(15):4002-4009.
doi: 10.1080/09638288.2024.2436981. Epub 2024 Dec 6.

The potential of lower limb exoskeletons to enhance life-space mobility and to leverage green exercise in the rehabilitation of older adults: an expert perspective

Reinhard Claeys  1   2   3 , Elissa Embrechts  1   2   4   5   6 , Mahyar Firouzi  1   2   3   7 , Daan De Vlieger  1   2   3   8 , Tom Verstraten  2   9   10 , David Beckwée  1   2   4 , Eva Swinnen  1   2   3
Affiliations
Review

The potential of lower limb exoskeletons to enhance life-space mobility and to leverage green exercise in the rehabilitation of older adults: an expert perspective

Reinhard Claeys et al. Disabil Rehabil. 2025 Jul.

Abstract

Purpose: As the global population aged 60+ grows, ensuring mobility and independence for older adults is a critical public health goal. This paper examines barriers to life-space mobility in older adults and explores wearable lower limb exoskeletons (LLEs) and green exercise as innovative solutions.

Methods: Literature search and interdisciplinary expert input were utilized.

Results: Life-space mobility, the physical space individuals move through daily, is often restricted by physical and environmental barriers, leading to increased dependency, depression, and reduced quality of life. LLEs offer promising support by compensating for decreased intrinsic capacities, thus facilitating outdoor mobility. Green exercise (i.e., physical activity in nature) provides mental and physical health benefits, further promoting mobility and well-being.

Conclusion: Combining LLEs with green exercise may create powerful rehabilitation modalities, addressing both physical and mental aspects of aging. Integrating life-space mobility research into exoskeleton development and rehabilitation programs ensures these solutions meet real-world needs, supporting Healthy Aging by maintaining functional ability. Future research should focus on user-centered development of optimized exoskeleton designs for outdoor use, developing tailored rehabilitation programs, and educating healthcare professionals and caregivers to maximize benefits. This integrated approach holds potential to significantly improve life-space mobility and quality of life for the aging population.

Keywords: Lower limb exoskeleton; functional ability; green exercise; healthy aging; life-space mobility; older adults; rehabilitation.

Plain language summary

Life-space mobility, the physical space a person moves through daily, tends to decrease with increasing age due to physical and cognitive decline.(Assistive) lower limb exoskeletons could help older adults overcome physical and environmental barriers, enhancing their ability to engage in physical activity and enhance life-space mobility.Green exercise, which can benefit both mental health and rehabilitation effectiveness, may be even more effective when combined with lower limb exoskeletons.Rehabilitation professionals should consider lower-limb exoskeletons as a promising tool to promote exercise and physical activity beyond indoor laboratory settings.

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