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3/2026 vol. 20
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RESEARCH PAPER
Method for Improving Muscular Activations during Exoskeleton-Aided Therapy with Intelligent Algorithms and VR-Based Teleoperation
Piotr FALKOWSKI 1
,
 
Kajetan JEZNACH 1
,
 
Tomasz OSIAK 1
,
 
Jan OLEKSIUK 1
,
 
Krzysztof ZAWALSKI 1
,
 
Piotr KOŁODZIEJSKI 1
,
 
Zbigniew PILAT 1
,
 
Daniel ŚLIŻ 1,2
,
 
Tomasz CHOMIUK 2
 
 
 
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1
Section of Biorobotics and Medical Devices, Łukasiewicz Research Network – Industrial Research Institute for Automation and Measurements PIAP, Poland
 
2
Department of Internal Diseases and Cardiology, Medical University of Warsaw, Poland
 
 
Submission date: 2026-02-12
 
 
Final revision date: 2026-06-22
 
 
Acceptance date: 2026-07-07
 
 
Publication date: 2026-08-14
 
 
Corresponding author
Piotr FALKOWSKI   

Section of Biorobotics and Medical Devices, Łukasiewicz Research Network – Industrial Research Institute for Automation and Measurements PIAP, Al. Jerozolimskie 202, 02-486, Warsaw, Poland
 
 
Acta Mechanica et Automatica 2026;20(3):584-593
DOI: https://doi.org/10.65731/ama/2026-0058
 
 
Article (PDF)
References (43)
 
HIGHLIGHTS
  • Automating of exoskeleton-aided physiotherapy is possible with biomedical signals
  • Teleoperating via the digital twin in VR correlates with the operator experience
  • The developed system is safe in terms of automatic detection of risks
  • Intelligent algorithms increase patients' muscular engagement in therapy
KEYWORDS
digital twin
exoskeleton
human-in-the-loop
intelligent algorithm
minimally-supervised-therapy
rehabilitation robotics
 
TOPICS
ABSTRACT
Population ageing, neurological and orthopaedical diseases, and shortages in medical staff result in the need to develop tools for minimally su-pervised therapy. To guarantee effective kinesiotherapy in high doses, rehabilitation robots are required. However, they require additional tech-nologies for automating treatment and monitoring patients' safety. This paper presents and assesses such technologies integrated with the SmartEx-Twin exoskeleton of a lower extremity and its digital twin in virtual reality (VR) for teleoperation during emergency cases. The intelligent algorithms were proven to increase the effectiveness of the therapy, as assessed based on the EMG measured. The VR system was validated as also increasing the effectiveness, but reducing the perception of tiring exercises, based on EEG tracking. Additionally, the accuracy of controlling exoskeleton movements was measured. It was found out that the poor operation skills of the physiotherapist in the VR environment can increase motion inaccuracies by as much as 30 degrees per joint. Additional emergency tools trig-gered by spastic cramps detected and risk of pain were assessed as fully reliable and working with the delay of up to 125 ms and 2 s, respec-tively. The whole system was implemented for the exoskeleton and will undergo further tests to minimize control inaccuracies and teleoperation delays.
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