P-MATE: making gait rehabilitation technology simpler and more accessible
After a stroke, many people need intensive rehabilitation to regain their mobility, confidence and independence. Walking training plays an important role in this recovery process. At the same time, providing enough therapy time is not always easy in practice. Rehabilitation care is under pressure from rising demand, staff shortages and the need to organize support closer to people’s daily lives.
Technology can help. But many rehabilitation robots are expensive, complex and mainly available in specialized centers. P-MATE takes a different route. Instead of adding more motors, software and control systems, the project explores how simple mechanical principles can contribute to intensive gait training. P-MATE stands for Passive Mechanical Add-on for Treadmill Exercise. It is being developed within the Convergence Human Mobility Center, where researchers work on rehabilitation technologies that are practical, personalized and accessible
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Using the body’s own walking pattern
P-MATE is designed as an add-on that can be placed around a standard treadmill. The system uses elastic tendons and pulleys to connect both legs during walking.
This creates a dynamic link between the less affected and more affected leg. During treadmill walking, the movement of the less affected leg can help support the movement of the affected leg. In this way, P-MATE uses the body’s natural reciprocal walking pattern to assist the impaired leg during the swing phase.
Because the system is passive, it does not need motors or active control. The person using the device remains actively involved in the movement, while the system provides mechanical support. The configuration of the tendons and pulleys can also be adapted, which may allow the device to be adjusted to different users and training goals.
| P-MATE uses elastic tendons and pulleys around a standard treadmill to create a dynamic connection between both legs during walking. The image shows the system overview and two human-device interface prototypes tested in the first study: a cuff prototype and a bandage prototype. |
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Why this matters
One of the challenges in rehabilitation is not only how to make technology more advanced, but how to make it usable in real care settings. A device that is too expensive, too complex or too difficult to set up may never reach the people who could benefit from it.
P-MATE addresses this challenge by focusing on a lower-cost and relatively simple design. The goal is not to replace therapists, but to support more frequent and accessible gait training. In the longer term, this type of technology could be relevant not only in rehabilitation centers, but also in physiotherapy practices or other supervised settings closer to the patient’s own environment.
With P-MATE, we are exploring whether simple mechanical principles can help make gait rehabilitation more accessible. The aim is not to replace therapists, but to develop technology that could support more frequent and personalized training in realistic care settings.
From prototype to first user experience
The first paper on P-MATE was presented at ICORR 2025 during RehabWeek in Chicago. The study focused on the design, usability and first user experiences with the system.
In these first tests, the researchers studied two different human-device interfaces: a cuff prototype and a bandage prototype. They looked at practical and biomechanical aspects such as setup time, walking parameters, interaction forces and user experience. The first results are promising from a usability perspective, while also showing that the design needs further refinement before it can move toward clinical application.
The first results are promising from a usability perspective, while also showing that the design needs further refinement before it can move toward clinical application.
This is exactly the phase where collaboration matters. Engineering choices, such as the position of pulleys or the design of the interface with the user, need to be connected to clinical questions: Is the system safe and comfortable? Can it be set up easily? Does it support the movement in a useful way? And could it eventually fit into the workflow of a therapist?
The project is currently in the prototype development and refinement phase. The team has recently completed additional experiments with the device, including work by a master’s student and further experiments by Irene Beck. These results are now being analyzed and will help guide the next design steps.
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The power of convergence
P-MATE is part of the Convergence Human Mobility Center, a Flagship within Convergence Health & Technology. The Center connects researchers, clinicians and innovation partners around one shared ambition: developing rehabilitation technologies that can support recovery in ways that are effective, accessible and realistic in practice.
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For P-MATE, this combination of perspectives is essential. Mechanical engineering and biomechanics help shape the device itself: the elastic tendons, pulleys and treadmill setup. Rehabilitation medicine brings in the clinical question: what kind of support is actually needed during gait training after stroke, and what would make the system useful in practice? Human-robot interaction and movement science help the team understand how a person interacts with the device and how the system can be made more comfortable and intuitive to use.
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The project brings together the Department of Cognitive Robotics and the Department of Biomechanical Engineering at Delft University of Technology, the Department of Rehabilitation Medicine at Erasmus MC and the Institute of Automatic Control at RWTH Aachen University. Within the broader CHMC network, the work is connected to partners such as Erasmus University Rotterdam and Rijndam Rehabilitation, where questions around implementation, accessibility and use in real rehabilitation settings are central.
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From prototype toward practice
That is the power of convergence: a clinical rehabilitation question is not viewed from one discipline alone. Engineers, clinicians and movement scientists work together from the start. As a result, the project is not only about a technically smart prototype, but also about whether the system is safe, usable and feasible in practice.
P-MATE is not a finished product yet. But it is a promising example of how relatively simple technology, shaped by different disciplines, can open new directions for accessible gait rehabilitation.
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Researchers involved
P-MATE is led by Irene L. Y. Beck. The first P-MATE study was conducted together with Belle C. Hopmans, Bram Haanen, Levi Kieft, Heike Vallery, Laura Marchal-Crespo and Katherine L. Poggensee.
Paper: A Passive Mechanical Add-on for Treadmill Exercise (P-MATE) in Stroke Rehabilitation