Who can benefit from a smart-powered orthosis like the Agilik?

A smart-powered orthosis, like the Agilik, can make a real difference for people who can walk but are limited by muscle weakness, a crouch gait, or knee instability. By combining advanced technology with expert orthotic design, it provides adaptive support that works with the body, helping to create a more efficient, controlled walking pattern in everyday settings.

For the right individual, it can support greater independence, reduce fatigue, and help maintain mobility into adulthood.

What are smart-powered orthoses?

Smart-powered orthoses, sometimes described as robotic orthoses or robotic-assisted leg braces, represent the next stage in orthotic technology. These devices combine traditional bracing with powered assistance at key joints, most often the knee, to help improve walking patterns, posture, and endurance.

Unlike robotic exoskeletons, which take over movement entirely, a smart powered orthosis, such as the Agilik, works with the user’s own muscles. It detects the leg’s position during the gait cycle and applies gentle, timed power to assist movement. This allows the person to walk more efficiently while maintaining active control of their limbs.

These devices are particularly helpful for people who can already walk but experience fatigue, crouch gait, or difficulty keeping their knees straight while walking.

Who can benefit from a smart-powered orthosis?

Children and young people with cerebral palsy

For many children with cerebral palsy, walking is possible but not always efficient. Some develop a pattern known as crouch gait, where the knees remain bent throughout the stance phase of walking.

A smart powered orthosis like the Agilik can support these patients by:

• assisting knee extension during stance and controlled flexion during swing
• encouraging more upright posture and alignment of the hips and pelvis
• improving energy efficiency and walking endurance
• helping to prevent progressive knee and hip flexion contractures by promoting full extension in each step

These benefits are most often seen in children classified as GMFCS Levels II–III, who walk independently or with aids but struggle with crouch gait, fatigue, or instability despite well-fitted AFOs.

People recovering from brain injury

Following an acquired or traumatic brain injury, some people retain partial mobility but experience weakness or poor coordination, especially at the knee. This can lead to inconsistent step timing, knee buckling, or over-reliance on the stronger leg.

A robotic orthosis provides targeted knee assistance during both stance and swing phases. By supporting active movement, it can:

• improve knee control and confidence in walking
• reduce compensatory patterns such as circumduction or trunk lean
• allow greater distances to be walked with less fatigue

People with incomplete spinal cord injury (SCI)

In incomplete spinal cord injury, there may be enough motor function preserved to allow walking, but often with poor control at the knee. The quadriceps may not generate sufficient force to maintain the leg in extension, leading to instability.

A smart-powered orthosis can assist with both stance control and swing initiation, providing:

• controlled knee extension to prevent collapse
• support during stair ascent and descent
• a smoother, safer gait pattern with less compensatory upper body effort

By augmenting voluntary movement, robotic orthoses like the Agilik can improve independence and expand walking opportunities beyond the therapy setting.

People with neuromuscular conditions

Conditions such as muscular dystrophy, spinal muscular atrophy (SMA), or other neuromuscular disorders often cause progressive weakness of the quadriceps and hip extensors.

Maintaining upright mobility in these conditions helps preserve bone and muscle strength and delays secondary complications such as joint stiffness or contractures.

Smart-powered orthoses can:

• Provide proportional assistance to weakened muscles during walking.
• Reduce the energy cost of ambulation.
• Help maintain participation in daily life and extend the period of functional walking.

Suitability should be carefully assessed by an orthotist and physiotherapist to ensure there is sufficient voluntary control to activate the device safely.

Who it may not be suitable for

Smart-powered orthoses are assistive, not fully robotic, and require some active movement from the user. They may not be appropriate for people who:

• Have complete paralysis or flaccid tone in the lower limbs.
• Have severe spasticity or involuntary movements that disrupt normal gait cycles.
• Have fixed flexion contractures at the knee or hip (typically greater than 20 degrees).
• Cannot follow instructions or safely manage a powered device.

A comprehensive clinical assessment and gait analysis are essential before prescription to ensure the device will deliver safe and meaningful benefits.

What families and patients can expect

For suitable users, robotic orthoses like the Agilik can lead to noticeable improvements in daily walking. Families often notice:

• A more upright and symmetrical gait pattern
• Reduced crouching and less knee collapse during stance
• Improved walking endurance and participation at school or work
• Decreased fatigue and better energy for other activities

Clinicians have also observed secondary benefits such as improved posture, reduced shoe wear (from better foot clearance), and potential carry-over effects, where walking improves even without the device.

How the technology works

At the core of a smart powered orthosis is a motorised knee joint linked to sensors and a compact battery unit.

• The motor delivers torque to assist movement in both flexion and extension.
• Sensors at the knee and foot continuously measure position and pressure, allowing the device to identify which phase of gait the user is in.
• A microprocessor analyses this data in real time to decide when and how much power to apply.

This allows the orthosis to provide adaptive support that matches the user’s natural movement rather than enforcing a rigid pattern.

Some models, including the Agilik, were originally developed in military applications, meaning the components are lightweight yet robust enough for daily use.

Funding and access

Because these devices involve advanced robotic technology, they are typically funded through:

• Medico-legal or case-managed rehabilitation programmes, such as after an accident or birth injury.
• Insurance settlements or personal injury compensation funds.
• Private funding or, occasionally, support from charitable organisations.

A trial fitting is often available so families can see the potential benefits before making a long-term decision.

Setting realistic goals

Smart powered orthoses are designed to improve real-world mobility rather than replace therapy. Goals should be clear, achievable, and focused on function. Som examples might be:

• Walking with a more natural, upright posture.
• Reducing fatigue at school or during community activities.
• Increasing walking distance or tolerance to slopes and stairs.
• Preventing long-term joint contractures by promoting full extension.

Consistency of use and regular reviews are key to achieving and maintaining results.

A smart powered orthosis, like the Agilik, can offer significant benefits for people who are able to walk but limited by weakness, crouch gait, or instability. By combining robotic technology with expert orthotic design, it provides adaptive assistance that supports efficient, controlled movement in real-life environments.

For the right patient, this technology can enhance independence, reduce fatigue, and help preserve mobility well into adulthood.