The-state-of-the-art of soft robotics to assist mobility: a review of physiotherapist and patient identified limitations of current lower-limb exoskeletons and the potential soft-robotic solutions.
Leah Morris, Richard S Diteesawat, Nahian Rahman and 3 others
PMID 36717869WHAT IT FOUND
Physiotherapists and patients report rigid exoskeletons are often unsafe, time-consuming to fit, and uncomfortable.
Soft robotic alternatives offer solutions by being lighter, wearable under clothes, and easier to put on, potentially saving valuable therapy time.
Key findings
01Rigid exoskeletons are perceived as unsafe due to risks of forcing unnatural movements or misinterpreting muscle tone, and are often too heavy or difficult to fit.
02Soft robotic exoskeletons use lightweight textiles and pneumatic or electric actuators to improve comfort, portability, and ease of use compared to rigid devices.
03Time spent on donning and doffing rigid devices reduces actual therapy time, a key concern given that stroke survivors already receive less physiotherapy than recommended.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a narrative review, not a systematic review or meta-analysis, so it does not provide pooled effect sizes. Many of the 'solutions' discussed are prototype technologies not yet widely available or clinically tested in large trials. The review focuses on lower-limb exoskeletons, so findings may not apply to upper-limb devices. Patient perspectives were drawn from a small number of studies, some of which involved users who had not actually used the devices.
Declared interests
The review was funded by the Engineering and Physical Sciences Research Council (UK). The authors state no other conflicts of interest.
The easy way to misread this
Do not assume soft exoskeletons are currently available or proven to be superior in clinical trials. This review identifies potential engineering solutions to known problems, but many of these devices are still in development or prototype stages, not standard care.