Wearable robotics for greater mobility in old age

As people age, mobility often declines, frequently limiting their independence, participation in social life and quality of life. So-called soft robotic suits offer a promising technological approach to addressing this issue at an early stage. These are textile, wearable robotic systems that assist movement rather than taking it over or replacing it.

Even slight reductions in walking speed or distance are associated with an increased risk of falls, hospitalisation, the need for care and mortality. The transition from robust health to so-called pre-frailty is particularly critical. In this phase, much is still possible: functional reserves are still present, but losses in mobility are often reversible. At the same time, there is a growing risk of a gradual withdrawal from physical activity, as walking is increasingly perceived as strenuous. This is precisely where soft robotic suits come in: they support movement in everyday life, reduce the perceived strain and can help maintain activity.

From rigid exoskeletons to soft robotics

Early exoskeletons were heavy, rigid systems with high energy requirements. They were primarily suited to industrial applications or for people with severe paralysis. For older users, they were hardly practical due to their weight, inertia and restricted freedom of movement.

Today’s soft robotic suits consist of textile components; they are flexible, lightweight and resemble clothing. At the Munich Institute of Robotics and Machine Intelligence (MIRMI) at the Technical University of Munich, for example, robotic ‘shorts’ have been developed that weigh only around 2.5 kilograms. Force transmission is achieved via cable-based actuators that specifically assist hip flexion during the swing phase of walking.

Sensors, cameras and AI

A key feature of modern soft robotic suits is their consistent user-centred design. Inertial sensors continuously monitor the user’s individual gait pattern, and the control system adjusts the assistance in real time. The exosuit does not dictate movement, but solely amplifies the activity initiated by the user. The user remains active and sets the pace. The suits are increasingly incorporating artificial intelligence and environmental sensors. Camera-based systems enable the environment to be recognised – such as stairs, slopes or obstacles – and the support strategy to be adjusted automatically. The user does not need to intervene actively, which can help prevent falls, particularly in complex or unfamiliar environments.

In the long term, the use of targeted gait perturbations is also being discussed to train responsiveness and balance. This shifts the focus from pure assistance to active prevention.

This principle is particularly crucial for use in everyday life and in geriatric care. Users retain control over their movements at all times. The system is not perceived as a foreign object, but as a supportive extension of one’s own physical abilities. This ensures greater acceptance and is crucial for long-term use.

Evidence from real-life situations

The effectiveness of soft exosuits has been investigated both in the laboratory and under real-life conditions. Studies involving older adults aged between 67 and 82 showed that the soft robotic shorts significantly reduce energy expenditure during walking. Participants required less energy to cover the same distance, without any unphysiological changes to joint mobility or gait patterns.
Subjectively, users reported a high degree of safety, comfort and freedom of movement. Furthermore, the support was described as intuitive and pleasant.

Support for everyday transitions

In addition to walking, the focus is also on everyday movement transitions, such as standing up from a seated position. Studies show that soft robotic suits reduce the time taken to stand up, increase the muscle force exerted and simultaneously reduce the metabolic load. It is precisely such seemingly small movements that often determine how independent a person remains in everyday life. This opens up new possibilities for use in the home environment, in rehabilitation or in preventive training programmes.
The interface between healthcare and high-tech

Soft robotic suits are not a substitute for exercise, physiotherapy or traditional aids. Rather, they are intended as a complementary measure to promote activity, particularly during periods of reduced physical capacity, following acute illnesses or in cases of chronic fatigue.

Research is currently also being conducted into the use of soft robotic suits for neurological conditions such as multiple sclerosis, heart failure and targeted fall prevention. In the long term, they could help not only to maintain mobility but also to firmly establish it as an active therapeutic goal in the everyday lives of older people.

At REHACARE, the international trade fair for rehabilitation and care, the focus is on aspects such as independence, suitability for everyday use and care concepts. XPONENTIAL Europe, meanwhile, as the leading European trade fair for autonomous technologies and robotics, offers a platform for discussing technological innovations, AI-based control and robotic systems in an international context. Both events demonstrate how closely medicine, care and high-tech have now converged.

Author: Sonja Buske