A leading orthotist has spoken of the “life-changing” impact of a smart‑powered orthosis on children and adults with lower-limb weakness.

The London Orthotics Consultancy (LOC) introduced the Agilik smart orthosis to the UK in March 2025 and has since enabled patients with conditions such as cerebral palsy and spina bifida to walk independently with a correct gait pattern for the first time.

The device, developed in partnership with Bionic Power and global distributor Thuasne, is designed to help wearers walk with a straighter, more controlled leg and improve gait stability. 

Unlike other exoskeletons that intend to hold a patient up and walk for them, it functions as a mobility device by assisting or resisting knee extension and flexion throughout the gait cycle.

Testing the Agilik in their gait lab at LOC in Kingston upon Thames, orthotists have been able to use a dedicated app to fine‑tune the Agilik for each patient.

They’ve also conducted home trials, allowing patients to try the device in their own environment and provide real‑world feedback.

Sharing this experience with neuro professionals attending Naidex Roadshow South on September 9, Sam Walmsley, Director and Senior Orthotist at LOC said: “It’s very exciting as an orthotist to be able to stand with a patient and say, ‘I think you need a little bit more power in your knee flexion, so we’re going to add power and lift your foot off the floor.’ We’re doing all that at a touch of a button.”

Life-changing device

For many years, LOC has been fitting patients with custom-made orthotics in-house, achieving significant results – one patient with cerebral palsy can now walk with parallel bars, something she never thought possible.

But by integrating the Agilik smart orthosis with traditional Knee Ankle Foot Orthoses (KAFOs), orthotics at the clinic have been able to go further.

“We have taken children up our stairway in the clinic and into the workshop upstairs. They’ve then had a walk around the workshop and walked back down again, and that’s the first time in their lives they’ve managed stairs unaided. So, this can be quite a life-changing device,” said Sam.

“One patient said that wearing the Agilik was like having two physiotherapists constantly strapped to his legs as he walked and extended.”

The Agilik connects to a battery, which powers the various motors in the knee joint through different phases of the gait cycle.

Smart sensor technology within the foot shell and the knee evaluates the patient’s gait while they are walking. Motors are then engaged to assist movement when needed, making real-time gait adaptations, which support knee extension when standing and assist leg movement when walking.

Patient stories

During his talk on the Neuro Professionals stage at Naidex Roadshow South, Sam also shared some case studies to demonstrate the positive outcomes for patients when trialling the Agilik.

“One little boy came to us when he was eight years old. He has CFC syndrome and couldn’t walk independently,” Sam said.

“Part of his condition is continual knee flexion contractures. We initially intervened with our traditional processes – we used AFOs and our orthotic footwear, and we improved the range of movement and the final positioning of the knee with greater extension, but we were about 15 to 20 degrees off full knee extension.

“That’s not good enough because he would still end up having multiple surgeries to keep him on his feet,” Sam explained.

“With the Agilik test drive, we achieved greater knee extension and a stretch to the end of his range of movement. So, we’ve taken this child’s knee joint kinematics to very close to normal through their gait pattern.”

Another patient with dyskinetic cerebral palsy and severe crouch gait presentation also experienced significant improvements when using the Agilik.

“Over the years we’ve provided AFOs and footwear and really encouraged knee extension and hip extension on every step through therapy,” Sam said.

“It’s arduous work among clinicians and family members, and that process in itself has been transformational. But as the patient got older, things got harder as she grew.

“Now, with the Agilik, she can stand independently, so it’s offering her stability, control, and this means everything for a child with this type of cerebral palsy.”

Future ambitions

LOC and Thuasne are currently gathering evidence to evaluate the effects of clinic- and home-based training with the Agilik smart orthosis in the hope that it will one day be made available on the NHS and in hospitals across the globe.

“We have three gait labs across the country, and one is at a university setting in Salford where we have a professor who is working with us to produce some exciting evidence,” said Sam.

“The device is probably a way off reaching the NHS because it takes a while for these things to be agreed, but if you look at how physiotherapists have shrunk in numbers and don’t always have the time to offer daily intervention therapies to children…could the Agilik replace that service in that group of patients as they grow?”

The aim of the global team behind the Agilik is for the device to be used on a daily basis, not only as a therapy tool but also as a functional aid, especially in adults.

“We have patients with spinal injury who can take steps with their existing calipers, but their movement is bad and it takes quite a lot of effort, but with the Agilik they can stand up, get out of their car, put their wheelchair in the boot and move around the house,” Sam said.

“Many patients I’ve spoken to say fatigue is what limits them, so offering something that can reduce that - allowing them to walk further and do more - is very exciting.”

Thuasne conducted a live trial of the Agilik smart orthosis at Naidex in March. Read about the results here.