From the treadmill to the exoskeleton. Evolution of mechanical gait assistance methods

Limited independent walking and the resulting disabilities are a serious issue for a growing group of patients. These patients are often dependent on a wheelchair, or are bedridden until the end of their lives. For this reason, the development of gait re-education methods and devices for mechanical gait assistance are very important elements in maintaining or regaining a high quality of daily and social life. New technologies allow for the construction of devices that support the rehabilitation process, which reduce the workload of therapists and ensure the best execution of the patients’ movement patterns. This paper presents the development of devices used for the mechanical support of gait starting from the simplest ones like treadmills or standing frames, through stationary robots, to the most technologically advanced ones, i.e. exoskeletons. An exoskeleton is a wearable robot which supports, or in some cases, substitutes for the user’s own movements. The first attempts to create such devices were undertaken 40 years ago. This paper discusses their clinical applications and their effectiveness in gait re-education based on the existing scientific evidence. These new technologies in gait re-education are now becoming an integral part of the rehabilitation process.