In the last two decades, numerous powered ankle-foot orthoses have been developed. Despite similar designs and control strategies being shared by some of these devices, their performance in terms of achieving a comparable goal varies. It has been shown that the effect of powered ankle-foot orthoses on healthy users is altered by some factors of the testing protocol. This paper provides an overview of the effect of powered walking on healthy and weakened users. It identifies a set of key factors influencing the performance of powered ankle-foot orthoses, and it presents the effects of these factors on healthy subjects, highlighting the similarities and differences of the results obtained in different works. Furthermore, the outcomes of studies performed on elderly and impaired subjects walking with powered ankle-foot orthoses are compared, to outline the effects of powered walking on these users. This article shows that several factors mutually influence the performance of powered ankle-foot orthoses on their users and, for this reason, the determination of their effects on the user is not straightforward. One of the key factors is the adaptation of users to provided assistance. This factor is very important for the assessment of the effects of powered ankle-foot orthoses on users, however, it is not always reported by studies. Moreover, future works should report, together with the results, the list of influencing factors used in the protocol, to facilitate the comparison of the obtained results. This article also underlines the need for a standardized method to benchmark the actuators of powered ankle-foot orthoses, which would ease the comparison of results between the performed studies. In this paper, the lack of studies on elderly and impaired subjects is highlighted. The insufficiency of these studies makes it difficult to assess the effects of powered ankle-foot orthoses on these users.To summarize, this article provides a detailed overview of the work performed on powered ankle-foot orthoses, presenting and analyzing the results obtained, but also emphasizing topics on which more research is still required.

Despite the increasing interest in using powered ankle-foot orthoses for assistive purposes, their development and benchmarking still present core challenges. Powered orthoses have to be safe and provide adequate torque while keeping limited size and weight. The discordance of these requirements is a challenge for the development of these devices. This paper describes the control strategy and characterization of a compact variable stiffness actuator, to be used in an assistive ankle-foot orthosis for impaired subjects. The results of the characterization experiments show the advantageous behavior of the actuator and its performance in providing different relevant assistive torque profiles, with different actuator stiffnesses, during emulated walking experiments. However, some divergences in the results obtained in different testing conditions highlight the need for more general benchmarking techniques. Towards this objective, the paper also proposes a novel performance indicator that can be used to better evaluate the performance of robotic actuators both in quasi-static and in dynamic conditions. The article concludes with a call for research on new benchmarking techniques, to understand more in-depth series elastic's actuators behavior under dynamic conditions.

Despite the increased interest in exoskeleton research in the last decades, not much progress has been made on the successful reduction of user effort. In humans, biarticular elements have been identified as one of the reasons for the energy economy of locomotion. This document gives an extensive literature overview concerning the function of biarticular muscles in human beings. The exact role of these muscles in the efficiency of human locomotion is reduced to three elementary functions: energy transfer towards distal joints, efficient control of output force direction and double joint actuation. This information is used to give an insight in the application of biarticular elements in bio-inspired robotics, i.e. bipedal robots, exoskeletons, robotic manipulators and prostheses. Additionally, an attempt is made to find an answer on the question whether the biarticular property leads to a unique contribution to energy efficiency of locomotion, unachievable by mono-articular alternatives. This knowledge is then further utilised to indicate how biarticular actuation of exoskeletons can contribute to an increased performance in reducing user effort.