Hybrid Assistive Limb Beyond Clinical Rehabilitation: A Narrative Review of Community-Based Applications, Healthy Aging and Implementation

Population aging has increased the need for technologies that support functional ability, independent living, and participation beyond hospital-based rehabilitation. This narrative review examined how the Hybrid Assistive Limb (HAL), a wearable robotic system developed primarily for rehabilitation, is being extended into home, community, preventive, and long-term care settings. Structured searches of PubMed and Scopus identified 268 records, of which 19 studies were included in the thematic synthesis. Three pathways were identified: Translational Pathways, describing the transition from clinical rehabilitation to home and everyday-life settings; Preventive and Community-Oriented Applications, encompassing foundational evidence, frailty prevention, health maintenance, and social participation; and Implementation and Care Support, addressing caregiver burden and use in long-term care settings. The included studies suggested that HAL use outside conventional rehabilitation may be feasible and safe and may contribute to physical function, maintenance of mobility, caregiver support, and participation in community life. However, most studies were small pilot or feasibility studies, and evidence regarding long-term outcomes, quality of life, cost-effectiveness, and implementation remains limited. HAL should therefore be evaluated not only as a device for improving physical performance, but also as a technology that may support functional ability, autonomy, social participation, and dignity. We propose the “socialization of HAL” as a framework for repositioning HAL from a specialized rehabilitation device to a social resource supporting Healthy Aging.