Toward a Personalized Knee Ankle Wearable Exoskeleton for Partial Stroke Rehabilitation: A Review of Design, Control, and Clinical Evidence

Stroke remains a leading cause of long term physical disability worldwide, and a majority of survivors present with hemiparetic gait patterns marked by foot drop, knee hyperextension, reduced propulsion, and asymmetric stance. Wearable lower limb exoskeletons have emerged as a promising complement to conventional physiotherapy, yet most reported systems assist only a single joint, most commonly the ankle, and rely on generic rather than patient specific assistance profiles. This paper reviews recent clinical and technical literature on ankle and knee exoskeletons for post stroke gait rehabilitation, synthesizes the biomechanical rationale for combined knee and ankle assistance, and examines control architectures ranging from impedance based and adaptive oscillator schemes to biofeedback augmented assistance and variable stiffness artificial muscle actuation. Building on this synthesis, we outline an architecture for a personalized knee ankle exoskeleton intended for partial, task specific rehabilitation rather than full time ambulation support, and discuss design and deployment challenges relevant to resource constrained clinical settings such as those found in much of Sub Saharan Africa.