AI Improves Gait Assistance for Neuromuscular Disorders

In a recent article published in the Journal of NeuroEngineering and Rehabilitation, researchers introduced an innovative deep reinforcement learning (RL)-based controller for lower limb rehabilitation exoskeletons (LLREs). This approach aims to provide autonomous and robust walking assistance to patients with various neuromuscular disorders

AI Improves Gait Assistance for Neuromuscular Disorders

RL-based motion imitation control of the LLRE (the LLRE control loop in Fig. 2). The inputs of the motion imitation network consist of the joint state history, the action history and the future target motions. This learning network outputs joint target positions, which are processed by a low-pass filter and then translated into torque-level commands by PD control. Image Credit:


LLREs are wearable robots designed to provide gait assistance and functional substitution for individuals suffering from motor disorders or loss of motor control due to spinal cord injury, stroke, or other neuromuscular diseases. Designing robust controllers for LLREs that can manage the uncertain human-exoskeleton interaction forces from patients is a challenging task.

Conventional controllers often rely on trajectory tracking, model-based predictive control, or impedance control, which may be ineffective, unstable, or require laborious tuning of control parameters. In contrast, data-driven, RL-based controllers are emerging as a promising alternative, capable of learning optimal control policies from data without relying on accurate models or predefined rules.

About the Research

In this paper, the authors proposed a novel deep neural network and reinforcement learning (RL)-based robust controller for a lower limb rehabilitation exoskeleton (LLRE). They employed a decoupled human-exoskeleton simulation training technique utilizing three independent networks: a motion imitation network, an interaction network, and muscle coordination networks.

The motion imitation network learns a control policy for the LLRE to mimic a reference walking motion while maintaining balance and stability under the influence of human-exoskeleton interaction forces. The interaction network learns a control policy for the human to minimize interaction forces with the LLRE, considering the patient's desire to follow the exoskeleton's movements and reduce strap pressure.

The muscle coordination network learns a control policy for humans to coordinate muscle activations to produce joint accelerations close to the desired ones from the interaction network. These three networks are trained together through simulations using the state-of-the-art RL algorithm known as proximal policy optimization (PPO).

To increase robustness across different human conditions, the researchers employed domain randomization during training. They randomized human muscle strength, exoskeleton mechanical properties, motor command tracking accuracy, control delay, and observation latency. This approach aimed to produce a universal controller that can adapt to varying degrees of human disability and exoskeleton uncertainty without requiring any control parameter tuning.

Furthermore, the trained controller was tested in various simulated scenarios with human subjects exhibiting different neuromuscular disorders, such as muscle weakness, passive muscles (quadriplegic), or hemiplegic conditions. It was evaluated based on joint tracking accuracy, center of pressure (CoP)-based stability, gait symmetry, and reward statistics. Additionally, an ablation study was conducted to demonstrate the effects of different components of the controller, including the interaction network, the muscle coordination network, and domain randomization.

Research Findings

The outcomes showed that the new controller provided robust walking assistance under varying human-exoskeleton interactions and exoskeleton dynamics. It effectively handled different patients without needing any control parameter modifications. The controller demonstrated strong robustness against a wide range of exoskeleton dynamic properties and interaction forces.

The interaction and muscle coordination networks improved performance by reducing interaction forces and enhancing muscle coordination. Additionally, domain randomization enhanced the controller's generalization ability by exposing it to diverse environments during training.


The developed controller has significant potential for both home and clinical use of LLREs. It offers reliable walking assistance to patients with various neuromuscular disorders without requiring prior knowledge of the patient's condition. The controller adapts to different patient needs and conditions by handling uncertainties and variations in exoskeleton dynamics and human-exoskeleton interactions.

This controller can improve mobility and quality of life by allowing patients to perform daily activities without the use of crutches or other balance aids. It makes the rehabilitation process more efficient and less labor-intensive for both patients and therapists. In clinical settings, it can be integrated into rehabilitation programs to provide consistent and reliable assistance, leading to more personalized rehabilitation plans as the exoskeleton adjusts in real-time to the patient’s progress.

The technology also reduces the burden on caregivers and therapists by minimizing the need for constant supervision. It can be extended to other wearable robots, such as upper limb exoskeletons and prosthetic devices, enhancing their functionality and usability.

Furthermore, the robust and adaptable nature of this controller can lead to innovations in other fields, like industrial robotics, where precise and adaptive control is essential. The principles developed for this LLRE controller could inspire new approaches to designing controllers for various robotic systems that interact closely with humans.


In summary, the novel controller effectively leveraged the potential of deep learning for LLRE. It could be adapted for other types of wearable robots, such as upper limb exoskeletons or prosthetic devices.

The researchers suggested future directions for their work, including testing the controller on physical exoskeleton hardware, incorporating more realistic human models and exoskeleton designs, and extending the controller to other tasks and skills beyond walking.

Journal Reference

Luo, S., Androwis, G., Adamovich, S. et al. Robust walking control of a lower limb rehabilitation exoskeleton coupled with a musculoskeletal model via deep reinforcement learning. J NeuroEngineering Rehabil 20, 34 (2023).,

Disclaimer: The views expressed here are those of the author expressed in their private capacity and do not necessarily represent the views of Limited T/A AZoNetwork the owner and operator of this website. This disclaimer forms part of the Terms and conditions of use of this website.

Article Revisions

  • Jun 21 2024 - Title changed from "Universal Neural Network Controller for Rehabilitation Exoskeletons " to "AI Improves Gait Assistance for Neuromuscular Disorders"
Muhammad Osama

Written by

Muhammad Osama

Muhammad Osama is a full-time data analytics consultant and freelance technical writer based in Delhi, India. He specializes in transforming complex technical concepts into accessible content. He has a Bachelor of Technology in Mechanical Engineering with specialization in AI & Robotics from Galgotias University, India, and he has extensive experience in technical content writing, data science and analytics, and artificial intelligence.


Please use one of the following formats to cite this article in your essay, paper or report:

  • APA

    Osama, Muhammad. (2024, June 21). AI Improves Gait Assistance for Neuromuscular Disorders. AZoRobotics. Retrieved on July 19, 2024 from

  • MLA

    Osama, Muhammad. "AI Improves Gait Assistance for Neuromuscular Disorders". AZoRobotics. 19 July 2024. <>.

  • Chicago

    Osama, Muhammad. "AI Improves Gait Assistance for Neuromuscular Disorders". AZoRobotics. (accessed July 19, 2024).

  • Harvard

    Osama, Muhammad. 2024. AI Improves Gait Assistance for Neuromuscular Disorders. AZoRobotics, viewed 19 July 2024,

Tell Us What You Think

Do you have a review, update or anything you would like to add to this news story?

Leave your feedback
Your comment type

While we only use edited and approved content for Azthena answers, it may on occasions provide incorrect responses. Please confirm any data provided with the related suppliers or authors. We do not provide medical advice, if you search for medical information you must always consult a medical professional before acting on any information provided.

Your questions, but not your email details will be shared with OpenAI and retained for 30 days in accordance with their privacy principles.

Please do not ask questions that use sensitive or confidential information.

Read the full Terms & Conditions.