2011 6th International Conference on Industrial and Information Systems, ICIIS 2011, Aug.
16-19, 2011, Sri Lanka
A Brief Review on Upper Extremity Robotic
Exoskeleton Systems
R. A. R. C. Gopura, Member, IEEE, Kazuo Kiguchi, Member, IEEE, D. S. V. Bandara
Abstract-Robotic exoskeleton systems are one of the highly
active areas in recent robotic research. These systems have
been developed significantly to be used for the human power
augmentation, robotic rehabilitation, human power assist, and
haptic interaction in virtual reality. Unlike the robots used in
industry, the robotic exoskeleton systems should be designed
with special consideration since they directly interact with
human user. In the mechanical design of these systems,
movable ranges, safety, comfort wearing, low inertia, and
adaptability should be especially considered. Controllability,
responsiveness, flexible and smooth motion generation, and
safety should especially be considered in the controllers of
exoskeleton systems. Furthermore, the controller should
generate the motions in accordance with the human motion
intention. This paper briefly reviews the upper extremity
robotic exoskeleton systems. In the short review, it is focused to
identify the brief history, basic concept, challenges, and future
development of the robotic exoskeleton systems. Furthermore,
key technologies of upper extremity exoskeleton systems are
reviewed by taking state-of-the-art robot as examples.
Index Terms—Robotic exoskeleton systems, power-assist,
rehabilitation robotics, man-machine intelligent system
I. INTRODUCTION
A robotic exoskeleton system (or an exoskeleton robot) is
a novel man-machine intelligent system. It fully merges the
human intelligence and machine power. It is an orthotic
device with corresponding joints and links to the human
joints and links. The robotic exoskeleton transmits torques
to the human joints from the actuators through its links.
Over the decades researchers have been making effort to
implant the intelligence to the robots. Advancement of
robotic exoskeleton technology is a milestone of this effort
since the robotic exoskeleton is a man-machine intelligence
system. Therefore, not only the intelligence of the robot but
power of human user is also get enhanced. The robotic
exoskeleton technology has acquired a rapid development in
recent years with the advances in the technology in
mechanical engineering, biomedical engineering, electronic
engineering & artificial intelligence.
R. A. R. C. Gopura is with the Department of Mechanical Engineering
University of Moratuwa, Katubedda, Sri Lanka 10400 (corresponding
author: +94-11-2640472; fax: +94-11-2650622; e-mail: gopura@ieee.org)
Kazuo Kiguchi is with the Department of Advanced Technology Fusion,
Saga University, 1 Honjo machi, Saga shi, Saga 840-8502 (e-mail:
kiguchi@ieee.org)
D. S. V. Bandara is with the Department of Mechanical Engineering
University of Moratuwa, Katubedda, Sri Lanka 10400 (e-mail:
sanjaya@mech.mrt.ac.lk)
978-1-61284-0035-4/11/$26.00 ©2011 IEEE
346
Exoskeleton robots are supposed to play an important role
in the field of power-assist, rehabilitation robotics, robot
tele-operation, and haptic interaction in virtual reality. It is
important to develop exoskeleton systems to assist and/or
rehabilitate physically weak people in the present society in
which considerable percentage of population is aged and
physically weak.
Robotic exoskeleton systems were studied for the
purposes of industry or medical applications in the 1960s
and 1970s [1]-[4]. Hardiman [1], which was the first whole
body robotic exoskeleton system, was actuated by hydraulic
actuators and was supposed to be driven by a human
operator from the inside of exoskeleton system. In addition,
some exoskeleton systems were proposed to extend the
strength of the human [5], [6] in early 1990s. In recent
years, many upper extremity exoskeleton systems [7]-[33]
have been proposed for the rehabilitation, and/or power-
assist, haptic interaction, and human power augmentation.
However, some of the issues in the areas of biomechanical
design, safety, efficient transmission, small sized and higher
performance actuator, and effective control algorithm are
still to be addressed. Identification and clarification of the
requirements, existing challenges and the state-of-the-art of
those systems are very important to find the solutions for the
existing challenges in the system. This paper briefly reviews
the upper extremity robotic exoskeleton systems. In the
short review, it is focused to identify the basic concept,
challenges, state-of-the-art, and future development of the
robotic exoskeleton. Although robotic exoskeleton systems
can be categorized into three types as upper extremity (i.e.,
upper-limb), lower extremity and full body, the main focus
of this review is upper extremity exoskeleton systems. At
first, the concept of robotic exoskeleton system is identified.
Then, the challenges to develop a proper upper extremity
exoskeleton are presented. The key technologies of those
systems are reviewed by selecting state-of-the-art robot as
examples. Future developments in these systems are
discussed finally. Although robotic systems of upper
extremities can mainly be divided into two types: end-
effector-based robots (i.e., end manipulators) and robotic
exoskeletons, the review is limited to only the robotic
exoskeleton systems in this paper.
II. CONCEPT OF EXOSKELETON SYSTEMS
The concept of an exoskeleton system can be identified as
an extension of the exoskeleton in biology, in which the
exoskeleton is an outer cover on a creature to shield support,
 2011 6th International Conference on Industrial and Information Systems, ICIIS 2011, Aug. 16-19, 2011, Sri Lanka
Fig. 1. Basic concept of a robotic exoskeleton - Top view.
power enhancement or sensing and data fusion [22]. The
best example of an exoskeleton in biology is a shell of a
crab which serves not only as a shield over the body, but
also as a surface for muscle connection, a waterproof wall
against desiccation, and a sensory interface with the
surroundings. In robotics, an exoskeleton is usually a
wearable device which consists structural mechanism with
actuators and sensors whose links and joints correspond to
those of the human body. Figure 1 shows the concept of a
robotic exoskeleton. Human upper extremity and an upper
extremity wearable robot structure are shown in the figure.
Links, corresponding joints, and motors are also shown.
When a robotic exoskeleton is worn by the human the
physical contact between the user and the exoskeleton
allows direct transfer of mechanical power and information
signals. In utilizing the robotic exoskeleton for daily motion
assist, the user provides the control signal for the
exoskeleton, while the actuator of the exoskeleton provides
most of the power necessary for performing the task.
Therefore, power of the robot user and the intelligent of the
robot is get enhanced for the daily motion assist.
III. CHALLENGES
Main challenge for the development of robotic
exoskeleton systems is the unavailability of proper
accessory devices. Available actuation technology and
power transmission technology are not in an appropriate
state to develop a perfect robotic exoskeleton system. Here
the “perfect robotic exoskeleton system” is a system which
helps the wearer to assist/rehabilitate his motions or tele-
operate other systems without giving any burden to him.
The robot should not give unbearable weight to the wearer.
The exoskeleton robot should generate natural motions of
upper-limb with the wearer does not feel any vibration, jerk
or sudden motion change. Small sized high torque actuators
with high power-weight ratio are essential to develop such
kind of exoskeleton systems. Available actuation technology
should be improved to provide better power-weight ratio to
the exoskeleton system. Furthermore, back-drivability is
essential if the exoskeleton robot use geared electric motors
for this purpose. The power transmission technologies with
high transmission efficiency and minimum friction are
347
required for the exoskeleton systems to be perfect. Moreover
the back-drivability of the transmission is also essential for
these systems to eliminate possible discomfort to the user.
Rather due to the complexity of the upper extremity,
design of a perfect robotic exoskeleton system is sometimes
difficult. Therefore, special design efforts have to be made
to design some section of the upper extremity robotic
exoskeletons. Special design efforts have to be made when
designing the shoulder joint and the wrist joint of the
exoskeleton system to generate biomechanically similar
motions as the human. Shoulder complex is one of the
biomechanically complex area in the human body. Its center
of rotation (CR) is changing with its motions [7]. If the
robot generates the shoulder motion and is directly attached
to the upper-arm of the user, the shoulder mechanism is very
important. Design of a proper shoulder mechanism for an
upper extremity robotic exoskeleton to change its CR with
its motions is a difficult task.
So far several exoskeleton robots [8], [12], [17] have been
developed for wrist joint motions. The axis offset of wrist
axes have been considered in some of them [8]. However,
all of the designs have been considered that wrist flexion
and extension motions generate through one axis and wrist
radial and ulnar deviation generate through one axis. To
generate biomechanically similar wrist motions, wrist joint
should be designed with four axes with an individual axis
for each wrist flexion, extension, radial deviation, and ulnar
deviation. Otherwise there might be a wrist pain for some
user of the exoskeleton robot since the wrist joint is highly
sensitive to the changes in position and torque [12].
The structures of the exoskeletons should be flexible with
high strength. Furthermore, those should have less weight to
eliminate user feeling discomfort or fatigue. Therefore, the
materials of the exoskeleton structures should be specially
considered so that the exoskeleton system will become a
second skin to the wearer.
IV. REVIEW OF UPPER EXTREMITY ROBOTIC
EXOSKELETONS
In recent years, several upper extremity robotic
exoskeleton systems have been proposed for various
purposes such as an assistive device, a rehabilitation device,
a human amplifier and a haptic interface [7]-[33]. The
mechanical designs of active upper-limb exoskeleton robots
are reviewed in a previous paper of the authors [21]. This
paper reviews the upper extremity robotic exoskeletons
especially considering most recent developments. Main
specialty of the recent upper extremity robotic exoskeleton
is the use of serial manipulators in almost all of their designs
(Gupta et al. [9] and Klein et al. [10] have proposed
exoskeletons with parallel link mechanism). Electric motors
or pneumatic actuators have been used as the actuator in
most of the upper extremity exoskeleton systems except
Sarcos Master Arm [11], which used a hydraulic actuator.
 2011 6th International Conference on Industrial and Information Systems, ICIIS 2011, Aug. 16-19, 2011, Sri Lanka
Fig. 2. SUEFUL-7 [8], EXO-7 Exoskeleton system [12], 4DOF exoskeleton
robot of Laboratoire Ampere UMR [24], Rehab-robot [25].
More than 65% exoskeleton systems included to this review
used electric motors as the actuator. About 27% systems were
actuated pneumatically and rest of the systems was actuated
hydraulically or other means. The upper extremity
exoskeletons can be classified based on the actuator used in
their mechanical design as: 1) Type A- electrically actuated,
2) Type B- hydraulically actuated, 3) Type C-pneumatic
actuated. Considering the above types state-of-art upper
extremity robotic exoskeleton systems are reviewed in next
sub sections. Certain exoskeleton systems are selected based
on their key technological features in either mechanical
design or control methodology. Most recent upper extremity
robotic exoskeletons which have key features are compared in
Table I.
A. Electrically Actuated Upper Extremity Robotic
Exoskeleton Systems
As in the case of ordinal robots, upper extremity robotic
exoskeleton systems are commonly actuated by electric
motors since their advantages such as high speed and
precision, and ability to be used for advanced motion
control.
1. Upper Extremity Robotic Exoskeletons of Saga
University, Japan [7], [8]
In an upper extremity exoskeleton system, shoulder
mechanism should generate shoulder moving CR. The
mechanism should allow moving of the CR of the shoulder.
Kiguchi et al. [7] have proposed a moving CR mechanism for
the shoulder. The mechanism moderately adjust the distance
between the upper arm-robot attachment and the CR of the
shoulder joint of the robot in accordance with the shoulder
motion, in order to cancel out the ill effects caused by the
position difference between the CR of the system shoulder
and the human shoulder. However, since they have limited
the shoulder vertical motion to 90 degrees the effectiveness of
the shoulder mechanism was not assessed for the motions in
above shoulder level. Initially, they have assembled the
shoulder moving CR mechanism to a 2DOF shoulder
exoskeleton robot [7]. The latest prototype of the robot [8],
SUEFUL-7 (see Fig. 2) is 7DOF and in addition to the
shoulder moving CR mechanism, a wrist joint mechanism has
been included in it to generate biomechanically similar wrist
motions.
2. 7DOF Exoskeleton Robot: EXO-7 [12]
Since the exoskeleton system is worn by the human user,
anthropometric design is important to have comfortable wear
and so that to generate natural human motions.
Considering the fact, Perry and Rosen [12] have designed
anthropometric 7DOF powered exoskeleton system which
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is shown in Fig. 2. The anthropomorphic nature of the joints
combined with negligible backlash in seven force-reflecting
articulations is set as the special feature of the EXO-7.
However, the design can be improved implementing the
wrist axes off set in wrist joint. In EXO-7, shoulder
internal/external rotation and forearm pronation/supination
generate from an open human- robot attachment rather
than that of the other exoskeletons [7], [8] that use attachment
which fully enclose the arm. Therefore, the user can insert his
arm easily to the robot without placing it from the device
shoulder and sliding it axially down the length of the
device.
3. 4DOF Exoskeleton Robot of Laboratoire Ampere
UMR [24]
This upper extremity exoskeleton [24] is capable of
generating 4DOF of the shoulder joint and 3DOF of the
elbow joint (see Fig. 2). The shoulder height, the shoulder
width and the arm length of the robot can be varied and
therefore the robot is adaptable to patients with different body
sizes. The controller of the robot is based on the information
feedback signals, from the user and the exoskeleton.
4. Rehab-robot of National Taiwan University [25]
The Rehab-robot developed by Tsai et al [25] in 2010 is
shown in Fig. 2. This upper extremity exoskeleton can be
used for the rehabilitation of the patients and capable of
generating 6DOF at the shoulder complex, 1DOF at the
elbow joint and 2DOF at the wrist joint. Using both EMG
signals of the patient and force sensor signals, the robot is
capable of supporting the human motion without going
through any of the ill-postures that is possible reaching the
end effector position.
5. Index Finger of Exoskeleton [27]
Zheng et al [27] developed a 4DOF index finger
exoskeleton for thumb and index finger rehabilitation. The
robot is capable of handling some variety of hand sizes, with
the prismatic kinematic joints it is using. In addition, it
generates bi-directional movements for all joints via power
transmission through cables.
6. Other Electrically Actuated Exoskeleton Robots
ARMin II [13], L-EXOS [33], and haptic arm exoskeleton
robot of Rice University [9] are reviewed detailed in a
previous paper of the authors [21]. Therefore, those are
omitted in this review. Yamaura et al. [15] have proposed a
3DOF hand rehabilitation system for patients suffering from
paralysis or contracture. It consists of a hand rehabilitation
exoskeleton and a data glove. The combination of the wire-
driven mechanism and closed four-link mechanism in the
design increase the movable range and made the design
compact than conventional device.
It is important in a robotic exoskeleton system to enable the
reduction of moving masses and required power to obtain
high performance design. 5DOF robotic exoskeleton in [16]
combined electric motors and pneumatic muscle actuators to
obtain high performance in the design. For ergonomics and
 2011 6th International Conference on Industrial and Information Systems, ICIIS 2011, Aug. 16-19, 2011, Sri Lanka

TABLE I
MOST RECENT UPPER EXTREMITY ROBOTIC EXOSKELETONS

Reference Application Active DOF Actuators Power Control Method/ Input Special Feature/s
Transmission
Rehabilitation 4DOF shoulder Relatively
Brushless DC Force controlling with lightweight with
Moubarak et al [24] training for weak joint and 3DOF Gear drives
motors position feedback a high ratio of
and injured people elbow joint
DOF/weight
6DOF at shoulder Avoid going
Rehabilitation robot 1DOF at the through the ill-
Tsai et al [25] DC motors Gear drives Electromyography
for upper limb elbow 2DOF at postured
the wrist joint configurations
To assist in daily Motion was
activities (Assist 1DOF supination Two push-button assumed to be
Ngai [26] Stepper Motor Gear System axial, but forearm
Carpal Tunnel and pronation sensors as user inputs
Syndrome patients ) was resisting the
axial rotation of

Thumb and Index Separate Can accommodate

Rehabilitation variety of hand
Ruoyin et al [27] Finger 4DOF actuation Cables
Procedure sizes to some
Rehabilitation module
extent
Controller
3DOF shoulder
To assist shoulder, guarantees the
joint; 1DOF
Wen et al [28] elbow and wrist Motors Gear System Not given in the paper asymptotic
elbow joint;
motions stability, for this
3DOF wrist joint
class of robotic
manipulators
Lara et al [29] To assist arm 1DOF Shape Memory Shape Force Controlling Compact and
motions Alloys Memory portable
To assist workers Allows true joint
and reduce Ball-screws Controller is under torque control
Garrec [30] 7DOF Motor
musculoskeletal and cables development without force
disorders sensor
Produce the vivid
3DOF for Crank-Slider feeling in addition
For Bilateral shoulder, 1DOF Pneumatic Force and position
Jiafan et al [31] mechanism to the soft control
Teleoperation for elbow and actuators sensors
and Links interface
3DOF for wrist

kinematical compatibility purposes, three passive DOF are
implemented to avoid macro misalignments of the shoulder
center position and one to avoid micro misalignment of the
elbow rotation center with reference to the wrist. Therefore,
the robot can increase the comfort and the reduction of
interference with other body parts.
B. Pneumatically Actuated Upper Extremity Robotic
Exoskeleton Systems
Although pneumatic actuators keep clear working area and
can be stopped under load without any damage they have
problems such as low accuracy and difficulty of precision
velocity control. Therefore, a small number of robotic
exoskeleton systems are pneumatically actuated.
1. 7DOF “Soft-Actuated” Exoskeleton Design [17]
A 7DOF pneumatically actuated robotic exoskeleton (see
Fig. 3) has been developed by Tsagarakis and Caldwell [17].
In this design, two pneumatic muscle elements are applied as
an antagonistic scheme simulating a biceps-triceps system to
provide the bidirectional motion/force. The antagonistic
action permits compliance control. Therefore, it has
advantages in terms of safety and more human ‘soft’
interaction which provides a soft feeling in human
manipulation. The system is able to generate motions of
shoulder, elbow, forearm, and wrist to rehabilitate the upper
extremity. Joint motion on robot has achieved by producing
appropriate antagonistic torques through cables and pulleys
driven by the pneumatic actuators.
2. Biomimetic Orthosis for Neurorehabilitation
(BONES) [10]
A novel 4DOF exoskeleton system proposed in [10] has the
ability to generate arm internal/external rotation without any
circular bearing element such as a ring, a design feature
inspired by the biomechanics of the human forearm. The
device (BONES) is pneumatically actuated and used for
rehabilitation of the upper-limb. It is based on a parallel
mechanism that actuates the upper-arm by means of two
passive, sliding rods pivoting with respect to a fixed structural
frame. Four mechanically grounded pneumatic actuators are
placed behind the main structural frame to control shoulder
motion via the sliding rods, and a fifth cylinder is located on
the structure to control elbow flexion/extension.
3. Muscle Suit [18]
Kobayashi and Hiramatsu [18] have presented a novel
concept to the robotic exoskeleton by developing garment
like wearable robot. Although it is referred as a robotic
exoskeleton it does not have a metal frame. It uses McKibben

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 2011 6th International Conference on Industrial and Information Systems, ICIIS 2011, Aug. 16-19, 2011, Sri Lanka
Fig. 3. Pneumatically actuated exoskeleton systems, Salford University
robotic exoskeleton [17], BONES [10], Muscle suit [18].
actuators driven by pneumatic.The device, “muscle suit”
provides muscular support for the paralyzed or those who are
unable to move by themselves.
4. Active Support Splint (ASSIST) [32]
A light weight 1DOF exoskeleton robot, ASSIST has been
developed by Sasaki et al. [32]. It has the ability of relieving
the restrained feeling when the device is not operated since it
consists of plastic interface with rotary type soft actuators
(McKibben pneumatic muscle). It can be used to assist
wrist flexion/extension of elderly or physically weak people.
Jiafan et al [31] have developed a 6DOF exoskeleton robot,
ZJUESA for bilateral teleoperation. The force feedback is
employed by the pneumatic system on ZJUESA to produce
the vivid feeling in addition to the soft control interface.
C. Hydraulically Actuated Upper-Limb Exoskeleton Robots
Although, hydraulic actuators are able to generate high
torques precisely and quickly, they have disadvantages such
as oil leakage, necessity of wide space and return oil line.
Therefore, upper extremity exoskeleton systems have rarely
used hydraulic actuators.
1. NEUROexos [19]
A bioinspired 3 joints-3 links robotic arm (NEUROexos)
is under development [19]. Main idea of this robot is for
implementing bioinspired control strategies and for obtaining
a human-like robotic arm to be used for assessing active
exoskeletons in fully safe conditions. The robotic system has
been deeply coupled to the human user and the exoskeleton
system is based on the human model in terms of
biomechanics, and control and learning strategies. The
NEUROExos platform is a neuro-robot because it has bio-
inspired morphological characteristics (e.g., antagonist
muscle-like actuators). The elbow module of the
NEUROexos has been developed [20]. It used two remote
antagonist muscle-like hydraulic pistons as actuators
powering the joints by means of steel wire ropes and Bowden
cables based transmission.
2. Sarcos Master Arm [11]
Sarcos Master Arm is a 7DOF hydraulically actuated
robotic exoskeleton system (Sarcos Master Arm, Sarcos, Inc.,
Salt Lake City). Its anthropomorphic design mimics a 7DOF
of the human upper extremity, such that any joint movement
of user’s limb will be approximately reflected by a similar
joint movement of the exoskeleton. Conversely, torques
applied by the joints will be reflected to the corresponding
joint of user’s limb. The user wields the device by holding on
a handle at the most distal joint and by a strapping of forearm.
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V. FUTURE DEVELOPMENT
Existing robotic exoskeletons often cause discomfort to the
user, especially when they wear it for daily activities.
Therefore, the systems should be improved to wear for daily
activities without any discomfort. Also the designer should
consider not only the outer anatomical features of human but
also the physiological demand of the user. Since most of
these robotic systems are supposed to be used for day-to-day
activities they should be more portable, fashionable, and
svelte in the future. To develop such kind of system, the
reliability, portability and inertia of robot, back-drivability of
its actuators have to be improved. Existing actuators are often
heavy with limited torque and power, often noisy and
unnatural in shape which influence negatively for the
cosmetics of robotic exoskeleton. The actuation technology
should be improved to develop small sized, more durable and
higher performance actuators for these robots. Back-
drivability of the transmission is essential in robotic
exoskeleton to eliminate possible uncomfortable to the user.
More efficient back-drivable system should be required for
the systems in the future.
As proposed in [22], the biomechanical investigation
should be carried out for these systems not only in shape but
also in function, and in degrees of freedom distribution as
well. The misalignment between rotational axes of the
exoskeleton joint and the user anatomical joint often affects
the generation of natural upper-limb motion. This problem
should be considered further especially for the shoulder joint
of the robot.
The future exoskeleton system should be included many
features to use it for the daily activities. (e.g., waterproof
function, withstand for range of temperature, withstand for
different environment conditions such as sunny, rainy, etc.)
Researchers expect that the future exoskeleton robot would be
designed as a ‘second skin’ [23] of the human. Going far
beyond that, in this review, it is envisaged that future
exoskeleton systems will act as a communication and
entertainment media and a sensory interface with the
surroundings of the wearer. The exoskeleton system will be
with the global positioning systems (GPS) so that location of
the wearer can be identified for the persons whom the wearer
has given permission. In addition the function of the mobile
phone and the music players such as ‘ipod’ can be included in
the exoskeleton robot so that the user does not want to
separately carry them. Further, the future robotic exoskeleton
systems could even power the music players, mobile phones,
and other portable electronic devices by tapping the
performed mechanical work during user motion. Moreover,
certain percentage of power requirement of the exoskeleton
system will be generated using the mechanical work during
user motion. Since the brain-machine interface technology is
developed in successful level, future robotic exoskeleton
systems will be controlled based on the brain signals and/or
combinations of EMG and brain signals so that user motion
intention can be effectively reflected.
 2011 6th International Conference on Industrial and Information Systems, ICIIS 2011, Aug. 16-19, 2011, Sri Lanka
CONCLUSION
The robotic exoskeleton system, specially the exoskeleton
system used for power assist is a brand new type of man-
machine intelligent system which fully combines the human
intelligence and machine power. Advancement of this
technology is a milestone of researchers’ effort to embed the
intelligence to the robots since the exoskeleton robot is a
man-machine intelligence system. With the advances in
recent technology in many fields including mechanical
engineering, electronic engineering, biomedical engineering,
and artificial intelligence the robotic exoskeleton technology
has acquired a rapid development in recent years. In this
paper a brief review of upper extremity exoskeleton systems
is presented. The concept of an exoskeleton system was
identified as an extension of the exoskeleton in biology. The
challenges for an upper extremity robotic exoskeleton were
identified. Special efforts have to be made when developing
exoskeletons for human shoulder, wrist, and thumb since
human shoulder, wrist and thumb motions are
biomechanically intricate. Upper extremity exoskeleton
robots can be classified according to the applied segment of
the upper extremity, the DOF, the actuators used in the
system, power transmission methods, purpose of the robotic
system and/or the control methods.
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