Human robotic exoskeletons can be used for the purpose of health, industrial labor, and military research and development. For health, exoskeletons can be used to restore someone’s limb functionality and help them to walk again.
Instances of health-related applications for exoskeletons include stroke, spinal cord injury, acquired and traumatic brain injury, muscular dystrophy, cerebral palsy, orthopedic injury, Guillain barre, brachial plexus injuries, multiple sclerosis. These diagnoses can result in a range of impairments including monoplegia, hemiplegia, paraplegia, quadriplegia, ataxia, and other weaknesses. Benefits of exoskeletons used in the healthcare field include: increased user independence, decreased chronic pain, reduction of energy required for movement, increased range of motion and endurance, increased quality of life, and more.
Patients with lower extremity mobility loss can enlist the help of lower body exoskeletons to address gait inefficiencies by supporting the spine, trunk, and legs including hip, knee, and ankle joints. In this instance, the exoskeleton promotes correct movement patterns in all phases of physical rehabilitation and challenges patients as they progress towards walking back into their communities.
Patients with upper extremity mobility loss can wear upper-extremity exoskeletons designed to assist their affected shoulder and arm during rehabilitation, resulting in rehabilitation sessions with a higher dosage, more intense therapy, and a wider active range of motion. An exoskeleton can provide access to the shoulder joint and scapula to help therapists facilitate movement while the device supports the patient’s arm with minimal interference, allowing for a natural motion.
For patients with acquired brain injury and stroke, lower-extremity robotic exoskeletons are utilized by physical therapists to improve patients’ orientation to midline, weight shift, stepping quality, and lower extremity muscle strength. These exoskeletons utilize the principles of neuroplasticity to help physical therapists deliver high quality, intense, repetitive, task-specific practice to patients on their journey of reclaiming independence.
Patients with spinal cord injury exhibit a wide range of potential symptoms including: extreme pain in the neck, back, or head, urinary or bowel urgency, retention, or incontinence, abnormal band-like sensations in the thorax, impaired breathing, weakness or paralysis in upper and/or lower extremities. The use of a robotic exoskeleton can help to significantly alleviate these symptoms or, in some cases, eliminate them. The patient wears a backpack-like support which connects to robotic leg-support structures and attaches comfortably to the waist, hips, legs, and feet. This helps to support the body and protect joints during preGait and gait training.
Those who suffer from loss of mobility after a stroke or ABI can wear a robotic exoskeleton, which provides therapists the opportunity to retrain their muscles and brains to regain lost mobility. This has proven to be successful in helping thousands of patients leave their wheelchairs or walkers behind. The 2022 clinical trial (WISE), performed by The International Spinal Cord Society, focused on a 12-week exoskeleton-based robotic gait training regimen to track clinically meaningful improvement in independent gait speed among participants with chronic incomplete spinal cord injury (iSCI). The results showed that the proportion of change in the clinical ambulation category was highest among participants in the group using exoskeletons developed by Ekso Bionics. 5 of 9 participants in the “Ekso group” exhibited the greatest change in ambulation status. In comparison, only 3 of 10 within the Active Control group showed improvement in the ambulation category, and 0 of 6 in the Passive Control group displayed any meaningful change (between group difference in proportions p < 0.05, Table 5).
For the prevention of injury rather than recovery from it, those working in industrial settings such as construction and manufacturing benefit significantly from exoskeleton technology. For industrial application, exoskeletons are designed to increase productivity and reduce fatigue, with the goal of eliminating work-related injuries to the neck, shoulder, and back.