Robotics and Exoskeletons in Neurorehabilitation

Neurological disorders such as stroke, spinal cord injury, Parkinson’s disease, and cerebral palsy are major contributors to long-term disability worldwide. Robotic rehabilitation systems and wearable exoskeletons are increasingly used to provide intensive, personalized, and evidence-based therapy. This chapter offers a comprehensive overview of robotic neurorehabilitation, covering devices from end-effector systems to wearable exoskeletons, and the biomechanical and neurophysiological principles that guide motor recovery. It emphasizes how engineering developments are applied in clinical practice and how patient outcomes are measured using biomechanical, electrophysiological, and metabolic indicators, alongside standard clinical scales. Evidence from controlled trials across different neurological conditions is reviewed, highlighting both the potential benefits and current limitations of robotic interventions. The chapter also examines key control strategies, including assist-as-needed approaches, impedance control, and brain–computer interfaces, and their role in promoting neuroplasticity and functional recovery. It also discusses ongoing challenges and future directions, including improving outcome standardization, facilitating the transfer of skills to daily activities for wider clinical adoption.