Robotika ir egzoskeletonai

Robotics and exoskeletons

In recent decades, advances in robotics have led to significant advances in the healthcare sector, particularly in areas related to mobility enhancement and rehabilitation. Wearable robotic exoskeletons, once the stuff of science fiction, are now being actively used to help people regain or improve mobility. Robotic rehabilitation devices are also expanding therapeutic options for patients recovering from injuries or living with disabilities. This article provides a comprehensive overview of the applications of robotics in healthcare, focusing on two main areas: (1) mobility assistive devices to improve mobility and (2) rehabilitation robotics to support recovery processes.

1. The evolution of robotics and exoskeletons

1.1 Early development

The idea of ​​a mechanical device to help humans enhance their strength and mobility dates back several decades. The first military studies in the 1960s and 1970s explored the possibility of creating electrically powered exoskeletons to enable soldiers to carry large loads over long distances (Herr, 2009). Although these early attempts were limited by cumbersome designs and inadequate power sources, they laid the foundation for modern exoskeletons.

1.2 Technological progress

Over time, improved motors, batteries, sensors, and control algorithms have accelerated the development of exoskeletons. More efficient electric motors and lightweight materials such as carbon fiber and high-performance aluminum alloys have made exoskeletons lighter and more suitable for everyday use (Gandhi et al., 2021). Meanwhile, a variety of sensors—such as inertial measurement units (IMUs), force sensors, and electromyography (EMG) sensors—allow real-time detection of user intent, making exoskeletons more fluid and intuitive to control (Yeung et al., 2017).

1.3 Modern applications of exoskeletons

Modern exoskeletons can come in various forms:

Lower limb exoskeletons: designed to assist with walking, standing or climbing stairs (e.g. ReWalk, Ekso Bionics, Indego).

Upper limb exoskeletons: often used in therapy to restore hand movements or to help patients recovering from stroke or other neurological damage (e.g. Myomo's MyoPro).

Industrial exoskeletons: used to reduce repetitive motion loads and reduce the risk of workers developing musculoskeletal disorders (e.g., SuitX shoulder support exoskeletons).

2. Assistive devices for mobility: to improve mobility

2.1 Overview

Assistive mobility devices are robotic technologies designed specifically to improve or restore a person’s ability to move. Their purpose is to increase independence, reduce the risk of secondary complications (e.g., pressure ulcers, muscle atrophy), and improve overall quality of life. Some of the best-known such devices are lower-limb exoskeletons, which often offer mobility solutions for people with spinal cord injury, multiple sclerosis, or age-related motor decline (Sale et al., 2012).

2.2 Mechanisms and benefits

Powered Actuation
Many exoskeletons use electric motors mounted at the hip and/or knee joints to assist in walking. Integrated sensors detect the user’s posture or intention to move, and actuators then provide the necessary torque (Dollar & Herr, 2008). This real-time support can allow people to walk on flat surfaces or even climb stairs, depending on the specific design of the device.

Body weight maintenance
Some mobility devices partially support the user's body weight, reducing physical strain during movement. This is especially useful for patients who are retraining to regain gait or those with limited muscle strength.

Personalization and adaptability
Advanced algorithms allow exoskeletons to adapt to changing user conditions, such as gait speed, direction, or incline. This adaptability helps ensure greater comfort, safety, and energy conservation (Zhang et al., 2017).

Better health
Regular use of an exoskeleton may help reduce the risk of secondary complications associated with immobility (muscle atrophy, bone loss, cardiovascular problems). Several studies have shown that users have experienced improvements in balance, muscle strength, and overall well-being (Kressler et al., 2013).

2.3 Challenges related to widespread application

Despite their great potential, assistive mobility exoskeletons face certain obstacles:

High price: Development and production costs lead to a high purchase or rental price for devices, making them more difficult to access.

Training needs: Special training for users and caregivers is required to safely operate robotic exoskeletons.

Regulation: each device must meet strict clinical standards and certifications (e.g. FDA in the US, CE marking in Europe), which can take time and delay market entry.

Environmental limitations: Exoskeletons work best on relatively flat surfaces, so uneven or outdoor conditions can be more challenging.

3. Rehabilitation robotics: to support recovery processes

3.1 The role of rehabilitation

Rehabilitation robots are designed to assist patients recovering from physical trauma, stroke, or neurological disorders. Often used in clinics, they provide high-intensity, repetitive, task-specific training under the supervision of therapists. It is this type of learning that is crucial for neuroplastic changes and functional recovery (Mehrholz et al., 2018).

3.2 Main areas of rehabilitation robotics

Upper limb rehabilitation
Many people who have had a stroke have hemiparesis (weakness on one side of the body) that makes everyday movements difficult. Robotic devices for the upper extremities often use cable-operated systems, robotic arms, or exoskeletons to assist or complicate movements of the shoulders, elbows, and wrists (Kwakkel et al., 2017). Examples include the Armeo Power (Hocoma) and the MIT-Manus robotic arm (Krebs et al., 2003).

Lower limb rehabilitation
Robotic gait training devices, such as the Lokomat (Hocoma), use a treadmill system with robotic assistance at the hip and knee joints. Patients are suspended by harnesses that partially support their body weight, while robotic “legs” guide the patient’s limbs in a natural gait trajectory, helping them relearn how to walk.

Hand and finger rehabilitation
Finger or hand exoskeletons are designed to improve dexterity and fine motor skills, often using light actuators and sensors to assist in grasping and releasing objects (Li et al., 2011). They are particularly useful for patients recovering from stroke or hand injuries.

Integration with virtual reality (VR)
Many advanced rehabilitation robots are combined with virtual reality or game-like interfaces to stimulate patients and provide real-time feedback.VR environments increase motivation, engagement levels, and promote better functional outcomes (Deutsch et al., 2020).

3.3 Benefits and clinical evidence

High repetitions and intensity
Robotic devices can provide the continuous, high-intensity therapy regimen necessary to promote neuroplastic changes (Langhorne et al., 2009).

Objective assessment
Data from implanted sensors (e.g., force, range of motion, muscle activity) allows for individualized monitoring of progress and adaptation of therapy (Bernhardt et al., 2017).

Consistency and reliability
Compared to manual therapy alone, a robot can provide highly consistent repetition of movement trajectories and control the level of assistance or resistance, reducing therapist fatigue and ensuring a more consistent exercise experience (Mehrholz et al., 2018).

Help for therapists
Robots are not designed to replace human therapists, but rather to complement them. They perform repetitive tasks, allowing therapists to focus more on strategic decisions and individual patient needs.

3.4 Challenges of rehabilitation robotics

Price and complexity: Advanced robotic systems can be expensive for clinics; funds are also needed for repairs, maintenance, and staff training.

Diversity of individual needs: patients require different therapy methods, so devices and programs must be individually adapted.

Technological limitations: Current devices may not fully replicate complex natural movements, so continued research in biomimetic design and intelligent control is essential.

Regulation and insurance issues: to obtain regulatory approval and insurance reimbursement, the effectiveness and cost-effectiveness of such technologies must be thoroughly demonstrated (Bertani et al., 2021).

4. Future directions and new trends

Soft Exoskeletons
Rigid frames can limit the user’s comfort and range of motion. Soft exoskeletons, made of textiles, ropes, and lightweight actuators, aim to provide assistance without the bulkiness of traditional exoskeletons (Cao et al., 2020).

Brain-Computer Interfaces (BCI)
In some prototypes, people with severe paralysis can control robotic limbs or exoskeletons directly from the brain (Ang et al., 2010), which could open up new possibilities for individuals with advanced spinal cord injuries or progressive neurodegenerative diseases.

Artificial Intelligence (AI) and Machine Learning
By integrating AI algorithms, exoskeletons and rehabilitation robots can learn and adapt to the unique characteristics of a user’s gait or therapeutic progression. Such adaptation could improve personalized treatment and efficiency (Orekhov et al., 2021).

Wearable sensors and monitoring
Wearable sensors integrated into clothing or exoskeletons can collect a wealth of biomechanical and physiological data. Using cloud computing, this data can be analyzed in real time, helping doctors adjust therapy and improve outcomes (Artemiadis, 2014).

Remote rehabilitation (tele-rehabilitation) and monitoring
Thanks to increasing connectivity, exoskeletons and rehabilitation tools can be used at home, and the clinical team can monitor progress remotely.This would increase the availability of specialized care in remote or resource-limited communities (Tyagi et al., 2018).

Conclusion

Robotics and exoskeleton technologies have ushered in a new era in the field of mobility enhancement and rehabilitation care. From enhancing mobility for individuals with spinal cord injuries to more effective therapy for stroke patients, these devices reveal great potential for engineering and medicine to collaborate. While barriers related to cost, regulation, and technological shortcomings still exist, ongoing research and innovation in design, control, and AI offer hope for a bright future. As these devices become more advanced and widely available, they have the potential to significantly improve the quality of life for millions of people around the world.

Links

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The purpose of this article is to provide general information about robotics and exoskeleton technologies for mobility enhancement and rehabilitation. This information is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional for specific patient needs.

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