The future of exoskeletons – Exoskeletons of the future

The first exoskeletons in the healthcare sector supported people with limited mobility. Later models were added that support nursing staff in physically demanding activities and surgical teams during long procedures. Today, development continues with exoskeletons becoming lighter, smarter, and more versatile.

Researchers and industry are working on systems that adapt, think for themselves, and respond specifically to individual requirements. New technologies in the fields of sensor technology, control systems, and materials science are enabling these advances. In this article, we provide an overview of current exoskeleton research and show how it could shape exoskeleton development in healthcare, whether for therapy or for the work of staff.

Future exoskeletons will be more tailored to their respective environments. While earlier systems were primarily used in stationary therapy settings, mobile and autonomous variants are now increasingly being added.

One example is the 'Eve' model from French manufacturer Wandercraft. It is based on the 'Atalante' clinical exoskeleton (more on 'Atalante' in our interview), which was developed for rehabilitation, and is designed for use in a home environment outside the clinic. With the help of AI and the fusion of sensor systems, it balances itself independently and adapts to different movement sequences. Wearers can control it themselves using a joystick.

This development reflects a trend away from pure power amplification and mobility aids toward intelligent assistance with a high degree of adaptability.

The integration of artificial intelligence is a central research topic in exoskeleton development. AI algorithms interpret sensor data in real time, enabling them to anticipate movement intentions and – like 'Eve' – enable partial autonomous control. The goal is intuitive use without conscious control commands and improved mobility in everyday life.

Learning systems are also used in rehabilitation and therapy, adapting to patients' progress by increasing or reducing the amount of force required for an exercise. In 2024, researchers at the University of Houston reported on a generative model for an arm exoskeleton for stroke rehabilitation that optimizes movements based on individual parameters such as remaining mobility and strength. Such systems can also be used to provide feedback to the therapeutic staff. The exoskeleton could then measure how well exercises can be performed and what needs to be trained more.

Modern exoskeletons use multiple sensor levels to recognize movement intentions and provide support. In addition to classic inertial sensors, surface EMG, pressure sensors, and textile strain gauges can also be integrated. A current prototype of a 'soft leg sleeve' combines different types of sensors as part of a lightweight material composition, achieving differentiated movement analysis with high suitability for everyday use. Such sensor technology can in turn interact with AI-based control systems.

A key development goal is to reduce weight while expanding functionality. Lightweight materials such as carbon, titanium alloys, and high-strength plastics improve wearability.

Soft exoskeletons made of textile or pneumatic structures are also gaining importance. They are ultimately intended to be more flexible in use than the rigid exoskeletons known today, offering greater comfort and freedom of movement. Lighter exoskeletons will also be more energy-efficient and thus have a longer 'running time', in the truest sense of the word. One development in this direction is a soft exoskeleton being developed by the Harvard School of Engineering and Applied Sciences.

Market developments paint a clear picture: demand for exoskeletons in the healthcare sector is growing. Forecasts predict a global market volume of over two billion US dollars by 2030. This trend is being driven by technical advances, an aging population, and increasing workloads in nursing and clinical professions.

In the future, exoskeletons will not only enable people with limited mobility to be more independent, but will also be used preventively, to relieve staff during physically demanding work, and, of course, to continue to support therapeutic movement exercises. These developments will not only benefit patients through better outcomes, but also employees and, ultimately, the entire healthcare sector through cost savings.

Exoskeleton research in the medical field is at a turning point: exoskeletons will evolve from a specialized expert solution to a versatile, customizable technology for work and everyday life.