On February 14, 2023, Prof. Dr.-Ing. Rüdiger Rupp, Head of the Experimental Neurorehabilitation Section, Clinic for Paraplegiology, Heidelberg University Hospital, gave an exciting lecture on opportunities and challenges of using lower limb exoskeletons for clinical applications, particularly for spinal cord injury (SCI) patients. Key points include:

- SCI Statistics: In Germany, there are 1,800-2,300 new SCI cases annually. Main causes include diseases, accidents, and falls. SCI results in motor, sensory, and autonomic impairments.

- Neurobiological Insights: The spinal cord has limited regenerative ability. Techniques like Body Weight Supported Treadmill Training (BWSTT) and robotic devices like Lokomat are used to enhance mobility.

Exoskeletons: Current exoskeletons offer various designs, such as ReWalk and Ekso, but challenges remain, such as trunk stability, upper extremity function, ease of use, and adaptability to daily activities. Despite high expectations, only about 10% of SCI patients benefit from exoskeleton technology.

Clinical Trials: Studies on exoskeletons like the ABLE exoskeleton show improvements in walking speed and distance but also highlight technical challenges like weight and device dimensions. User-centered design is emphasized, focusing on making the technology more accessible and improving its functionality based on user feedback.

- User Satisfaction: Surveys indicate high satisfaction with feedback from exoskeletons, though users desire improvements in aspects such as noise emission and walking patterns.

Prof. Dr. Rupp concluded by emphasizing refining exoskeleton designs to meet users' needs better, considering both technical and legal challenges in the clinical setting.