C O M M E N T A R Y Open Access
The Cybathlon promotes the development
of assistive technology for people with
Background: The Cybathlon is a new kind of championship, where people with physical disabilities compete
against each other at tasks of daily life, with the aid of advanced assistive devices including robotic technologies.
The first championship will take place at the Swiss Arena Kloten, Zurich, on 8 October 2016.
The idea: Six disciplines are part of the competition comprising races with powered leg prostheses, powered arm
prostheses, functional electrical stimulation driven bikes, powered wheelchairs, powered exoskeletons and
brain-computer interfaces. This commentary describes the six disciplines and explains the current technological
deficiencies that have to be addressed by the competing teams. These deficiencies at present often lead to
disappointment or even rejection of some of the related technologies in daily applications.
Conclusion: The Cybathlon aims to promote the development of useful technologies that facilitate the lives of
people with disabilities. In the long run, the developed devices should become affordable and functional for all
relevant activities in daily life.
Keywords: Competition, Championship, Prostheses, Exoskeletons, Functional electrical stimulation, Wheelchairs,
Brain computer interfaces
Millions of people worldwide rely on orthotic, pros-
thetic, wheelchairs and other assistive devices to improve
their qualities of life. In the US there live more than 1.6
million people with limb amputations  and the World
Health Organization estimates the number of wheelchair
users to about 65 million people worldwide . Unfortu-
nately, current assistive technology does not address
their needs in an ideal fashion. For instance, wheelchairs
cannot climb stairs, arm prostheses do not enable versa-
tile hand functions, and power supplies of many orthotic
and prosthetic devices are limited. There is a need to
further push the development of assistive devices by
pooling the efforts of engineers and clinicians to develop
improved technologies, together with the feedback and
experiences of the users of the technologies.
The Cybathlon is a new kind of championship with
the aim of promoting the development of useful tech-
nologies. In contrast with the Paralympics, where para-
thletes aim to achieve maximum performance, at the
Cybathlon, people with physical disabilities compete
against each other at tasks of daily life, with the aid of
advanced assistive devices including robotic technolo-
gies. Most current assistive devices lack satisfactory func-
tion; people with disabilities are often disappointed, and
thus do not use and accept the technology. Rejection can
be due to a lack of communication between developers,
people with disabilities, therapists and clinicians, which
leads to a disregard of user needs and requirements. Other
reasons could be that the health status, level of lesion or
financial situation of the potential user are so severe that
she or he is unable to use the available technologies. Fur-
thermore, barriers in public environments make the use of
assistive technologies often very cumbersome or even
Six disciplines are part of the competition, addressing
people with either limb paralysis or limb amputations.
Sensory-Motor Systems Lab, ETH Zurich, Tannenstrasse 1, 8092 Zurich,
Spinal Cord Injury Center, University Hospital Bagrist, University of Zurich,
© 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Riener Journal of NeuroEngineering and Rehabilitation (2016) 13:49
The six disciplines comprise races with powered leg pros-
theses, powered arm prostheses, functional electrical
stimulation (FES) driven bikes, powered wheelchairs and
powered exoskeletons (Fig. 1). The sixth discipline is a
racing game with virtual avatars that are controlled by
brain-computer interfaces (BCI). The functional and assist-
ive devices used can be prototypes developed by research
labs or companies, or commercially available products. The
competitors are called pilots, as they have to control a de-
vice that enhances their mobility. The teams each consist of
a pilot together with scientists and technology providers,
making the Cybathlon also a competition between compan-
ies and research laboratories. As a result there are two
awards for each winning team in each discipline: a medal
for the person who is controlling the device and a cup for
the provider of the device (i.e. the company or the lab).
A rehearsal was organized in July 2015 to test race
tracks, scoring system and logistics and to generate foot-
age for advertisement. The premiere will take place at
the Swiss Arena, in Kloten, Zurich, on 8 October 2016.
More information can be found on the Cybathlon web-
The six disciplines and the challenges in their fields
Pilots with above knee amputations will use actuated
prosthetic devices and compete along an obstacle course
containing ramps, stairs, doors, soft-cushioned seats, bar-
riers etc. Most of the commercially available leg prosthesis
technologies are passive ballistic devices, which are easy to
control but make uphill walking and stair ascent challen-
ging. In persons with intact legs, especially the knee joint
requires much higher capability of joint power generation
during ascent than during level walking . Consequently,
users of passive prostheses, including microprocessor-
controlled dissipative knee prostheses, have to use hand
rails and/or perform an asymmetric non-physiological gait
to compensate for the missing power generation in the
knee (see for example  among many other studies).
Powered leg prostheses can induce the missing power and
in this way solve these deficiencies; however, the control
of such devices is not trivial when interfacing them with
the user’s motion intention . Additionally, state-of-the-
art batteries are either too heavy or lack sufficient capacity
to provide power throughout an entire day. The teams at
the Cybathlon will showcase new technologies that might
overcome current deficiencies.
At the Cybathlon, pilots with amputations of the lower
arm or above will use actuated prosthetic hands and arms
to complete various household and food preparation tasks
(Fig. 2). The dexterity and versatility of currently available
prosthetic hand devices is usually limited with respect to
the number of grasps and tasks that can be successfully
performed. Therefore, persons with unilateral amputations
use their intact arm to perform most daily tasks. Bimanual
tasks, which require a high load transfer (e.g., carrying a
heavy box) or particular fine motor skills (e.g., opening a
small jar of jam) are challenging, because they cannot be
solved with most state-of-the-art upper arm prostheses.
Consequently, up to 60 % of people with upper-limb am-
putation fitted for conventional upper-limb prosthetic de-
vice fail to use it regularly or reject it altogether [6, 7]. The
high rejection rate of upper limb prostheses has been
attributed to poor training, late fitting, limited usefulness
especially for the users with more proximal amputations,
and various other factors. Significantly lower rates of re-
jection can be seen for more advanced, i.e. body-powered
(26 %) and electric (23 %) devices .
Four out of the six disciplines of the Cybathlon ad-
dress people with limb paralysis of varying degrees after
lesions such as spinal cord injury: Pilots with complete
paraplegia will compete in a bike race, where FES de-
vices assist them in performing pedaling movements.
FES technology has been used for movement restoration
for decades, but has not achieved satisfactory perform-
ance due to limitations in setup-time, movement con-
trollability, muscle force magnitude, muscle selectivity
and fatigue resistance [9, 10]. Most promising stimula-
tion systems are implanted, as they yield better selectiv-
ity and higher force output than non-invasive systems
[9, 11]. However, there are drawbacks with respect to in-
vasiveness, risk of infections and costs. Because of these
deficiencies, current FES technology has not been
Fig. 1 Arena with four parallel race tracks designed for the exoskeleton competition. The pilots start at the left and have to overcome six obstacles
with increasing difficulty level
Riener Journal of NeuroEngineering and Rehabilitation (2016) 13:49 Page 2 of 4
accepted by physicians and patients for daily clinical
In both the powered wheelchair race and the powered
exoskeleton race, pilots with paralysis will master obstacle
courses with ramps, stairs, bends, doors and uneven ter-
rain (Fig. 1). More and more companies offer advanced
and powerful solutions for wheelchairs. However, control
technology does not provide adequate mobility and com-
fort for many electrically powered wheelchair users, espe-
cially under adverse driving conditions . Wheelchair
accessibility in public buildings is still limited despite the
enforcement of existing laws and regulations . Most
outdoor devices are too bulky and not agile enough for in-
door use, whereas commercial indoor wheelchairs are not
capable of overcoming uneven terrain or steps. So called
intelligent or smart wheelchairs have been available for de-
cades, but have not yet been adopted by a large portion of
the population [15, 16]. An alternative to wheelchairs are
exoskeletal devices that assist people with paraplegic le-
sions during gait in the upright position [17, 18]. However,
battery power is limited to a few hours of operation and
the devices are still very bulky and heavy. Most of the
commercially available multi-joint exoskeletons have
weights in the range of 21–28 kg, with the device “REX”
reaching a weight of almost 40 kg [17, 19]. Furthermore,
current commercial systems have a limited number of de-
grees of freedom and reduced ranges of movements pre-
venting the devices from gait on inclined surfaces or
stairs. Thus, exoskeletal devices are not yet a realistic al-
ternative for lightweight, energy efficient, and often fold-
able manual wheelchairs.
In the BCI race, pilots with paralysis of all four limbs
will control a virtual avatar in a racing game displayed
on a computer screen. The best pilots will be able to dis-
tinguish three different commands to overcome three
different kinds of virtual obstacles and, thus, will be
rewarded by a temporal advantage in the game. A wrong
command or a command with too long latency will be
penalized by decelerating the avatar on its track. BCI
technology is becoming more and more popular, how-
ever most systems only function accurately in a lab en-
vironment . The time needed for device setup,
comfort, cosmetic aspects, function and reliability are
still not satisfactory and have prevented broad use and
acceptance outside labs .
The Cybathlon will provide a platform that encourages
exchange between people with disabilities or physical
weaknesses, the research and development world, fund-
ing agencies, and the general public. In this way, the
Cybathlon aims to promote the development of useful
technologies that facilitate the daily lives of people with
disabilities or physical weaknesses and provide the basis
for more independence. In the long run, the developed
devices should become affordable and functional for all
relevant activities in daily life.
Cybathlon can also be considered as a complement to
the Olympic or Paralympic games. In contrast to the
Paralympic games, it allows the use of any kind of tech-
nical aids, thus also enabling people with more severe
disabilities to participate in a competition. The goal is
not to be the fastest and the strongest among the partic-
ipants, rather the goal is to be the most skilled pilot who
utilizes advanced technologies in ways that allow the
challenges of everyday life to be overcome with ease.
Fig. 2 Pilot with a powered arm prosthesis performing a daily living task. Picture was taken at the Cybathlon rehearsal in July 2015 by Alessandro
Della Bella, ETH Zurich. The pilot on this image as consented to the publication of this image
Riener Journal of NeuroEngineering and Rehabilitation (2016) 13:49 Page 3 of 4
BCI, Brain-Computer Interface; FES, Functional Electrical Stimulation; US,
Special thanks go to Roland Auberger Verena Klamroth-Maganska, Domen
Novak, Anna Pagel, Serge Pfeifer, Kai Schmidt, Linda Seward, Roland Sigrist,
Peter Wolf, Dario Wyss for their contributions to this manuscript, including
organization of references and proof-reading.
This work is funded by ETH Zurich, Switzerland, and the Swiss National Science
Foundation (SNSF) National Competence Center in Research (NCCR) in Robotics.
Availability of data and materials
RR is the inventor, initiator and chief organizer of the Cybathlon. He has
drafted the manuscript.
Cybathlon is a non-profit, charitable event. The author is initiator of the
Cybathlon and member of the organizing board. The author confirms that
there are no further competing interests.
Ethics approval and consent to participate
The individual in Fig. 2 consented to the publication of this image.
Received: 4 April 2016 Accepted: 23 May 2016
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