Researchers from the Medical University of Vienna, in collaboration with ETH Zurich, Technical University of Munich, and Belgrade Faculty of Medicine, have developed a wearable neurorobotic system that combines electrical nerve stimulation with a hand exoskeleton. In a clinical trial of 14 patients with hand impairments due to nerve damage, the technology supported finger mobility, tactile perception, and grip force control. The results demonstrate the potential for personalized support systems for people living with the effects of spinal cord or brain injuries. The study was recently published in the journal Science Advances.
Hand movements and the sense of touch are essential for everyday activities such as grasping, eating, dressing, and hygiene. However, damage to the central nervous system often leaves motor and sensory deficits in the hands. While traditional rehabilitation can provide improvement, it does not always fully restore hand function. Therefore, there is a great need for assistive technologies suitable for everyday use.
A research team led by Stanisa Raspopovic, Research Director at MedUni Vienna’s Center for Medical Physics and Biomedical Engineering, has developed the “SensoExo” system to assist people with sensorimotor disorders of the hand. It combines a wearable hand exoskeleton with a custom-fit neurostimulation sleeve. The sleeve stimulates specific nerves and muscles in the forearm through the skin. Sensors in the fingers detect contact and grip forces and convert this information into electrical stimulation to provide tactile feedback to the user. Additionally, functional electrical stimulation allows users to open and close their fingers more easily.
Our aim was not only to provide mechanical support for movement, but also to restore the sense of touch. The interaction of force, movement, and tactile sensation is especially important when gripping. Without feedback about how firmly objects are being held, hand function in everyday life remains severely limited. ”
Stanisa Raspopovic, Vienna MedUni Center for Medical Physics and Biomedical Engineering
Individual support based on disability
The system was tested on 14 patients with hand neuropathy. All study participants exhibited sensory impairment and therefore received tactile feedback via transcutaneous electrical nerve stimulation. Functional muscle stimulation was also used to support hand opening and grip strength, particularly in seven individuals with severe motor impairments.
This study compared three conditions: no support, support with only an exoskeleton, and a combination of exoskeleton and nerve stimulation. Eight of the 14 participants also completed tasks that involved functional grasping and release of bulky and fragile objects. This study reveals that combining exoskeleton and neural stimulation provides additional benefits compared to exoskeleton alone. In patients with severe movement disorders, SensoExo improved finger mobility significantly more than the exoskeleton alone. Artificially mediated tactile feedback also increased the area of the hand where touch sensations were perceptible.
“This result shows that motor assistance and sensory feedback need to be considered together,” explains lead author Andrea Cimolato from the Center for Medical Physics and Biomedical Engineering at MedUni Vienna. “This system can be adapted according to an individual’s disability profile. People with more severe motor impairments particularly benefited from additional motor support, while those with significant sensory loss used sensory feedback to more accurately grasp fragile objects.”
Improving grasping ability for everyday objects
In functional testing, participants using SensoExo achieved the highest success rate when grasping and carrying objects. For bulky objects, muscle stimulation supported grip strength. For fragile objects, sensory feedback helped avoid applying too much pressure.
“This technology is currently a prototype and is not a fully developed medical device for everyday use,” Rapopovic stressed. “However, this study provides early clinical evidence that the combination of non-invasive neural stimulation and wearable robots can form a realistic basis for future personalized assistance systems.”
In addition to MedUni Vienna, a research team led by Lorenzo Masia from the Technical University of Munich and Olivier Lambercy from the ETH Zurich developed the exoskeleton, and Ljubica Kostadinovic and his team from the Belgrade Faculty of Medicine assisted with clinical evaluation. Future studies with larger patient groups, grouped more specifically according to symptom type and severity, will help determine the robustness of these effects and assess the extent to which such systems can be integrated into rehabilitation and daily life over time.
sauce:
Medical University of Vienna
Reference magazines:
Timolato, A. others. (2026). Fusion of neural stimulation and exoskeleton to enhance sensorimotor function of the hand after brain or spinal cord injury. scientific progress. DOI: 10.1126/sciadv.ady3144. https://www.science.org/doi/10.1126/sciadv.ady3144
