Walking on Real-World Terrain with an Ankle Exoskeleton in Cerebral Palsy

Emmanuella A. Tagoe, Ying Fang, Jack R. Williams, Zachary F. Lerner

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Despite medical treatment focused on addressing walking disability, many millions of people with neurological conditions, like cerebral palsy (CP), struggle to maintain independent mobility. Lower limb exoskeletons and exosuits may hold potential for augmenting walking ability. However, it remains unknown whether these wearable robots are safe and beneficial for use outside of highly controlled laboratory environments, the demonstration of which is necessary for clinical translation. Here, we show that a lightweight, portable, ankle exoskeleton with an adaptable one-size-works-for-all assistance controller can improve energy efficiency and walking speed for individuals with CP spanning a wide spectrum of lower limb impairment in a multi-terrain real-world environment. Tested on an outdoor walking route with level, sloped, and stair terrain, robotic assistance resulted in a 15-18% (p = 0.013-0.026) reduction in estimated energy cost and a 7-8% (p = 0.001-0.004) increase in average walking speed across 'shorter' 6-minute and 'longer' 20-minute walking durations relative to unassisted walking. This study provides evidence that wearable robots may soon improve mobility in neighborhood, school, and community settings for individuals with CP.

Original languageEnglish (US)
Pages (from-to)202-212
Number of pages11
JournalIEEE Transactions on Medical Robotics and Bionics
Issue number1
StatePublished - Feb 1 2024
Externally publishedYes


  • Cerebral palsy
  • exoskeleton
  • exosuit
  • metabolic cost of transport
  • real-world

ASJC Scopus subject areas

  • Control and Optimization
  • Artificial Intelligence
  • Human-Computer Interaction
  • Biomedical Engineering
  • Computer Science Applications


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