Challenges in the Development of Exoskeletons for People with Disabilities

Abstract

The development of exoskeletons aimed at enhancing the mobility and autonomy of people with disabilities marks a significant advance toward social and occupational inclusion, fostering greater independence and improved quality of life. However, their implementation poses multidisciplinary challenges, including technical issues, usability, cost, and user acceptance. This article synthesizes the main challenges, recent advancements, and future perspectives identified in scientific literature through a systematic review conducted under the PRISMA^® methodology. Forty-three high-impact publications indexed in SCOPUS, Web of Science, ScienceDirect, Taylor & Francis, IEEE Xplore, and PubMed were analyzed, showing an almost perfect inter-rater agreement (Cohen’s Kappa = 0.8390). The findings underscore the need to optimize control systems, reduce costs, and improve device adaptability. Artificial intelligence emerges as a key enabler to overcome these limitations, offering more efficient, affordable, and personalized solutions. This work provides an up-to-date overview of the field and outlines future directions for exoskeleton research and development, highlighting their transformative potential in the lives of people with disabilities.

1. Introduction

The development of exoskeletons for people with disabilities has seen significant advances in recent decades thanks to the integration of innovative technologies and new materials [1]. These devices offer promising solutions to improve mobility, independence, and rehabilitation processes in the medical field [2]. However, their implementation faces considerable challenges, including technical, ergonomic, economic, and accessibility aspects [3].

The design of exoskeletons necessitates an interdisciplinary approach that combines biomedical engineering, bioengineering, artificial intelligence, and advanced mechanics to create devices that are efficient, safe, and adaptable to individual needs [4]. Key challenges include optimizing weight and ergonomics [5], improving energy autonomy [6], and developing intuitive control interfaces. The availability and affordability of these devices remain limited, restricting their access to a large part of the population that could benefit from them [7].

The scientific literature has addressed studies on the use of exoskeletons in rehabilitation, the application of advanced technologies, functional challenges, manufacturing costs, and specific applications for individuals with disabilities. Although these devices aim to support activities of daily living, their self-perceived effectiveness varies, prompting research to enhance their designs and functionalities. For example, active exoskeletons have been created to assist walking in people with lower limb disabilities. However, these devices have not yet reached the full capacity to overcome physical obstacles, such as stairs or slopes, or to perform complex functional tasks [8].

Exoskeletons face challenges in terms of functional status, such as the need for devices that provide a significant functional gain to the user [9]. Likewise, the feasibility of studies with high statistical reliability evaluating the neurological and functional effects of the use of exoskeletons in people with chronic spinal cord injuries has been questioned due to logistical and methodological challenges [10].

The bibliometric visualization generated by VOSviewer (Figure 1) enables us to identify three main thematic clusters that structure the current research landscape on exoskeletons for people with disabilities. The red cluster brings together studies focused on technological development, with the text string TITLE-ABS-KEY ((“exoskeleton” OR “robotic suit” OR “wearable robot” OR “assistive device”) AND (“disability people” OR “people with disabilities” OR “physical limitation”) AND (“mobility” OR “movement” OR “function” OR “independence”) AND (“technology” OR “innovation” OR “engineering” OR “design”)), and represents the core of research aimed at the design of robotic systems, sensors, and control interfaces. This line of work focuses on improving the functionality, efficiency, and accuracy of devices, seeking increasingly robust solutions for motor assistance. The green cluster, on the other hand, reflects an orientation towards the application and social impact of these technologies, addressing concepts such as “brain–computer interfaces”, “quality of life”, and “activities of daily living”. This group focuses on integrating the exoskeleton into the daily lives of users, with an emphasis on accessibility, ergonomics, and customization tailored to specific needs. The blue cluster includes demographic, perceptual, and methodological research, with terms such as “male”, “female”, and “priority journal”, which suggest an interest in the diversity of participants, the analysis of subjective experience, and sensory and emotional interaction with the device.

Although these three dimensions address fundamental aspects of technological development, practical integration and user experience, the analysis of their interconnections reveals a worrying thematic fragmentation. The connections between the technology cluster (red) and the experiential cluster (blue) are weak, making it challenging to design solutions that effectively respond to the experiences and needs of end users. Similarly, although the green cluster reflects a concern for demographic inclusion, its links to sensory and emotional dimensions remain limited. This thematic separation highlights the urgent need for more interdisciplinary approaches that integrate engineering with user-centered design and the social sciences. Only through greater convergence between these areas is it possible to move towards exoskeletons that are truly effective, accessible, culturally accepted, and ethically designed to improve the quality of life of people with disabilities.

Figure 2 illustrates the contribution of this review to the development and fulfillment of the Sustainable Development Goals (SDGs) proposed by the United Nations. Understanding the challenges in developing exoskeletons for individuals with disabilities provides criteria to improve design, performance, usability, and ergonomic conditions, ultimately driving better use of exoskeletons.

The development of exoskeletons contributes to the achievement of the Sustainable Development Goals (SDGs) in various ways [11], aligning with goals such as reducing inequalities, promoting health and well-being, and fostering sustainable innovation. These devices improve quality of life, health, and well-being (SDG 3) and enhance users’ physical capabilities. Additionally, they promote occupational health and safety in the workplace [12].

Exoskeletons support SDG 9 by driving resilient infrastructure and sustainable industrialization through technological innovation and improve industrial productivity while protecting workers’ health with inclusive ergonomic solutions [13]. Through the development of exoskeleton technologies, international research and collaboration (SDG 17) is promoted to design solutions and technologies adapted to local needs.

Using exoskeletons makes it possible to reduce height and strength inequalities among operators, promoting the implementation of SDG 10. By focusing on accessibility and low-cost technologies, exoskeletons can be designed for resource-limited communities, reducing inequalities in the use of these technologies [14] and further promoting gender equality (SDG 5), decent work, and economic growth (SDG 8). In addition, thanks to their flexibility of movement, exoskeletons make it possible to dispense with specialized energy-intensive machinery. This promotes more efficient energy use, thus contributing to more sustainable industrial practices (SDG 13).

This paper addresses the functional status of exoskeletons, an aspect of increasing relevance currently part of the discussion agenda at the United Nations [15,16].

This article aims to synthesize the advances, challenges, and prospects in developing exoskeletons for people with disabilities, providing a comprehensive view that will help guide future developments and applications in this emerging and transformative field. This study analyzes the key challenges in developing and implementing exoskeletons for people with disabilities, addressing the technological, economic, and social barriers that still need to be overcome to ensure their mass adoption and effectiveness in different settings [17]. Prospects in this field are explored, highlighting innovations that could transform the robotic assistance landscape in the coming years [18].

Understanding the challenges in the development of exoskeletons for people with disabilities can be of great use to diverse audiences, including researchers and academics specializing in biomedical and robotic engineering, health and rehabilitation professionals working with these devices, engineers and developers seeking to improve assistive technology, manufacturers and investors interested in the exoskeleton market, as well as those responsible for public policies that regulate their accessibility and financing. People with disabilities and patient associations can benefit from a deeper understanding of the technological and economic barriers that influence the adoption of these solutions, while educators and science communicators can utilize this information to educate and raise awareness about the advances and limitations in robotic assistance.

2. Methodology

The systematic review was conducted in accordance with the guidelines of the PRISMA^® methodology. Further details about the review process are provided in [19]. The literature search focused on scientific publications from the past ten years. Journal articles and conference papers indexed in major databases and repositories, such as SCOPUS, Web of Science, ScienceDirect, Taylor & Francis, IEEE Xplore, and PubMed, were considered.

The primary research question guiding the review was the following: What are the main challenges in developing and implementing exoskeletons for people with disabilities? The review process was carried out in three phases: formulation of the research questions, definition of the scope, and planning of a comprehensive search strategy to collect all relevant documents for information extraction.

The specific research questions (RQs) formulated for data extraction were as follows: RQ1: What developments in exoskeletons for people with disabilities have been made in the past ten years? RQ2: What are the intended functions of exoskeletons developed for people with disabilities? RQ3: What challenges and limitations have been identified in the development and implementation of exoskeletons for people with disabilities? RQ4: What future perspectives are discussed regarding the development and implementation of these technologies? The proposed research questions enabled us to draw conclusions and establish criteria for the development of exoskeletons designed and evaluated for individuals with disabilities. RQ1 enabled the compilation of studies and updates from the last decade. RQ2 enabled the identification of the primary functions performed by exoskeletons for individuals with disabilities and a comparison with the functions of other types of exoskeletons. RQ3 provided relevant information on the challenges and limitations, which have been classified into technological challenges, usability, costs, user acceptability, and other aspects, such as complexity in interaction, security, and limitations of daily use. RQ4 presented useful and baseline information for future exoskeleton developments in this area.

The PRISMA^® checklist for exploratory reviews (

Table A1. Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Review (PRISMA-ScR) Checklist.

SECTION	ITEM	PRISMA-ScR CHECKLIST ITEM	REPORTED ON PAGE #
TITLE
Title	1	Identify the report as a scoping review.	1
ABSTRACT
Structured summary	2	Provide a structured summary that includes (as applicable): background, objectives, eligibility criteria, sources of evidence, charting methods, results, and conclusions that relate to the review questions and objectives.	1
INTRODUCTION
Rationale	3	Describe the rationale for the review in the context of what is already known. Explain why the review questions/objectives lend themselves to a scoping review approach.	1, 2, 3, 4
Objectives	4	Provide an explicit statement of the questions and objectives being addressed with reference to their key elements (e.g., population or participants, concepts, and context) or other relevant key elements used to conceptualize the review questions and/or objectives.	2
METHODS
Protocol and registration	5	Indicate whether a review protocol exists; state if and where it can be accessed (e.g., a Web address); and if available, provide registration information, including the registration number.	4, 5
Eligibility criteria	6	Specify characteristics of the sources of evidence used as eligibility criteria (e.g., years considered, language, and publication status), and provide a rationale.	5
Information sources *	7	Describe all information sources in the search (e.g., databases with dates of coverage and contact with authors to identify additional sources), as well as the date the most recent search was executed.	5
Search	8	Present the full electronic search strategy for at least 1 database, including any limits used, such that it could be repeated.	5
Selection of sources of evidence †	9	State the process for selecting sources of evidence (i.e., screening and eligibility) included in the scoping review.	5
Data charting process ‡	10	Describe the methods of charting data from the included sources of evidence (e.g., calibrated forms or forms that have been tested by the team before their use, and whether data charting was done independently or in duplicate) and any processes for obtaining and confirming data from investigators.	5
Data items	11	List and define all variables for which data were sought and any assumptions and simplifications made.	5
Critical appraisal of individual sources of evidence §	12	If performed, provide a rationale for conducting a critical appraisal of included sources of evidence; describe the methods used and how this information was used in any data synthesis (if appropriate).	5
Synthesis of results	13	Describe the methods of handling and summarizing the data that were charted.	5, 6
RESULTS
Selection of sources of evidence	14	Give numbers of sources of evidence screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally using a flow diagram.	5–17
Characteristics of sources of evidence	15	For each source of evidence, present characteristics for which data were charted and provide the citations.	-
Critical appraisal within sources of evidence	16	If performed, present data on critical appraisal of included sources of evidence (see Item 12).	-
Results of individual sources of evidence	17	For each included source of evidence, present the relevant data that were charted that relate to the review questions and objectives.	-
Synthesis of results	18	Summarize and/or present the charting results as they relate to the review questions and objectives.	1, 7, 10
DISCUSSION
Summary of evidence	19	Summarize the main results (including an overview of concepts, themes, and types of evidence available), link to the review questions and objectives, and consider the relevance to key groups.	17, 18
Limitations	20	Discuss the limitations of the scoping review process.	2, 16
Conclusions	21	Provide a general interpretation of the results with respect to the review questions and objectives, as well as potential implications and/or next steps.	18
FUNDING
Funding	22	Describe sources of funding for the included sources of evidence, as well as sources of funding for the scoping review. Describe the role of the funders of the scoping review.	18

JBI = Joanna Briggs Institute; PRISMA-ScR = Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. * Where sources of evidence (see second footnote) are compiled from, such as bibliographic databases, social media platforms, and Web sites. ^† A more inclusive/heterogeneous term used to account for the different types of evidence or data sources (e.g., quantitative and/or qualitative research, expert opinion, and policy documents) that may be eligible in a scoping review as opposed to only studies. This is not to be confused with information sources (see first footnote). ^‡ The frameworks by Arksey and O’Malley (6) and Levac and colleagues (7) and the JBI guidance (4, 5) refer to the process of data extraction in a scoping review as data charting. § The process of systematically examining research evidence to assess its validity, results, and relevance before using it to inform a decision. This term is used for Items 12 and 19 instead of “risk of bias” (which is more applicable to systematic reviews of interventions) to include and acknowledge the various sources of evidence that may be used in a scoping review (e.g., quantitative and/or qualitative research, expert opinion, and policy document).

in Appendix A) was applied, indicating the specific page numbers where relevant information can be found. Additionally, the questions presented in

Table 1. Quality Assessment Questions for paper quality.

Quality Assessment Questions	Answer
Does the document describe designs or prototypes of exoskeletons specifically developed, or can people with disabilities use them?	(+1) Yes/(+0) No
Does the document describe the uses, characteristics, or impacts of exoskeletons on people with disabilities?	(+1) Yes/(+0) No
Does the paper highlight the challenges and limitations of developing or implementing exoskeletons for use by people with disabilities?	(+1) Yes/(+0) No
Is the journal or conference in which the article was published indexed in the SJR?	(+1) if it is ranked Q1, (+0.75) if it is ranked Q2, (+0.50) if it is ranked Q3, (+0.25) if it is ranked Q4, (+0.0) if it is not ranked

were used to assess the quality of the selected scientific articles.

2.1. Inclusion Criteria

Journal articles and conference papers that address the use of exoskeletons for people with disabilities were chosen for information extraction. Review articles that describe the challenges from multiple approaches and recommend solutions to improve the performance and usability of exoskeletons were preferred. The search terms included the following words: “challenges, exoskeleton, disabilities” (

Table 2. Search strings for reference articles in scientific literature.

Database	String Search	Studies Number
ProQuest	exoeskeletons (Topic) and disabilities (Topic)	100
Taylor & Francis	[Abstract: exoeskeletons challenges] AND [Abstract: disabilities]	91
Scopus	ALL (“exoeskeletons” “disabilities” “challenges”)	25
Science Direct	“exoeskeletons” “technologies” “disabilities”	167
PubMed	Search: (exoeskeletons) AND (disabilities) AND (Technologies)	14
	Total number of studies	397

). Publications from the last ten years that have a first or second quartile ranking in their journals, according to the SJR Scimago ranking, were considered.

In addition, other sources were used, such as reports from official websites related to the development of exoskeletons for disabilities. The study was expanded to include articles specifically designed for particular disabilities.

2.2. Exclusion Criteria

Publications that did not explicitly focus on improving the performance or functional strengthening of exoskeletons designed for people with disabilities were excluded. This review emphasized user-centered research focusing on usability, comfort, and the functional outcomes associated with device implementation. Therefore, we did not consider studies whose primary focus was theoretical or technical—for example, kinematic or dynamic modeling, control strategies, signal processing algorithms, or hardware design—unless they explicitly demonstrated their impact on the user’s experience with disabilities.

Papers that dealt solely with purely mechanical, electromechanical, or electrical systems, without a direct relationship to user-centered performance metrics, were also excluded. This included studies focused on sensor calibration, motor controller design, or simulations without experimental or clinical validation with people with disabilities. These exclusion criteria aimed to ensure that the review maintained a practical and user-oriented approach, avoiding technical developments that do not directly translate into functional improvements or greater accessibility of exoskeleton systems.

Figure 3 shows the selection process of reference articles related to the search keywords: “challenges, development, people with disabilities, exoskeletons.” This workflow is based on a search carried out in the indicated scientific databases to apply the inclusion and exclusion criteria described. Of a total of 397 articles identified, 45 were excluded because they were duplicates, 271 were discarded due to the title of the work that did not address developments or evaluations related to exoskeletons for people with disabilities, of which 81 articles remained, and finally abstracts were evaluated and 36 documents were discarded, obtaining 45 reference documents, of which 43 were accessible.

3. Results

Exoskeletons have undergone significant evolution in recent years, offering innovative solutions for individuals with disabilities. Their development has covered different types of disabilities, from neuromuscular conditions to spinal cord injuries, improving users’ mobility, rehabilitation, and quality of life. Figure 4 presents a statistic of the number of articles addressing exoskeleton developments published in the SCOPUS database between 2014 and 2025, which were identified with the text string “TITLE-ABS-KEY (“exoskeleton” OR “robotic suit” OR “wearable robot” OR “assistive device” W/“passive”) AND PUBYEAR > 2013 AND PUBYEAR < 2026”. A total of 572 documents were identified, which were divided into ten segments of similar samples. The frequency of documents identified for each category—sport, rehabilitation, military, industrial, and disabilities—was plotted (Figure 4).

Figure 4 shows a high occurrence of terms related to rehabilitation and industry studies related to exoskeletons, which suggests a limited scientific production related to exoskeletons for disability. The complexity and multiple challenges in developing exoskeletons for users with disabilities can hinder significant progress in this area; however, there have been some developments specifically tailored for users with disabilities that have been evident in the last decade and are presented below.

3.1. Upper Extremity Disability Exoskeletons

Upper limb exoskeletons assist people with disabilities resulting from cerebrovascular conditions, spinal cord injuries, and neuromuscular disorders. The development of exoskeletons contributes to the performance of daily activities, rehabilitation, improvement of mobility, and independence for people with disabilities. Various models, such as HEXORR, ETS-MARSE, Gloria, and HandSOME, have been demonstrated to be effective in restoring mobility and functionality to the hands and arms in individuals with disabilities [3]. There are case-specific developments, such as the WREX device, which is designed for individuals with conditions like muscular dystrophy and arthrogryposis to assist with daily routine activities. For people with Duchenne muscular dystrophy, mobility can be maintained despite progressive muscle loss, and the DMD exoskeleton has been developed [20]. To assist the movement of children with upper limb disabilities, a soft, pneumatic exoskeletal garment has been developed to improve shoulder abduction and daily activity performance [21].

Focused on the field of rehabilitation, exoskeletons such as MAHI Exo-II have been designed to be suitable for patients with stroke and spinal cord injuries, allowing elbow, forearm, and wrist mobility [22]. The ETS-MARSE exoskeleton, with its seven degrees of freedom, allows movement of the shoulder, elbow, forearm, and wrist [23]. The development of P-WREX has been designed for pediatric treatments, specifically for infants with neuromuscular weaknesses, to assist anti-gravitational movements of the arms and improve interaction with objects in the environment [24].

One of the primary focuses in the design of these devices is control using electromyographic (EMG) and electroencephalographic (EEG) signals, which enables a more intuitive and natural interaction with the user [4]. In addition, mathematical and artificial intelligence models have been implemented to improve the estimation and application of joint torque [5].

A notable development is the modular mobile robotic platform designed for individuals with moderate to severe disabilities, which integrates an upper limb exoskeleton mounted on a robotic wheelchair. This platform provides assistance and rehabilitation to users with reduced mobility in their arms [2].

Several of the aforementioned features have been developed modularly to allow the exoskeleton to be adjusted to the specific needs of each user, optimizing its functionality and comfort. This modular alternative has been crucial in adapting devices for patients with different degrees of reduced mobility in the upper extremities.

3.2. Lower Limb Disability Exoskeletons

Assistive exoskeletons have been developed for daily mobility. For example, a ReWalk™ model [25] that allows paraplegic people to stand, walk, and climb stairs, has a mechanical system controlled by a device located on the user’s wrist [26]. The Phoenix Exoskeleton device has a lightweight (12 kg) and modular structure that assists people with paralysis or weakness in the legs, employs hip motors, and is used with the use of crutches for balance [27]. The lightweight (12 kg) Indego exoskeleton has a compact design ideal for use by people with spinal cord injuries or paralysis when walking [28].

The ATLAS 2030 device, developed by the Spanish National Research Council, is designed to improve mobility in people with severe motor disabilities [6]. This exoskeleton incorporates artificial intelligence to adjust assistance in real time according to the user’s needs, optimizing recovery and improving their independence in daily activities. The Hybrid Assistive Limb (HAL 3) exoskeleton developed by the Japanese company CYBERDYNE assists people with disabilities by contributing to their mobility in the lower limbs [29].

Developed for rehabilitation and used in clinics and hospitals, multiple exoskeletons have been implemented to help people regain mobility. HAL–medical version [30] enables neuromuscular rehabilitation to assist patients with spinal cord injuries, neuromuscular diseases, and strokes. The eLEGS device (Ekso) is hydraulically operated and designed for people with paralysis, allowing standing and walking with the support of crutches or walkers; it is activated by interpreting the movements of the users [31]. The CP Walker 2.0 exoskeleton offers active therapy for gait and posture correction in children with cerebral palsy, employed in personalized neurorehabilitation strategies [32]. The Wandercraft-Atalante autonomous exoskeleton operates autonomously to allow the rehabilitation of people with paralyzed walking; it is characterized by the fact that it does not require the use of crutches [33]. Developed by the Institute for Bioengineering of Catalonia (IBEC), the NeuroExo exoskeleton incorporates neural interfaces to improve user interaction [34]. The ExoAtlet exoskeleton has an assisted version; however, a rehabilitation version has been developed for patients with spinal cord injuries, strokes, partial or complete paralysis, and neuromuscular diseases [35]. The Rex Bionics device has been developed for people who use wheelchairs to stand and walk [36].

There are also exoskeletons designed explicitly for people with cerebral palsy, multiple disabilities, and neurological disorders. A prominent example is the Lokomat, a robotic locomotor training system effective in gait rehabilitation [37]. A fundamental advance in the evolution of these devices is the incorporation of advanced sensors and adaptive control systems, which allow the level of assistance to be modulated according to the user’s muscular response. This innovation has significantly improved the effectiveness of gait training, promoting a progressive reduction in the user’s dependence on the device.

3.3. Specific Features of Exoskeletons for People with Disabilities

While general-purpose exoskeletons are geared towards enhancing human capabilities in military, industrial, and specific medical contexts, exoskeletons designed explicitly for people with disabilities are primarily intended to assist individuals with mobility issues, focusing on rehabilitation and support in activities of daily living. These specialized devices prioritize user comfort, customization, and the implementation of adaptive control systems to significantly improve the quality of life for people with disabilities.

Table 3. Comparison between the characteristics of general exoskeletons and exoskeletons for specific disabilities.

Feature	General Exoskeletons	Exoskeletons for Specific Disabilities
Primary Use	Military, industrial, general medical [38]	Rehabilitation, daily assistance [8,39,40,41]
Design Focus	Strength, performance, ergonomics [42,43]	Customization, user comfort, adaptive control [8]
Control Mechanisms	Electrical motors, impedance control, force control [42]	EMG sensors, electro-stimulators, specialized control strategies [39,41,44]
Control Systems	Advanced synchronization with human movements [38,45]	Biosignal-based, adaptive to user needs [41,44]
Safety and Usability	General safety features [43,46]	High priority on minimizing fall risk, ease of use, comfort [8]
User Benefits	Enhanced capabilities, reduced fatigue [42]	Mobility restoration, improved quality of life [40,47]

presents a detailed comparison of the general characteristics of general-purpose exoskeletons and those developed specifically for people with disabilities.

Unlike general-purpose exoskeletons, which are designed to enhance physical capabilities in military, industrial, or general medical contexts, exoskeletons aimed at people with disabilities incorporate specific features designed for rehabilitation, assistance in daily activities, and comprehensive improvement of quality of life. These particularities make them essential tools to address this group of users’ unique needs. Applications of exoskeletons for people with disabilities are primarily focused on two key areas: clinical rehabilitation and assistance with activities of daily living.

In the field of clinical rehabilitation, these devices have been developed to facilitate functional recovery in people with spinal cord injuries, strokes, or other conditions that affect mobility [48,49]. Their design focuses on providing adaptive support that promotes neuroplasticity and restores motor functions, thereby contributing to a more effective and personalized rehabilitation process [50,51,52]. These devices allow the execution of repetitive and highly controlled exercises, which stimulate neuroplasticity and strengthen the muscles, facilitating functional recovery.

Some models are specifically designed to assist users in activities of daily living, such as walking, standing, or performing everyday tasks with greater independence. This functionality not only improves the autonomy of users but also reduces the need for constant external assistance, promoting greater social integration and a better quality of life [42,53,54,55].

Design considerations for the development of exoskeletons aimed at people with disabilities focus on addressing the individual needs of users, prioritizing customization, implementation of advanced control systems, comfort, and light weight.

These devices must be highly customizable, adapting to various morphologies and types of disability. To achieve this, they incorporate adjustable structures and interchangeable modules that allow precise adaptation to each user’s body size and specific constraints. This approach ensures an optimal ergonomic fit and greater efficiency in use, improving the user experience and maximizing functional benefits [53,56].

Since users can utilize the exoskeleton for extended periods, it is essential to employ lightweight and resistant materials that guarantee comfort and lightness, thus helping to reduce fatigue. In addition, ergonomics is considered a key factor in design to optimize the user experience and prevent injuries associated with prolonged use. A suitable ergonomic design ensures that the device fits optimally to the body, distributing loads in a balanced way and minimizing physical stress on joints and muscles. This comprehensive approach not only improves usability but also promotes the safety and well-being of the user during their interaction with the exoskeleton [57].

Unlike general-purpose exoskeletons, which focus on maximizing strength and physical performance, exoskeletons designed for people with disabilities incorporate advanced biosensor-based control systems, such as EEG (electroencephalography) or EOG (electrooculography) signals. These systems enable the interpretation of the user’s intentions and respond adaptively to their specific movements and needs. This intuitive and personalized interaction capability not only improves the effectiveness of the device but also facilitates a more natural and fluid user experience, dynamically adapting to the individual conditions and requirements of each user [51,55,58].

The benefits offered by these exoskeletons focus on three main aspects: restoring mobility, personalized rehabilitation, and significantly improving the quality of life for people with disabilities.

First, restoring mobility through an exoskeleton allows users to walk, stand, and move around more independently. This advancement has a physical impact, improving motor functionality, and generates a profound emotional effect, fostering self-esteem and autonomy. Second, personalized rehabilitation facilitates functional recovery through programs tailored to individual needs, promoting neuroplasticity and muscle strengthening. Finally, these devices contribute to a comprehensive improvement in the quality of life by reducing dependence on external assistance and facilitating participation in daily and social activities [42,49,50,53].

The personalized rehabilitation offered by exoskeletons enables the implementation of therapeutic routines specifically designed for functional recovery. These routines promote significant improvements in key aspects such as muscle strength, coordination, and balance. By adapting to the individual needs of each user, exoskeletons not only optimize therapeutic outcomes but also speed up the rehabilitation process. This personalized approach ensures that users can achieve their goals more efficiently, contributing to a comprehensive and sustainable recovery [48,50,52].

These exoskeletons not only positively impact the physical functionality of users but also play a crucial role in their emotional well-being, self-esteem, and social inclusion. By encouraging autonomy and reducing reliance on caregivers, the devices empower patients, allowing them to participate more actively in their daily lives and social settings. This increase in independence improves confidence and self-esteem and promotes greater social integration, reducing isolation and contributing to a better quality of life in emotional and psychological terms [59,60].

3.4. Developmental Challenges in Exoskeletons for People with Disabilities

Proper exoskeleton design has significant potential to improve the quality of life for people with disabilities. However, during its development, multiple challenges arise (Figure 5) that hinder its widespread adoption and limit its effectiveness. These challenges can be classified into four main categories: technical issues, usability challenges, economic barriers, and user acceptance challenges. Each of these aspects represents a critical hurdle that needs to be addressed to ensure that exoskeletons are accessible, functional, and well received by the target population.

Figure 5 categorizes the main challenges that limit the development and adoption of exoskeletons for people with disabilities into four hierarchical and interdependent categories: technical, usability, economic, and user acceptance. At the heart of it are technical challenges, including aspects such as range, weight, mobility, kinematic compatibility, and control techniques. These elements are critical, as they define the functional viability of the device. From this base, usability challenges emerge, related to ease of use, user–exoskeleton interaction, and the ability to customize, aspects that determine the comfort and effectiveness of daily use. Economic challenges, including high development and maintenance costs, as well as inadequate insurance coverage, impact both the accessibility and sustainability of these technologies. Finally, challenges related to user acceptance—such as stigmatization, the need for assistance in donning the device, or the lack of accessible infrastructure—represent social and cultural barriers that directly influence the actual adoption of the exoskeleton.

3.4.1. Technical Challenges

Exoskeletons face multiple technical challenges that impact their functionality, comfort, and efficiency. One of the main problems is the excessive dimensions of the device, which can lead to muscle fatigue, making it difficult to use for a long time [61] and limiting freedom of movement in everyday life [62]. Strategies such as using lightweight and resilient materials, miniaturizing components, and implementing ergonomic design have been implemented to mitigate this difficulty. However, these efforts are not always enough to ensure an optimal user experience.

Another significant challenge is battery life. Ensuring long battery life without compromising the device’s compact and lightweight design represents a complex technical challenge. The need for frequent refills limits their continuous use, reducing their practicality in everyday situations. Although energy recovery technologies have been explored, such as systems that harness the user’s movement to recharge the battery, a completely satisfactory solution that balances energy efficiency, durability, and compact design is yet to be found. These technical challenges underscore the need for continuous innovation in exoskeleton development to overcome current limitations and improve their adoption and functionality [63,64]. Exoskeleton control systems face significant challenges, as they must be robust, accurate, and able to interpret user intent in real time. Integrating biomechanical sensors and advanced algorithms, essential for smooth and adaptive interaction, adds complexity to the design and increases the device’s power consumption. Additionally, certain control methods, such as voice commands, may be ineffective in noisy environments or situations where verbal communication is not possible. These challenges highlight the need to develop more efficient and versatile control systems that adapt to users’ diverse needs and contexts without compromising the autonomy or functionality of the exoskeleton [65,66]. Finally, kinematic compatibility is a crucial aspect of exoskeleton design, as it directly influences the user’s comfort and the effectiveness of the interaction between the device and the human body. Although mimicking the entire joint kinematics could offer a more natural and fluid movement, its implementation is extremely complex due to the difficulty of accurately replicating human rotation axes. Alternatively, simplified mechanisms have been developed that eliminate relative movement between the exoskeleton and the user, making it easier to integrate and use without compromising functionality. These approaches aim to strike a balance between biomechanical precision and practicality, ensuring the device is both comfortable and effective in its application [15].

To address the challenge posed by the control system of exoskeletons and their use by people with disabilities, a distributed control architecture for electrohydraulic humanoid robots (HYDROïD) has been proposed, inspired by the functionality of the human nervous system [67], and it could be applied to active exoskeletons. This architecture overcomes the limitations of classical systems by distributing intelligence among joint controllers, allowing them to make decisions, control actuators and communicate their status autonomously. One of the advantages of this development is that it enables operation in a flexible, centralized or decentralized manner depending on the task, allowing for precise control of movement or dynamic compliance as required. According to evaluations by the National Institute of Science, the company has achieved a 50% improvement in update rate and a 30% reduction in latency, consolidating itself as an original and adaptable advance in the control of robotic systems that can be applied to active exosuits and exoskeletons.

The integration of Artificial Intelligence with the Internet of Things (AIoT) has the potential to significantly enhance the recognition of human intent and the dynamic adaptation of activities, enabling systems to respond more accurately and contextually, as highlighted [67]. This synergy is key to overcoming usability and control limitations, as it enables us to anticipate user behaviors, optimize interaction, and adjust devices or environments in real time according to the needs detected, which is essential in applications such as personalized assistance, rehabilitation, or intelligent automation.

Table 4. Synthesis of selected technical challenges and proposed solutions.

Category	Identified Challenges	Proposed Category
Mechanical and Ergonomic	Joint misalignment and poor fit [68,70]	Highly customizable designs [69,76]
Control and Sensing	Excess weight and mobility restriction [69,72]	Use of lightweight materials and 3D printing [71,72]
Energy and Power	Mechanical failures [70]	Evolutionary computation methods like genetic algorithms [77]
Interaction and Safety	Complex control algorithms [70,73]	Force myography (FMG) for reliable control [75]
Customization and Accessibility	Sensor failures and unreliable feedback [70,74]	Efficient power systems and regenerative energy solutions [70,74]

summarizes the main challenges and proposed solutions in the design of exoskeletons for individuals with disabilities, organized into five key categories. In the mechanical and ergonomic field, problems such as joint misalignment [68], excessive weight [69], and the possibility of mechanical failures [70] stand out, which are addressed through highly customizable designs [71] and the use of lightweight materials such as those obtained by 3D printing [72]. In terms of control and sensing, complexity in algorithms [73] and sensor failures [74] are addressed using evolutionary computation methods, such as genetic algorithms [75] and technologies like force myography (FMG) [76]. In the field of energy management, high consumption is recognized as a limitation [70] for which the development of more efficient energy systems and regenerative solutions is proposed [74]. The interaction and safety category encompasses fall hazards and the need for adequate training [77], which is addressed through real-time monitoring, emergency training, and response programs. Finally, in customization and accessibility, the challenges of adapting devices to individual needs [71] and maintaining their affordability [9] are noted; these challenges are mitigated through economical manufacturing and the design of portable devices that do not require clinical supervision [72]. This classification enables us to visualize both the complexity of exoskeleton design and the emerging lines of research in recent literature.

3.4.2. Usability Challenges

The usability of exoskeletons faces multiple challenges that directly impact their adoption and effectiveness. First, ease of use is a critical factor, as a complex process for donning and doffing the device can discourage frequent use and limit its integration into the user’s daily life. To ensure a positive experience, it is essential that handling the device does not require specialized assistance. In addition, the device’s adaptability to various contexts and activities, along with an accessible control interface, are key aspects for improving usability. These challenges underscore the importance of prioritizing the user’s needs in the design and development process [8].

The interaction between the user and the exoskeleton should minimize contact forces to prevent discomfort or potential injuries, thereby ensuring comfort and safety [78]. Mobility and independence are also essential factors, as many current devices are limited to clinical settings and require supervision, which reduces their usefulness in everyday life [10]. Finally, adaptability and customization pose a significant challenge, as anatomical differences among users necessitate specific adjustments tailored to each individual’s physiology. This increases both the complexity of the design and the overall cost of the device [3,18].

3.4.3. Cost Challenges

Exoskeletons face significant economic challenges that limit their widespread adoption and accessibility. First, the high costs associated with their development, manufacturing, and maintenance stem from the use of advanced materials and sophisticated technologies, which significantly increase the device’s final price. Although innovative methods, such as 3D printing, are being explored to reduce costs and optimize production processes, these solutions have not yet been widely implemented or managed to substantially lower prices. As a result, exoskeletons remain inaccessible to a large part of the population that could benefit from them, underscoring the need for further research into economically viable approaches to democratize access to this technology [72,79]. As a result, the high cost of these devices makes them inaccessible to a large part of people with disabilities, limiting their reach and effectiveness. Additionally, since they are not always covered by health insurance or public health systems, their adoption is further limited. This economic barrier prevents many people from accessing transformative technology and reduces the potential impact of exoskeletons on improving the quality of life and social inclusion of those who need them [72,78]. In addition, using exoskeletons requires specialized training, which represents an additional expense for both users and the health facilities that implement them [6].

3.4.4. User Acceptance Challenges

User acceptance of exoskeletons faces multiple challenges that hinder their widespread adoption. One major barrier is social stigmatization, as many users may feel uncomfortable or self-conscious when using bulky and highly visible devices in public environments. This factor can lead to rejection or resistance to the use of such technologies, even when their functional benefits are evident. To enhance acceptability, it is essential to design more discreet, aesthetically integrated, and less intrusive exoskeletons [80].

Table 5. Challenges in the development and implementation of exoskeletons for people with disabilities.

Challenge	Description	Reference
Technical	Weight, size, battery life, control systems, kinematic compatibility	[15,16,65,66,72]
Usability	Ease of use, interaction forces, mobility, and independency	[8,15,78]
Cost	High manufacturing costs, affordability	[72,79]
User acceptance	Stigmatization, comfort and safety, training and adaptation	[10,81,82]
Others	Complexity in user–exoskeleton interaction, safety, clinical evidence, limitations in everyday use	[7,83,84,85,86]

outlines the challenges in the development and implementation of exoskeletons, describing various parameters classified by type of challenge.

Comfort and safety are essential factors for the acceptance and long-term use of exoskeletons. The risk of falls, as well as abrasions or skin injuries caused by prolonged contact with the device, can lead to user distrust and limit adoption. Ergonomic designs that minimize pressure points are fundamental to addressing these challenges, preventing injuries, and enhancing comfort [10,81].

Another significant challenge to user acceptance is the need for training and adaptation. Many devices require extensive and complex training to operate efficiently, which can be intimidating and discourage adoption. To overcome this barrier, it is essential to develop more intuitive and easy-to-learn exoskeletons, minimizing the learning curve and enabling users to become familiar with their operation quickly. The implementation of simplified control interfaces, real-time feedback systems, and automated assistance can significantly enhance usability and user acceptability [82].

Multiple factors influence acceptability [83], including the need for intuitive human–machine interaction, effective control methods—such as voice commands or eye-tracking systems—as well as the environmental context in which these devices are used [7]. Additionally, factors such as user safety, stability, fall risks, and potential system failures can negatively impact psychological acceptance [17]. Moreover, the lack of clinical evidence and long-term studies makes it difficult to validate the therapeutic benefits, optimal usage dosage, and overall impact of exoskeletons across various disabilities, which significantly affects their acceptance in medical and rehabilitation settings [84,85,86].

3.5. Perspectives on Future Developments in Exoskeletons for Disabilities

A promising future is in sight for exoskeletons, particularly for people with disabilities, driven by technological innovations and interdisciplinary advances. Below are several key areas that are setting the course for future developments, potentially significantly transforming the functionality, accessibility, and adoption of these devices. These innovations aim to address current challenges and enhance the possibilities for improving users’ mobility, independence, and quality of life (Figure 6).

Figure 7 illustrates the key areas for the development and implementation of exoskeletons for people with disabilities. Technological aspects are highlighted to address problems such as spasticity and to improve the ability to perform standing tasks without assistance. Personalization emerges as a strategic axis that integrates interdisciplinary advances, particularly in artificial intelligence, nanoelectronics, and extended reality, to tailor devices to the individual needs of users.

Two facilitating factors of acceptance stand out: user-centered design, which prioritizes ease of use, comfort, simplicity, and the sustainability of materials, and the consideration of recyclable and durable components. These elements, although not strictly technological factors are essential to ensure social integration, a positive perception, and the viability of prolonged device use.

Materials such as carbon fiber and recycled plastics are being explored as durable and eco-friendly alternatives to traditional metals and polymers used in the manufacture of exoskeletons. These materials offer advantages in terms of strength and lightness, contributing to a reduction in the environmental impact associated with the production of these devices. In addition, additive manufacturing, or 3D printing, is gaining relevance as a technology that reduces waste, optimizes production processes, and improves design efficiency [87]. Shape memory alloys (SMAs) are being developed that offer dynamic adaptation to the specific needs of the user and their anthropometry, enabling bending and twisting movements in robots and soft wearable exoskeletons [88,89]. These alloys represent a significant advance, combining lightness, flexibility, and adaptability to easily integrate them into portable, user-friendly devices.

As exoskeletons have the potential to empower people with disabilities, it is imperative to move towards lighter, more portable designs that are adapted for use in the home and community settings [5]. These devices must withstand prolonged use without compromising comfort or functionality. In addition, it is critical to reduce production costs by implementing new manufacturing techniques, such as 3D printing, and using more economical and sustainable materials [17].

Developing customizable exoskeletons that prioritize the comfort of users with disabilities, despite the variable conditions they may present, poses a significant challenge due to the large number of variables involved, as well as the need for affordability and ease of use. Key design features include minimizing the risk of falls, ensuring comfort, simplifying the process of putting on and removing the device, and reducing purchase costs [90]. Involving users in the design process is crucial for ensuring that exoskeletons meet their specific needs and enhance device acceptance [91,92]. Active user participation allows to identify key requirements, such as comfort, ease of use, and adaptability, that might otherwise be overlooked. This user-centric approach optimizes the device’s functionality and fosters greater trust and adoption by ensuring that the design aligns with the expectations and realities of those who use it.

Creating efficient interfaces and controllers between humans and machines, enabling smooth and fluid movements, can benefit significantly from recent data processing and nanoelectronics advances. These emerging technologies offer the potential to develop more versatile exoskeletons that can dynamically adapt to user needs, thereby improving human–machine interaction [93]. The development of exoskeletons benefits from interdisciplinary collaboration, integrating knowledge from biomedical engineering, disability studies, and technological applicability. This approach addresses issues such as ableism and stigmatization, ensuring that devices are designed with a positive and inclusive view of disability [94,95]. Exoskeletons are being designed for a wide range of applications, including medical rehabilitation, assisting with activities of daily living, and supporting maintaining independence in older people. In particular, hand exoskeletons are being developed to rehabilitate and enhance manual dexterity and grip strength, which are crucial for the functional recovery of patients with motor limitations. On the other hand, lower-limb exoskeletons are proving to be effective tools for gait training in patients with spinal cord injuries or cerebral palsy, facilitating mobility recovery and promoting neuroplasticity [96,97,98]. These advances underscore the transformative potential of exoskeletons in the field of health and quality of life.

Future exoskeletons will need to be highly customized to meet the specific needs and goals of people with various levels of disability. This includes key functionalities such as standing up, spasticity control and facilitating participation in community roles. Personalization will enable devices to adapt to individual conditions, optimize their effectiveness, and promote greater social inclusion and autonomy for users [92]. The exoskeletons are expected to be integrated with other assistive technologies, forming a comprehensive support system for people with disabilities. This integration will include virtual reality, machine learning, and human–robot interaction, significantly improving functionality and user experience [81]. As exoskeleton technology advances, it is crucial to establish regulatory guidelines and robust safety standards that ensure its safe and effective use in both medical and non-medical applications [82].

It is crucial to improve methods for assessing comfort, acceptance, and functionality in users with moderate to severe disabilities to optimize the performance of exoskeletons [2]. AI-based adaptive control systems enable the impedance of joints to be dynamically adjusted in response to human–orthosis interaction, providing more accurate and personalized assistance [99]. Additionally, the use of deep learning algorithms and neural networks to generate specific gait trajectories has significantly enhanced the synchronization between the user and the exoskeleton, thereby promoting a more natural user experience [100]. Another prominent line is bio-signal-based control, where myoelectric (EMG) and even brain (BCI) signals are employed to detect the user’s intention to move, allowing the exoskeleton to act with a highly intuitive and personalized response [101]. These capabilities have already been implemented in experimental devices and clinical rehabilitation platforms. AI has been used to develop personalized rehabilitation therapies, through continuous analysis of user data and adaptive feedback, allowing rehabilitation programs to be designed tailored to each patient’s individual progress [102].

Implementing Artificial Intelligence (AI) is crucial for enhancing the device’s responsiveness to external disturbances and unexpected movements, thereby ensuring greater stability and adaptability [3]. In addition, integrating brain–computer interfaces (BCIs) can enhance intuitive control, reduce reliance on manual commands, and improve user–device interaction [6]. These innovations can be driven by the development of applications in rehabilitation and healthcare that incorporate virtual, augmented, and mixed-reality systems, which offer immersive and personalized environments to optimize physical therapy and accelerate functional recovery [83].

New lines of research are driving the development of pediatric exoskeletons to address the specific needs of children with cerebral palsy, representing a significant advance in early care and rehabilitation for children. In parallel, an emerging theme is the design of soft exosuits for post-stroke rehabilitation, which prioritize a user-centered approach and functional recovery. These devices, based on lightweight and adaptable technologies, offer a less invasive and more comfortable alternative, facilitating mobility and therapy in patients with sequelae of stroke. These developments reflect a trend towards customized and technologically innovative solutions in rehabilitation.

4. Discussion

The development of exoskeletons for people with disabilities represents a promising line of research but also a deeply challenging one due to the convergence of technical, usability, economic, and social factors that make it difficult to create functional, accessible, and widely accepted devices.

4.1. Technical Aspects

One of the main challenges is to strike a balance between complexity and functionality, highlighting the need for compact devices that offer convenience and allow for long-term use [54]. Although lightweight and strong materials have been used, along with the miniaturization of electronic components, integrating these advances without compromising durability and functionality remains a hurdle. Battery life is another significant limitation. Currently, the autonomy of exoskeletons in general represents a significant challenge. There have been some developments in energy recovery [63,64]; however, much work remains to be performed to achieve significant autonomy in compact designs. Control systems face the challenge of being both intuitive and accurate while also being energy-efficient, which is further complicated by the integration of biomechanical sensors [103], intelligent algorithms, and advanced control technologies [84]. Although addressed through simplified mechanisms, kinematic compatibility remains a complex challenge [58].

The use of artificial intelligence has proven to promote developments through machine learning and deep learning that allow improving employment and control systems by learning and modifying the performance of exoskeletons according to the movements of users [85]; therefore, AI will allow an important evolutionary leap in this type of technology. Figure 7 illustrates the contributions in multiple areas related to the development of exoskeletons, and that can impact development improvement for people with disabilities [86].

4.2. Usability and User Acceptance

The widespread adoption of exoskeletons largely depends on their ease of use, particularly in the processes of donning and doffing the device, as complex procedures tend to discourage users [59]. Additionally, minimizing contact forces is essential to avoid physical discomfort [87], as well as ensuring operability in uncontrolled environments, given that many devices still require clinical supervision, which limits user independence [10]. The anatomical diversity of users also presents a challenge in terms of adaptability and customization, increasing both technical complexity and production costs [3].

Moreover, social and psychological acceptance represents an additional barrier, especially when devices are bulky and highly visible, leading to stigmatization in public spaces [62]. This underscores the need to develop more discreet and comfortable exoskeletons that enhance user empowerment [10]. Furthermore, the learning curve and adaptation time influence users’ willingness to adopt these technologies, making it essential to implement intuitive and user-friendly interfaces that facilitate rapid familiarization [63]. These interrelated factors must be considered a priority in future user-centered design strategies.

4.3. Cost and Technological Complexity

The high cost of exoskeletons remains one of the main barriers to their widespread adoption, primarily due to the use of advanced materials and complex manufacturing processes [61]. Although 3D printing has begun to reduce some production costs, its large-scale application is still limited [88]. Additionally, the requirement for specialized training for both users and medical personnel further increases the overall cost [6]. Other significant challenges include human–machine interaction, safety in uncontrolled environments, the lack of long-term clinical evidence, and limited integration into daily life activities [7].

Nevertheless, the outlook is promising. The development of sustainable materials—such as carbon fiber and recycled plastics, alongside advances in brain–machine interfaces and artificial intelligence algorithms, is paving the way for a new generation of lighter, more accessible, and personalized exoskeletons. These innovations have the potential to overcome current limitations and substantially enhance the quality of life for individuals with disabilities [6,7,61,88].

4.4. Absence of Clinical and End-User Perspectives

The absence of studies that directly integrate the perspectives of end users or clinicians represents a major limitation for the development of exoskeletons for people with disabilities. Most of the research analyzed focuses on technical, functional, or design aspects, leaving aside qualitative data from lived experience or clinical practice. This absence of studies limits the comprehensive understanding of the factors that influence acceptance, usability, and effectiveness in real-world contexts. It is recommended that future research incorporate participatory methodologies, such as interviews and case studies, or user-centered approaches, to align technological development with the real needs, expectations, and challenges faced by both users and health professionals in the implementation of these technologies.

To effectively integrate the perspectives of end users and clinical professionals in future exoskeleton research, it is recommended that qualitative methodologies, such as focus groups and semi-structured interviews, be employed to explore perceptions, barriers, and needs based on lived experiences. Additionally, experimental validation in real-world settings—through clinical case studies and quasi-experimental designs—can help assess functionality, acceptance, and safety in everyday contexts. Triangulating objective data (e.g., EMG or inertial sensors), validated subjective instruments (such as NASA-TLX and QUEST 2.0), and direct user testimonies will provide a comprehensive understanding of the usability and impact of these technologies.

4.5. Other Challenges

Beyond technical and user acceptance challenges, the widespread adoption of exoskeletons also faces structural barriers related to regulation, reimbursement mechanisms, and clinical validation. Currently, many devices lack clear regulatory pathways that would allow them to be approved as medical technologies within national and international regulatory frameworks. This regulatory ambiguity makes it difficult to integrate into public or private health systems and limits coverage by insurance or reimbursement programs, thereby restricting access to users who could significantly benefit from its use. In addition, the scarcity of controlled and standardized clinical trials prevents conclusive proof of the efficacy, safety, and cost–benefit of these devices, hindering their institutional recognition as therapeutic tools. Therefore, it is a priority to promote robust clinical research, as well as to establish innovation policies that facilitate technical and clinical validation, facilitate public or private funding, and accelerate the path towards a safe, equitable, and sustainable adoption of exoskeletons.

5. Conclusions

The development of exoskeletons for people with disabilities is at a challenging stage of technological maturity in which technical, usability, economic, and social factors converge. Although significant advances have been made in materials, the miniaturization of components, and intelligent control using artificial intelligence, significant obstacles, such as energy autonomy, kinematic compatibility, and economic accessibility, remain. Overcoming these barriers requires a multidisciplinary approach integrating technological innovation with user-centered design.

Despite the current limitations, the future of exoskeletons is promising, thanks to the integration of emerging technologies such as artificial intelligence, 3D printing, and sustainable materials. These innovations will allow the development of lighter, more functional and affordable devices, favoring greater personalization and social acceptance. If investment in applied research continues and the inclusion of these devices in everyday life is promoted, exoskeletons could become transformative tools for the autonomy and quality of life of people with disabilities.

Exoskeletons explicitly designed for people with disabilities represent a technological evolution focused on the human being, where functionality is not limited to increasing strength or physical performance but seeks to restore mobility, promote personalized rehabilitation, and comprehensively improve quality of life. Unlike general-purpose devices, these exoskeletons prioritize adaptability, ergonomics, and intuitive control, responding to the individual needs of users through biosensor-based technologies and highly customizable designs. Its impact transcends the physical, empowering users emotionally, promoting autonomy, and boosting their social inclusion. This humanized and functional approach reaffirms the transformative role of exoskeletons as key tools in building a more inclusive and equitable society.