Recent Advances in Pediatric Wearable Lower-Limb Exoskeletons for Gait Rehabilitation: A Systematic Review

Cerebral palsy (CP) is the most common physical disability affecting children, often resulting in reduced quality of life due to challenges with movement control, posture, balance, and increased energy expenditure required to walk. Lower-limb exoskeletons (LLEs) offer a promising alternative to trad...

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Main Authors: Josue Pacheco-Cherrez, Juan C. Tudon-Martinez, Jorge de J. Lozoya-Santos
Format: Article
Language:English
Published: IEEE 2025-01-01
Series:IEEE Access
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Online Access:https://ieeexplore.ieee.org/document/10933913/
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author Josue Pacheco-Cherrez
Juan C. Tudon-Martinez
Jorge de J. Lozoya-Santos
author_facet Josue Pacheco-Cherrez
Juan C. Tudon-Martinez
Jorge de J. Lozoya-Santos
author_sort Josue Pacheco-Cherrez
collection DOAJ
description Cerebral palsy (CP) is the most common physical disability affecting children, often resulting in reduced quality of life due to challenges with movement control, posture, balance, and increased energy expenditure required to walk. Lower-limb exoskeletons (LLEs) offer a promising alternative to traditional rehabilitation methods, with the potential to improve mobility in children with CP. This review aims to provide an updated overview of mechanical characteristics, control strategies, technological advancements, clinical efficacy, and limitations associated with pediatric LLEs for gait rehabilitation in children with CP. The main objectives were to evaluate the current state of technology, review the clinical outcomes of exoskeleton use, and identify emerging trends and challenges in this field. To achieve this, a comprehensive search was conducted using Scopus and Web of Science databases to identify relevant recent studies published from 2020 onward. A total of 11 studies were included based on pre-defined inclusion and exclusion criteria. The findings suggest that pediatric exoskeletons have shown promise in improving gait parameters, such as walking speed and joint kinematics while reducing the metabolic cost in children with CP. Despite these positive outcomes, challenges remain regarding device customization, long-term adherence, and integration into clinical practice. The review underscores the potential of pediatric exoskeletons to significantly improve mobility and quality of life in children with CP but also emphasizes the need for further research to optimize device design, long-term outcomes, and standardized guidelines and protocols to conduct and evaluate clinical trials. These findings have important implications for clinicians, researchers, and developers who seek to advance the field of pediatric rehabilitation technologies.
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spelling doaj-art-8ba86aeb91ff421e87f1224da4f669d72025-08-20T03:42:15ZengIEEEIEEE Access2169-35362025-01-0113505115053310.1109/ACCESS.2025.355275710933913Recent Advances in Pediatric Wearable Lower-Limb Exoskeletons for Gait Rehabilitation: A Systematic ReviewJosue Pacheco-Cherrez0https://orcid.org/0000-0003-0678-5091Juan C. Tudon-Martinez1https://orcid.org/0000-0003-0646-1871Jorge de J. Lozoya-Santos2School of Engineering and Sciences, Tecnologico de Monterrey, Monterrey, MexicoSchool of Engineering and Sciences, Tecnologico de Monterrey, Monterrey, MexicoSchool of Engineering and Sciences, Tecnologico de Monterrey, Monterrey, MexicoCerebral palsy (CP) is the most common physical disability affecting children, often resulting in reduced quality of life due to challenges with movement control, posture, balance, and increased energy expenditure required to walk. Lower-limb exoskeletons (LLEs) offer a promising alternative to traditional rehabilitation methods, with the potential to improve mobility in children with CP. This review aims to provide an updated overview of mechanical characteristics, control strategies, technological advancements, clinical efficacy, and limitations associated with pediatric LLEs for gait rehabilitation in children with CP. The main objectives were to evaluate the current state of technology, review the clinical outcomes of exoskeleton use, and identify emerging trends and challenges in this field. To achieve this, a comprehensive search was conducted using Scopus and Web of Science databases to identify relevant recent studies published from 2020 onward. A total of 11 studies were included based on pre-defined inclusion and exclusion criteria. The findings suggest that pediatric exoskeletons have shown promise in improving gait parameters, such as walking speed and joint kinematics while reducing the metabolic cost in children with CP. Despite these positive outcomes, challenges remain regarding device customization, long-term adherence, and integration into clinical practice. The review underscores the potential of pediatric exoskeletons to significantly improve mobility and quality of life in children with CP but also emphasizes the need for further research to optimize device design, long-term outcomes, and standardized guidelines and protocols to conduct and evaluate clinical trials. These findings have important implications for clinicians, researchers, and developers who seek to advance the field of pediatric rehabilitation technologies.https://ieeexplore.ieee.org/document/10933913/Cerebral palsyclinical outcomesexoskeletongait rehabilitationlower-limb exoskeletonpediatric exoskeletons
spellingShingle Josue Pacheco-Cherrez
Juan C. Tudon-Martinez
Jorge de J. Lozoya-Santos
Recent Advances in Pediatric Wearable Lower-Limb Exoskeletons for Gait Rehabilitation: A Systematic Review
IEEE Access
Cerebral palsy
clinical outcomes
exoskeleton
gait rehabilitation
lower-limb exoskeleton
pediatric exoskeletons
title Recent Advances in Pediatric Wearable Lower-Limb Exoskeletons for Gait Rehabilitation: A Systematic Review
title_full Recent Advances in Pediatric Wearable Lower-Limb Exoskeletons for Gait Rehabilitation: A Systematic Review
title_fullStr Recent Advances in Pediatric Wearable Lower-Limb Exoskeletons for Gait Rehabilitation: A Systematic Review
title_full_unstemmed Recent Advances in Pediatric Wearable Lower-Limb Exoskeletons for Gait Rehabilitation: A Systematic Review
title_short Recent Advances in Pediatric Wearable Lower-Limb Exoskeletons for Gait Rehabilitation: A Systematic Review
title_sort recent advances in pediatric wearable lower limb exoskeletons for gait rehabilitation a systematic review
topic Cerebral palsy
clinical outcomes
exoskeleton
gait rehabilitation
lower-limb exoskeleton
pediatric exoskeletons
url https://ieeexplore.ieee.org/document/10933913/
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AT jorgedejlozoyasantos recentadvancesinpediatricwearablelowerlimbexoskeletonsforgaitrehabilitationasystematicreview