Merging neural stimulation and exoskeletons to enhance sensorimotor hand functions after brain or spinal cord injury.

Overview

1. Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
2. Comprehensive Center for Artificial Intelligence in Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
3. NeuroEngineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
4. Institute Mihajlo Pupin, University of Belgrade, Belgrade, Serbia
5. Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
6. Munich Institute of Robotics and Machine Intelligence, School of Computation Information and Technology, Technical University of Munich, Munich, Germany
7. Vilje Bionics AS, Hausmanns gate 16, 0182 Oslo, Norway
8. Clinic for Rehabilitation “Dr Miroslav Zotović,” Belgrade, Serbia
9. Technology and Innovation Unit and Department of Research, ZURZACH Care AG, Bad Zurzach, Aargau, Switzerland
10. Faculty of Medicine, University of Belgrade, Belgrade, Serbia
11. Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise, Singapore, Singapore

Abstract

Sophisticated hand movements are essential for daily activities, but central neurological impairments often compromise them. Since full recovery through conventional physiotherapy is rare, assistance is crucial. While neural implants show promise, clinical use remains distant, urging immediate assistive alternatives. Current exoskeletons and neurostimulation garments lack sufficient motor support and sensory feedback, limiting dexterity. We developed a neurorobotic system combining portable exoskeletons with targeted neurostimulation via custom-made e-sleeve and tested it in 14 individuals with central neural injuries. We provide evidence of restored finger mobility and tactile perception, even in patients with clinically complete sensory loss, by recruiting residual peripheral pathways. Eight participants completed functional assessments, in which they exploited neurostimulation to improve grasp precision and enhance strength. This enabled manipulation of fragile and cumbersome objects, essential for everyday activities. Personalized assistive technologies have clinical potential to promote independence and support the reintegration of people with neurological impairments into society.

Reproduced under the paper's license (CC BY), from the paper cited above.

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Data

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• zenodo:18744622, at Zenodo; found in “Data, code, and materials availability:”

Data, code, and materials availability

All data and code needed to evaluate and reproduce the results in the paper are present in the paper and/or the Supplementary Materials. In addition, the datasets supporting the findings of this study are publicly archived in the Zenodo repository (https://zenodo.org/records/18744622). This study did not generate new materials.

Reproduced under the paper's license (CC BY), from the paper cited above.

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Version 1, 27 September 2026: the first record

Recorded: type, language, journal, volume, issue, pages, dates, 17 authors, 9 MeSH terms, 2 funders, 79 references.

Cite

This paper

Cimolato, A., Cekić, D., Šećerović, N. K., Razzoli, M., Missiroli, F., Dittli, J., Palopoli, P., Bellomo, S., Kenel, J., Dujović, S. D., Frese, S., Masia, L., Djordjevic, O., Lambercy, O., Valle, G., Konstantinovic, L., & Raspopovic, S. (2026). Merging neural stimulation and exoskeletons to enhance sensorimotor hand functions after brain or spinal cord injury. Science advances, 12(25), eady3144. https://doi.org/10.1126/sciadv.ady3144

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