Electronics Guide

Smart orthotics represent a significant evolution in orthopedic technology, integrating electronic sensors, microprocessors, and actuators into traditional braces and supports to create devices that actively respond to user needs. Unlike passive orthotic devices that provide static support, smart orthotics dynamically adjust their properties based on real-time measurements of movement, load, and user intent. This fusion of electronics with biomechanical support enables more effective treatment of musculoskeletal conditions, improved rehabilitation outcomes, and enhanced quality of life for users.

The development of smart orthotics has been driven by advances in miniaturized electronics, sensor technology, and wearable computing. Modern microelectromechanical systems (MEMS) provide compact, low-power sensing capabilities that can be embedded within orthotic structures without adding significant bulk or weight. Battery technology improvements enable extended operation between charges, while wireless connectivity allows data transmission to healthcare providers for remote monitoring and treatment optimization.

Smart orthotics serve diverse clinical applications including stroke rehabilitation, spinal cord injury management, cerebral palsy treatment, and post-surgical recovery. By providing variable support that adapts to different activities and phases of gait, these devices promote more natural movement patterns while still protecting vulnerable joints and tissues. The data collected by smart orthotics also provides valuable insights for clinicians, enabling evidence-based adjustments to treatment plans and objective tracking of patient progress.

Dynamic Ankle-Foot Orthoses

Dynamic ankle-foot orthoses (DAFOs) with electronic control represent one of the most clinically significant smart orthotic applications. Traditional ankle-foot orthoses provide fixed support to compensate for foot drop or ankle instability, but this rigid support can interfere with natural gait mechanics during phases when the ankle should move freely. Electronically controlled DAFOs address this limitation by modulating stiffness and position throughout the gait cycle.

The electronic systems in dynamic AFOs typically incorporate inertial measurement units (IMUs) to detect gait phase, load sensors to measure ground contact forces, and angle sensors to track ankle position. A microcontroller processes this sensor data in real time to identify the current phase of gait and determine appropriate orthotic behavior. During swing phase, the system may provide dorsiflexion assistance to prevent toe drag, while during stance phase it may allow controlled plantarflexion for a more natural heel strike and push-off.

Actuation mechanisms vary among different dynamic AFO designs. Some systems use variable damping elements that adjust resistance to ankle movement without actively generating torque. Magnetorheological fluids change viscosity in response to magnetic fields, enabling rapid stiffness modulation. Other designs incorporate small electric motors or pneumatic actuators that actively drive ankle movement. The choice of actuation mechanism involves tradeoffs among power consumption, response speed, size, weight, and cost.

Clinical benefits of dynamic AFOs include improved walking speed, reduced energy expenditure, and more symmetrical gait patterns compared to passive orthoses. Users report greater confidence during activities that require varying ankle mechanics, such as stair climbing or walking on uneven terrain. The ability to adjust device behavior through software parameters allows clinicians to fine-tune performance for individual patients without fabricating new hardware.

Functional Electrical Stimulation Orthotics

Functional electrical stimulation (FES) orthotics combine structural support with electrical stimulation of paralyzed or weakened muscles to restore active movement. Rather than replacing lost muscle function entirely with mechanical actuators, FES systems activate the user's own muscles through precisely timed electrical pulses delivered via surface electrodes or implanted stimulators. This approach provides the dual benefits of functional movement restoration and therapeutic muscle activation that may promote neural recovery.

The electronic control system in FES orthotics must coordinate stimulation timing with the mechanical phases of movement. Sensors detect user intent and current limb position, enabling the controller to trigger stimulation at appropriate moments. For walking applications, foot switches or inertial sensors identify heel strike and toe-off events that define gait phases. The stimulation controller then activates muscle groups in sequences that produce coordinated movements such as stepping or grasping.

Hybrid FES-orthotic systems combine powered mechanical support with electrical stimulation for maximum functional benefit. The mechanical orthotic provides structural support and can supplement muscle force when stimulation alone is insufficient. This approach is particularly valuable for individuals with severely weakened muscles who cannot generate adequate force through stimulation alone. The mechanical and electrical systems work synergistically, with stimulation contributing physiologically beneficial muscle activation while mechanical elements ensure reliable function.

Surface FES systems use electrodes placed on the skin over target muscles, offering non-invasive application but limited selectivity in muscle activation. Implanted FES systems place electrodes directly within or adjacent to muscles, providing more selective stimulation and eliminating the need for daily electrode placement. Percutaneous systems use electrodes that penetrate the skin but remain externally powered and controlled. Each approach presents different tradeoffs in invasiveness, selectivity, reliability, and user burden.

Applications of FES orthotics span upper and lower extremity function. Lower extremity FES systems restore walking ability in individuals with spinal cord injury or stroke by stimulating hip flexors, knee extensors, and ankle dorsiflexors in coordinated patterns. Upper extremity FES systems restore grasp function by stimulating forearm muscles that control finger flexion and extension. Emerging applications include trunk stability systems and respiratory support through diaphragm stimulation.

Stance Control Knee-Ankle-Foot Orthoses

Stance control knee-ankle-foot orthoses (SCKAFOs) provide a critical solution for individuals with quadriceps weakness who require knee stability during standing and walking but benefit from free knee movement during sitting and swing phase. Traditional locked-knee orthoses maintain the knee in extension throughout all activities, resulting in stiff-legged gait and difficulty with sitting. Stance control mechanisms selectively lock the knee during weight-bearing while allowing free flexion during swing phase and seated activities.

Electronic stance control systems use sensors to detect weight bearing and gait phase, triggering knee locking mechanisms at appropriate times. Ground reaction force sensors embedded in the footplate detect when the user loads the limb, signaling the need for knee stability. Angle sensors and accelerometers detect knee position and movement to confirm gait phase. The control algorithm integrates these inputs to determine when the knee should be locked or unlocked.

Various locking mechanism designs achieve stance control function. Ratchet-type mechanisms allow knee flexion but prevent extension, useful for controlled descent during stairs or sitting. Wrap spring clutches engage when torque is applied in one direction while freeing movement in the other direction. Electromechanical solenoids provide active locking under electronic control, enabling precise timing of lock engagement and release. Hydraulic and pneumatic systems offer smooth, controlled resistance that can be varied continuously.

Advanced SCKAFOs incorporate multiple modes selectable by the user or automatically based on activity recognition. A walking mode provides stance control with free swing. A stair descent mode allows controlled knee flexion under load. A seated mode unlocks the knee completely for comfort. Activity recognition algorithms can switch between modes automatically based on sensor patterns, reducing the need for manual mode selection while ensuring appropriate knee behavior for each activity.

The clinical impact of stance control orthoses extends beyond improved gait mechanics. Users experience reduced compensatory movements at the hip and trunk that occur with locked-knee walking. Energy expenditure decreases as gait becomes more efficient. The ability to sit without removing or adjusting the orthosis improves social participation and vocational function. Many users who abandoned passive KAFOs due to the burden of locked-knee ambulation successfully use stance control devices for daily mobility.

Spinal Orthotic Systems

Electronic spinal orthotic systems address conditions affecting the vertebral column including scoliosis, kyphosis, and post-surgical stabilization. Traditional spinal orthoses apply static corrective forces, but smart versions can modulate these forces based on posture, activity, and treatment goals. The integration of sensing and feedback capabilities transforms spinal bracing from passive constraint to active treatment that adapts to user behavior.

Scoliosis management represents a major application of smart spinal orthotics. Adolescent idiopathic scoliosis affects millions of young people, with bracing the primary non-surgical treatment for moderate curves. Traditional braces apply constant corrective pressure, but compliance is challenging because wearing a rigid brace is uncomfortable and socially difficult. Smart scoliosis braces incorporate sensors that measure actual wear time and corrective pressure, providing objective compliance data to guide treatment.

Pressure monitoring within scoliosis braces enables optimization of corrective forces. Force sensing resistors or capacitive pressure sensors distributed across the brace interior measure the interface pressure between the brace and the patient's body. Real-time pressure feedback helps orthotists achieve optimal force application during fitting. Continuous monitoring during wear reveals how pressure distribution changes with different activities and postures, informing adjustments to improve both effectiveness and comfort.

Active spinal orthoses go beyond monitoring to provide dynamic correction. Actuated panels within the brace can vary corrective force based on posture detection. When sensors detect slouching or deviation from target posture, the system increases corrective pressure to encourage proper alignment. During rest or sleep, forces can be reduced to improve comfort. This approach may achieve better curve correction with improved compliance compared to constant-force bracing.

Post-surgical spinal orthoses with electronic features support recovery from fusion surgery or vertebral fracture treatment. Motion sensors detect excessive movement that could compromise healing, alerting both patient and care team. Activity monitoring provides data on rehabilitation progress and helps identify activities that may risk the surgical repair. Gradually increasing allowable motion ranges as healing progresses can be programmed into the device, automating what would otherwise require multiple clinic visits for brace adjustment.

Upper Extremity Smart Splints

Smart splints for the upper extremity apply electronic enhancement to devices treating conditions of the hand, wrist, elbow, and shoulder. Upper extremity function is critical for activities of daily living, making effective orthotic treatment particularly impactful. Electronic features enable dynamic positioning, force monitoring, and active assist functions that enhance treatment outcomes for conditions ranging from stroke-related spasticity to repetitive strain injuries.

Dynamic hand splints with electronic control address spasticity and contracture following stroke or traumatic brain injury. Spastic muscles resist stretching, and static splints that hold fingers in extension create constant force that can be uncomfortable and may trigger increased spasticity. Smart splints apply intermittent stretching with force limits determined by real-time sensing, reducing the risk of triggering spastic responses while achieving effective range of motion maintenance.

Wrist orthoses with activity monitoring address repetitive strain conditions including carpal tunnel syndrome. Sensors track wrist position and movement patterns throughout daily activities, identifying problematic postures and motions. Feedback alerts users when they maintain awkward positions for extended periods, enabling behavior modification to reduce reinjury risk. The data collected supports clinical decision-making about work modifications and treatment progression.

Powered assist orthoses for the upper extremity help individuals with weakness to perform functional tasks. Motors and cable-driven mechanisms provide assistance to finger flexion and extension, wrist movement, or elbow motion. Intent detection through residual muscle activity, joint angle measurement, or voice command triggers assistance at appropriate times. These devices bridge the gap between no function and independent function, enabling users to perform activities that would otherwise require caregiver assistance.

Rehabilitation-focused upper extremity smart splints combine support with therapeutic exercise. Resistance can be applied to strengthen weak muscles or assist movement to practice functional patterns. Game-like interfaces displayed on connected devices motivate repeated practice while sensors track movement quality and quantity. Progress data transmitted to therapists enables remote monitoring of home exercise programs and adjustment of therapy protocols between clinical visits.

Pediatric Growth-Adjustable Orthotics

Pediatric orthotics face the unique challenge of accommodating rapid growth while maintaining therapeutic function. Traditional pediatric orthoses require frequent replacement as children outgrow them, creating significant financial burden and periods of inadequate support during transition between devices. Smart orthotics with growth adjustment capabilities extend usable lifespan while maintaining optimal fit and function throughout the growth process.

Electronic growth monitoring systems within pediatric orthoses track changes in limb dimensions over time. Strain sensors measure the tension in straps and structural elements, detecting when fit becomes too tight. Pressure sensors at the skin-device interface identify developing pressure points that indicate outgrowth. This data enables proactive adjustment before fit problems cause skin breakdown or functional compromise.

Modular designs with electronic adjustment enable size changes without complete device replacement. Telescoping struts with motorized or manually adjustable length accommodate longitudinal growth. Expandable panels with variable overlap adjust circumference. Electronic control systems track cumulative adjustments and alert clinicians when the adjustable range approaches its limits, signaling the need for component replacement or full device upgrade.

Pediatric spinal bracing particularly benefits from growth adjustment features. Scoliosis braces must maintain corrective pressure as the child grows, requiring frequent adjustment or replacement. Smart braces can automatically adjust corrective force as the child grows, maintaining therapeutic effectiveness throughout the treatment period. Growth data collected by the brace provides valuable information about the relationship between growth rate and curve progression.

Compliance monitoring is especially important in pediatric applications where children may resist wearing uncomfortable devices. Smart orthotics can detect actual wear time through temperature sensors, motion sensors, or electrical contact detection. This objective data supplements parent reports and enables clinicians to assess whether treatment failures result from brace ineffectiveness or inadequate wear time. Positive feedback mechanisms including games or rewards activated by the orthotic can motivate improved compliance in younger children.

Pressure Monitoring Insoles

Pressure monitoring insoles represent a widely adopted category of smart orthotic technology, providing valuable data about foot loading patterns during standing and walking. These systems incorporate arrays of pressure sensors embedded within shoe insoles, continuously measuring the distribution of force across the plantar surface of the foot. Applications span diabetic foot care, sports performance analysis, gait rehabilitation, and orthotic fitting optimization.

Sensor technologies for pressure monitoring insoles include resistive, capacitive, and piezoelectric elements. Force sensing resistors (FSRs) change electrical resistance under compression, providing a cost-effective solution for basic pressure measurement. Capacitive sensors offer improved sensitivity and linearity through measuring changes in electrical capacitance with applied force. Piezoelectric materials generate electrical signals in response to dynamic pressure changes, particularly useful for capturing impact forces during walking and running.

Diabetic foot ulcer prevention represents a critical clinical application for pressure monitoring insoles. Diabetes causes peripheral neuropathy that eliminates protective sensation, allowing patients to unknowingly maintain positions that cause tissue damage from excessive pressure. Smart insoles detect high-pressure regions and alert users through vibration, auditory signals, or smartphone notifications to shift their weight. Longitudinal data collection identifies concerning trends that may predict ulcer development before visible tissue damage occurs.

Clinical gait analysis traditionally requires expensive laboratory equipment, but pressure monitoring insoles enable assessment outside clinical settings. Walking patterns during real-world activities often differ from laboratory conditions, making ambulatory measurement clinically valuable. Asymmetries in loading between left and right feet, abnormal pressure distributions, and timing irregularities provide diagnostic information about underlying musculoskeletal and neurological conditions.

Orthotic fitting optimization uses pressure data to verify that custom foot orthoses achieve their intended biomechanical effects. Pressure measurement before and after orthotic application confirms redistribution of forces away from problem areas. Comparison across different orthotic designs enables evidence-based selection. Long-term monitoring reveals whether therapeutic effects persist as orthotics wear and user activities change.

Athletic performance applications leverage pressure insole data for training optimization and injury prevention. Running gait analysis identifies asymmetries and impact characteristics associated with injury risk. Real-time feedback during training can help athletes modify technique to reduce harmful loading patterns. Fatigue monitoring tracks changes in gait patterns during extended activity that may increase injury risk.

Gait Correction Devices

Gait correction devices use electronic sensing and feedback to help users modify abnormal walking patterns. Unlike powered exoskeletons that actively move limbs, these systems provide cueing, feedback, and gentle guidance to promote user-driven improvement in gait quality. Applications include rehabilitation following stroke or orthopedic surgery, management of Parkinson's disease, and treatment of pediatric gait abnormalities.

Rhythm-based gait training uses auditory or vibratory cues to establish consistent step timing. Parkinson's disease often causes gait freezing and difficulty initiating steps, but external rhythmic cues can effectively trigger and maintain walking. Wearable devices deliver metronome-like pulses through earphones or vibrating elements on the body, providing the temporal structure that the basal ganglia can no longer generate internally. Adaptive algorithms adjust cue timing based on measured step patterns to optimize entrainment.

Biofeedback systems measure gait parameters and provide real-time feedback to guide correction. Inertial sensors track joint angles, step symmetry, and trunk movement during walking. Audio tones, visual displays, or vibrotactile signals inform users when gait deviates from target patterns. Repeated practice with feedback promotes motor learning, with the goal of achieving improved gait that persists even without ongoing feedback.

Robotic gait training devices provide physical guidance toward correct movement patterns. Cable-driven systems attached to limbs apply gentle forces that guide leg trajectory during swing phase or support loading during stance. Elastic resistance elements encourage activation of specific muscle groups at appropriate gait phases. The guidance force can be adjusted from high assistance for severely impaired users to minimal input for those practicing refinement of near-normal gait.

Virtual reality integration creates engaging rehabilitation environments that motivate extended practice. Users walk on treadmills or over-ground while viewing immersive displays that provide context for movement goals. Game mechanics reward achievement of gait targets, encouraging the repeated practice necessary for motor learning. Obstacle avoidance scenarios and varied terrain simulations promote adaptive gait strategies that transfer to real-world environments.

Pediatric gait correction addresses developmental conditions including cerebral palsy and idiopathic toe walking. Children often respond well to game-based feedback interfaces that make therapy enjoyable rather than tedious. Wearable sensors small enough for children track the specific gait deviations being targeted by treatment. Progress data shared between home practice and clinical visits enables therapists to adjust treatment protocols based on actual performance outside the clinic.

Compliance Monitoring Systems

Compliance monitoring systems track whether patients use their orthotics as prescribed, addressing a fundamental challenge in orthotic treatment. Studies consistently show that prescribed wear time often exceeds actual wear time, with patients overestimating their own compliance. Objective monitoring provides accurate data for clinical decision-making and enables interventions to improve adherence when problems are identified early.

Temperature-based monitoring detects orthotic wear through skin contact temperature changes. Thermistors or digital temperature sensors embedded in the orthotic register elevated temperatures when worn against the body. Time-stamped temperature data reconstructed after download reveals actual wear patterns. This approach works reliably for devices with sustained skin contact but may be less accurate for orthotics worn over clothing or those with poor thermal coupling to the skin.

Motion-based compliance monitoring uses accelerometers to detect movement patterns consistent with orthotic wear. A worn orthotic experiences body-associated motion with characteristic patterns during walking, standing, and other activities. Machine learning algorithms can distinguish worn states from device storage or transport with high accuracy. Motion monitoring provides activity context along with wear detection, revealing whether patients use orthotics during recommended activities.

Force and pressure sensing provides compliance data specific to functional orthotic use. Load sensors in lower extremity orthotics confirm weight bearing through the device rather than offloading around it. Pressure sensors in spinal orthoses verify that corrective forces are being applied. This approach addresses compliance quality beyond simple wear time, identifying situations where orthotics are worn but not functioning as intended.

Data transmission and analysis platforms transform raw compliance data into actionable clinical information. Wireless connectivity enables automatic upload of wear data without requiring manual download during clinic visits. Dashboard interfaces present compliance patterns to clinicians, highlighting concerning trends and summarizing adherence metrics. Automated alerts notify care teams when compliance falls below thresholds, enabling proactive intervention.

Patient engagement features use compliance data to motivate adherence. Smartphone applications display personal wear time data and progress toward goals. Gamification elements reward consistent use with points, badges, or other achievements. Social features enable sharing of progress with family members or support groups. These approaches leverage behavioral science principles to enhance intrinsic motivation for orthotic use.

Temperature-Regulated Orthotics

Temperature-regulated orthotics address thermal comfort challenges that significantly impact device acceptance and wear time. Orthotics create enclosed environments against the skin that trap heat and moisture, causing discomfort particularly in warm conditions or during physical activity. Active thermal management improves comfort while also providing therapeutic benefits for conditions responsive to temperature modulation.

Cooling systems for orthotics employ various mechanisms to dissipate heat. Thermoelectric Peltier devices pump heat away from the skin surface to external heat sinks, providing active cooling without moving fluids. Phase change materials absorb excess heat during temperature peaks, releasing it later when conditions allow. Forced air circulation through channels within the orthotic enhances evaporative cooling from skin perspiration. Liquid cooling systems circulate cooled fluid through embedded channels for maximum cooling capacity.

Heating capabilities benefit conditions including joint stiffness and pain that respond to thermal therapy. Resistive heating elements embedded in orthotic materials provide controlled warming. Temperature sensors monitor skin temperature to prevent overheating and ensure therapeutic target temperatures are maintained. Programmable heating cycles can deliver treatment according to prescribed therapeutic protocols.

Thermal therapy following injury or surgery accelerates healing through increased blood flow and reduced pain. Smart orthotics can alternate heating and cooling in contrast therapy protocols. Precise temperature control ensures therapeutic benefits while protecting against thermal injury. Integration of thermal therapy into functional orthotics enables treatment throughout daily activities rather than only during dedicated therapy sessions.

Moisture management complements temperature regulation for comprehensive comfort. Humidity sensors detect excessive perspiration that degrades comfort and skin health. Ventilation systems activate in response to moisture detection, promoting evaporation. Moisture-wicking materials conduct perspiration away from the skin surface. Data on moisture accumulation patterns can inform design improvements for future devices.

Control systems for thermal regulation balance comfort, therapeutic effectiveness, and battery life. User preferences for temperature can be learned over time through adaptive algorithms. Activity recognition enables automatic adjustment of thermal management intensity based on anticipated heat generation. Integration with weather data and indoor climate information enables predictive adjustment before discomfort develops.

Electronic Systems and Components

Clinical Applications and Outcomes

Design and Manufacturing Considerations

Designing smart orthotics requires integration of expertise from mechanical engineering, electronics, software development, and clinical practice. Mechanical design must accommodate electronic components while maintaining structural integrity and comfort. Electronics must survive the mechanical, thermal, and moisture stresses of body-worn operation. Software must provide reliable, intuitive function with appropriate safety protections. Clinical input ensures devices address real user needs and integrate into care workflows.

Regulatory requirements for medical devices significantly impact smart orthotic development. Classification as active medical devices triggers requirements for design controls, risk management, and clinical evaluation. Quality management systems must ensure consistent manufacturing. Post-market surveillance monitors for problems in deployed devices. International standards provide frameworks for demonstrating safety and effectiveness.

Manufacturing processes must achieve consistent quality while managing the complexity of integrated electromechanical systems. Custom fitting remains important for many orthotic applications, requiring processes that enable individualization within standardized electronic platforms. Additive manufacturing enables custom geometry while maintaining standard electronic component integration. Assembly processes must ensure reliable connections and proper sealing against moisture.

User training and support systems enable successful smart orthotic adoption. Patients and caregivers must learn device operation, maintenance, and troubleshooting. Clinical users require training on programming, data interpretation, and clinical integration. Remote support capabilities enable assistance without requiring physical device return. Clear documentation and intuitive interfaces reduce support burden.

Future Directions

The future of smart orthotics will see continued improvement in component miniaturization, enabling more sophisticated functions in less obtrusive packages. Flexible and stretchable electronics will integrate more seamlessly with orthotic materials, eliminating the rigid modules that currently house electronic components. Advances in battery technology and energy harvesting will extend operating time and reduce the burden of regular charging.

Artificial intelligence will enhance smart orthotic capabilities through improved activity recognition, adaptive control, and predictive functions. Machine learning models trained on large datasets will enable devices that automatically optimize their behavior for individual users. Natural language interfaces will allow users to adjust device settings through voice commands. AI-powered analysis of collected data will identify clinical patterns and generate treatment recommendations.

Integration with broader digital health ecosystems will multiply the value of smart orthotic data. Interoperability with electronic health records will make orthotic data available to entire care teams. Integration with other wearable devices will provide comprehensive pictures of patient activity and health status. Telehealth platforms will enable remote orthotic adjustment and monitoring, expanding access to specialized care.

Advances in materials science will contribute new capabilities to smart orthotics. Smart materials that change properties in response to electrical or thermal stimuli will enable variable stiffness without complex mechanical actuators. Self-healing materials will extend device lifetime by recovering from minor damage. Biointegrated materials will improve comfort and enable new sensing modalities through direct tissue interaction.

Personalized medicine approaches will optimize smart orthotic prescription and configuration for individual patients. Genetic and biomarker information may predict treatment response, guiding device selection. Machine learning on outcomes data will identify patient characteristics associated with benefit from specific orthotic features. Digital twins combining patient-specific anatomy with device models will enable virtual evaluation of orthotic options before physical fabrication.

Summary

Smart orthotics integrate electronic sensors, microprocessors, and actuators into traditional orthopedic braces to create devices that actively respond to user needs. Dynamic ankle-foot orthoses modulate stiffness throughout gait to improve walking efficiency. Functional electrical stimulation orthotics combine structural support with muscle activation for enhanced function and therapeutic benefit. Stance control knee-ankle-foot orthoses selectively lock during weight bearing while allowing free motion at other times.

Spinal orthotic systems monitor and optimize treatment for scoliosis and other vertebral conditions. Upper extremity smart splints address hand, wrist, and arm conditions with dynamic positioning and activity monitoring. Pediatric orthotics incorporate growth adjustment and compliance monitoring suited to developing users. Pressure monitoring insoles provide data for diabetic foot care, gait analysis, and orthotic optimization.

Gait correction devices use feedback and cueing to guide improved walking patterns. Compliance monitoring systems provide objective data on orthotic use that enables evidence-based treatment decisions. Temperature-regulated orthotics improve comfort through active thermal management while potentially delivering therapeutic heating or cooling.

The electronic systems underlying smart orthotics include diverse sensors, microcontrollers for signal processing and control, various actuation mechanisms, battery-based power systems, and wireless connectivity for data exchange. Clinical applications span neurological rehabilitation, musculoskeletal conditions, and pediatric care. Future developments will bring continued miniaturization, artificial intelligence integration, and personalized medicine approaches that further enhance the capabilities and clinical impact of smart orthotic technologies.