Identifying the Key Biomechanical Features of Movement Adaptation during Exoskeleton-Assisted Locomotion

The understanding of natural human adaptation during exoskeleton-assisted locomotion - particularly individual differences in adaptation behaviors and temporal progression - remains limited. In this work, we investigate temporal evolution of biomechanical variables to uncover participant-specific adaptation strategies across different exoskeleton-assisted locomotion scenarios. Nine healthy participants performed treadmill walking under three conditions: without an exoskeleton, with exoskeleton active ankle assistance, and with exoskeleton zero-torque. Lower limb kinematics, inter-joint coordination, and metabolic cost of transport (MCoT) were analyzed at both the group and individual levels. Results indicate that adaptation is gradual and highly individualized, with substantial variability in convergence timing and movement patterns across participants. Kinematic adaptation occurred asynchronously across lower limb, with larger fluctuations during the swing phase. Metabolic responses were heterogeneous and often non-convergent, highlighting the limitations of steady-state assumptions commonly adopted in the literature. These findings emphasize the importance of individual-level, temporal evolution analyses for understanding adaptation dynamics in exoskeleton use.