The second protagonist of the VBRRII interviews is Nicola Vitiello, from Torre Annunziata, Naples, but transplanted to Tuscany at the age of 18. Vitiello is a Full Professor at ScuolaSuperiore Sant’Anna in Pisa, where he co-founded and co-leads the Wearable Robotics Laboratory. He is also the co-founder of Iuvo, the spin-off company of the Scuola SuperioreSant’Anna, whose mission is to bring wearable technologies for human movement assistance to the market. For example, the Mate technology, developed in collaboration with Comau: a portfolio of technologies designed to support workers in strenuous tasks, such as overhead manipulation or load lifting.

How did the idea come about?

“As always, in response to a specific need: to reduce musculoskeletal overload in certain productive sectors, and consequently the perceived fatigue of workers. Exoskeletons are already being utilized in numerous production sites worldwide, and their effectiveness has been demonstrated by several instrumental studies. The next step will be to demonstrate that all of this is associated with a reduction in the economic ergonomic index and, therefore, a decrease in the incidence of musculoskeletal pathologies. The hope is that in the future, these exoskeletons will be considered as personal protective equipment (PPE), capable of safeguarding those who wear them from health and safety risks”.

How advanced is the occupational technology market?

“It is still in an embryonic phase, but it will increase in size, as will the actors involved. These technologies will become increasingly specific to production areas, and there will be a need to collect data that will then need to be processed to make production processes more efficient. The challenge will remain to develop devices whose benefits outweigh the annoyance they cause. Therefore, they should be light, breathable, and faithful to the fundamental rules of design, such as being compliant with human kinematics”.

Will only physically demanding jobs be considered?

“Absolutely not. In the collective imagination, only those who perform demanding and exhausting jobs are at risk. In reality, even those who spend 8 to 10 hours sitting at a desk are putting their health at risk. For this reason, there will be an increase in technologies for white-collar workers, individuals who have a sedentary lifestyle and can benefit from devices that encourage them to move more and better. So, we can envision people having a wearable life companion that will not only remind them to get up from the desk but also guide them towards healthier physical exercise”.

We always return to the concept of human functioning, the individual’s ability to express themselves in the environment in which they live.

“Exactly. When bioengineering is made available to individuals to protect their health, the goal is always well-being. Another key concept is the exposome. With wearable robotics, we intervene in the set of environmental factors that individuals are exposed to. The aim is to incorporate a technological element that minimizes physical strain, promotesmovement, and, in rehabilitation scenarios, compensates neurological impairments, enabling individuals to engage fully in social interactions. Indeed, Iuvo’s motto is: Wearable Technologies, Uplifted Life”.

Regarding rehabilitation medicine: How are wearable technologies changing its models?

“They have been changing for a long time, as I often explain to my students. Just think that robotics for rehabilitation was born in the 90s in Palo Alto, California, with Professor Peter Lum, a bioengineering professor who was the first to use robots to assist therapists in performing the most exhausting and repetitive part of rehabilitation. But there is no opposition between traditional rehabilitation and robotic rehabilitation. Thanks to the robot, there is greater patient engagement, making the exercises more efficient and enjoyable. Just think about virtual reality and serious gaming. This is the reality of some excellent facilities like Villa Beretta Rehabilitation Center, but unfortunately not all rehabilitation centers meet the same standards”.

What will be the future challenge?

“Bringing these technologies to the patient’s home, ensuring the so-called ‘continuum of care’”.

Is the biggest obstacle the costs?

“No, I wouldn’t be so reductionist. The economic aspect is just one of the problems. It is also necessary to provide the patient and caregiver with a certain level of supervision, such as in-person meetings at home periodically or opportunities for discussions via teleconference. But to achieve all this, it is necessary to develop models and, even before that, demonstrate that there is a real benefit for the individual, as well as an impact on the healthcare system. Once this is done, the expense will be justified”.

What challenges do you face as a developer of wearable technologies for rehabilitation?

“These technologies are inherently multidisciplinary. They involve collaboration among biomedical and biomechanical engineers, computer and electronic engineers, industrial designers, neuroscientists, physiotherapists, psychologists, and philosophers who contribute ethical insights to their development. As a bioengineer, I see myself as a facilitator. I collect ideas and input from diverse professionals, synthesizing their different perspectives to devise solutions that effectively address the practical needs of clinicians”.

And what about those who are studying to pursue a career like yours?

“The challenge that makes a difference is the interaction with clinicians, such as physiatrists and physiotherapists, and patients. It is no coincidence that when I was a doctoral student, about 15 years ago, my professors encouraged me to spend time inside rehabilitation clinics. I do the same with my students. This is the only way to acquire the sensitivity that allows you to understand whether a project truly meets the needs of people. On the contrary, if you spend too much time closed in the bioengineering lab, you risk developing technologies that are perfect from an engineering point of view but lack adherence to real needs. Therefore, in addition to dedicated degree courses, future bioengineers need research opportunities that allow them to immerse themselves in clinical settings. This is a choice that Scuola SuperioreSant’Anna has been pursuing for some time, for example with Villa Beretta Rehabilitation Center”.