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State of the Art Review of Wearable Exoskeletons

Anaya Reyes, Francisco, Ramasubramanian, Aswin, Langan, Ronan and Murray, Deirdre orcid logoORCID: 0000-0002-4314-4480 (2026) State of the Art Review of Wearable Exoskeletons. Project Report. Dublin City University/Insight Research Ireland.

Abstract
Wearable exoskeletons are moving from research prototypes to practical systems used in clinics, communities, and workplaces. This report reviews the state of the art across three application domains: rehabilitation exoskeletons used to deliver gait training, personal mobility exoskeletons intended to support everyday walking and community barriers, and industrial exoskeletons designed to reduce physical demands during work tasks. For each domain, the report describes user needs and use-cases, current system approaches (mechanics, actuation, sensing, control, safety, and usability), evidence from clinical and operational validation, and the main technology gaps and opportunities. In rehabilitation, published evidence is dominated by treadmill-based and overground lower-limb systems evaluated with standard mobility and independence outcomes. Many studies report improvements for selected users, but comparisons across devices remain difficult because protocols, training dose, and outcome selection vary widely and follow-up data are limited. Current clinical systems often prioritise robust, therapist-operable control strategies, while more adaptive, intent-aware approaches are being developed but are not yet consistently validated in routine practice. In personal mobility, evidence spans three main areas: community-delivered programmes in older adults, rigid devices designed to support high-demand tasks such as stairs and transfers, and lightweight passive or quasi-passive devices that reduce effort during walking or running. Structured community studies report feasibility and functional improvements, while controlled laboratory evaluations commonly report reduced metabolic cost under controlled conditions. However, long-term daily use remains constrained by worn mass and where that mass sits on the body, durability, the need for user adaptation and training, and acceptance factors such as comfort, appearance, and fit with daily routines and existing mobility aids. In industry, the literature focuses toward passive shoulder and back supports evaluated over short durations. Studies often report reduced muscle activity or perceived exertion in targeted tasks, but results are more variable in dynamic workflows, and long-term prevention impact is still uncertain due to limited long-duration field data. Across domains, the report highlights shared development priorities: lighter and better-fitting systems, faster donning and doffing, safe performance during transitions and variable real-world conditions, practical fail-safe behaviour outside controlled environments, and longer evaluations that capture sustained use, safety, side effects, and meaningful real-world impact.
Metadata
Item Type:Monograph (Project Report)
Refereed:No
Uncontrolled Keywords:Exoskeleton, Robotics, Rehabilitation
Subjects:Engineering > Robotics
Engineering > Biomedical engineering
Medical Sciences > Biomechanics
Medical Sciences > Health
DCU Faculties and Centres:DCU Faculties and Schools > Faculty of Science and Health
DCU Faculties and Schools > Faculty of Science and Health > School of Health and Human Performance
Publisher:Dublin City University/Insight Research Ireland
Official URL:https://www.dcu.ie/shhp
Funders:Irish Manufacturing and Research
ID Code:32308
Deposited On:02 Mar 2026 14:49 by Deirdre Murray . Last Modified 02 Mar 2026 14:49
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