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Acta of Bioengineering and Biomechanics Original paper
Vol. 22, No. 3, 2020 DOI: 10.37190/ABB-01541-2020-01
Modern technology assists disabled competitors:
the first “Cybathlon” special competition in Zürich
WŁODZIMIERZ S. ERDMANN1*, PIOTR ASCHENBRENNER1,
VASILIOS GIOVANIS2
1 Faculty of Physical Culture, Gdansk University of Physical Education and Sport, Gdańsk, Poland.
2 School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Dafni, Athens, Greece.
Purpose: The purpose of the study was presentation of modern bioengineering technology in order to help people with severe dis-
abilities. Methods: Bioengineering industry can offer severely disabled people several devices in order to enable them to take part in the
competition different than Paralympics. The first international competition for people with disabilities supported by modern assistive
technology, such as sensors, motors, displays were allowed to compete in Cybathlon held in Zürich in 2016. About 70 athletes and their
teams from 25 countries appeared at the event. Results: There were six disciplines (races): 1) Powered Arms (Upper Extremities) Prostheses
Race, 2) Powered Legs (Lower Extremities) Prostheses Race, 3) Powered Wheelchair Race, 4) Powered Exoskeleton Race, 5) Functional
Electrical Stimulation Bike Race, 6) Brain-Computer Interface Race. About a quarter of the teams represented industry and the rest rep-
resented university laboratories. Conclusions: The competition was a success. The organisers have decided for it to be organized every
four years, just like the Olympic Games for able bodied competitors. The main inventor of the event professor Robert Riener from Zürich
Polytechnic (ETHZ) said assistive technology should: a) be user-friendly b) to function well, c) be affordable, d) to be used within the
barrier-free environment.
Key words: disabled athletes, assistive technology, competition, Cybathlon
1. Introduction
Rehabilitation through physiotherapy, especially
kinesiotherapy, acts to bring people with disabilities
back into society. It is very emotional when patients
who previously could not leave their beds can sit,
stand, and walk after several months of intense train-
ing. These patients are also instructed to do exercises
by themselves in order to enhance their activity [1]. In
addition, technology, including robotics, helps people
with disabilities in their everyday lives [2]. Every
contemporary sport uses some kind of technical sup-
port providing the possibility to compete (e.g., balls,
bikes), to enhance performance (e.g., aerodynamic
covers), and to protect the body (e.g., helmets). These
devices are also used by disabled sportspeople. In
addition, some special equipment is utilised only by
them [3], [4].
Sometimes, there are controversies about whether
particular equipment can be used. Much is done to
provide an equal chance to all the participants in a sport
event, not only by establishing many divisions and
classes for participants with different disabilities, but
also when disabled sportspersons want to compete
with able-bodied competitors.
The bioengineering industry develops special tech-
nologies for disabled sportspeople who are not allowed
to participate at the Paralympics. It is difficult to achieve
equal chances within the same class of competition.
Several laboratories are working to design equipment
with better mechanical characteristics (usually, this
equipment is personalised) in order for elite adapted
sportspeople to obtain better results compared to their
______________________________
* Corresponding author: Włodzimierz S. Erdmann, Faculty of Physical Culture, Gdansk University of Physical Education and Sport,
ul. Kazimierza Górskiego 1, 80-336 Gdańsk, Poland. Phone: +48605304939, e-mail: wlodzimierz.erdmann@awf.gda.pl
Received: January 9th, 2020
Accepted for publication: May 22nd, 2020
W.S. ERDMANN et al.70
opponents [5]. In Zürich, a new kind of competition
was organised, namely the “Cybathlon”. This was
a championship where people with physical disabili-
ties competed against each other at the tasks of daily
life with the aid of advanced assistive devices, in-
cluding robotic technologies [6].
The process of introducing a new device to the pub-
lic is long. It consists mainly of: 1) proposing an idea,
2) elaboration of a project, 3) making a model prototype,
4) making a real dimensions device, 5) checking an
application of the device, 6) starting industry manu-
facturing. The “Cybathlon” competition played a role
of checking an application of different types devices.
2. Materials and methods
2.1. Participants
About 70 athletes and their teams from about 50
companies and universities from 25 countries (from
all continents) appeared at the event. About a quarter
of the teams represented industry, and the rest repre-
sented university laboratories. People with disabilities
that prevent them from taking part in the Paralympics,
being supported by modern assistive technology
such as sensors, motors, and displays, were allowed to
compete.
2.2. Disciplines
There were six disciplines during the event: 1) Pow-
ered Arms (Upper Extremities) Prostheses Race,
2) Powered Legs (Lower Extremities) Prostheses
Race, 3) Functional Electrical Stimulation Bike Race
4) Powered Wheelchair Race, 5) Powered Exoskele-
ton Race, 6) Brain-Computer Interface Race. The tasks
were chosen not from sports for able-bodied competi-
tors but rather from everyday living tasks, such as
walking on uneven surfaces, stair climbing, opening
and closing doors, and other tasks.
2.3. Location and time
of the competition
“Cybathlon”, the first international competition for
people with disabilities supported by modern assistive
technology, took place in Zürich, Switzerland. The
Swiss Arena Kloten was the venue for “Cybathlon”
(Fig. 1). The competition took place on October 8,
2016 from 10 am to 6 pm.
Fig. 1. General view of the „Cybathlon” venue in Zürich
Modern technology assists disabled competitors: the first “Cybathlon” special competition in Zürich 71
3. Results
3.1. Powered arms (upper extremities)
prostheses race
Pilots with one or both upper extremities ampu-
tated above or below the elbow competed in the race
using prosthetics handled with different kinds of con-
trollers (Fig. 2a). The pilots executed various steps
and movements using motorised prostheses. The tasks
were as follows [7]:
a) Puzzle. Placing all the puzzle pieces onto a neigh-
bouring table; challenge: fine motor skills, multi-
ple types of grips, finger strength.
b) Wire Loop. Moving a wire loop with a grip along
a curved wire without touching it; challenge: freedom
of movement in the forearm and wrist, precision.
c) Setting the Table. Bringing objects from a rack
to a table, opening and closing a door, inserting
a blue light bulb into a lamp; challenge: fine motor
skills, multiple types of grips, balancing objects on
a tray, coordination of both arms.
d) Preparing Breakfest. Opening a can, a bottle, and
a jar, unwrapping a sugar cube, cutting a slice of
bread; challenge: hand strength in opening the can,
the jar, and the bottle, strength for slicing the bread,
fine motor skills.
e) Hanging Up Laundry. Hanging a t-shirt on a line
with two clothes pegs, buttoning a blazer and
zipping up a jacket, putting them on hangers;
challenge: fine motor skills, coordination of both
hands.
f) Carrying Objects. Moving all the objects via the
stairs onto a table; challenge: stable connection
between the prostheses’ socket and the arm stump,
hand strength.
a) b)
c) d)
e) f)
Fig. 2. „Cybathlon” disciplines (races): a) upper extremity prosthesis, b) lower extremity prosthesis,
c) functional electro-stimulation bike, d) powered wheelchair (here competitor rides up-stairs
being with his back towards the direction of a ride), e) exoskeleton, f) brain – computer interface.
For wheelchair and exoskeleton users, few guards always assisted the competitor during the race
W.S. ERDMANN et al.72
3.2. Powered leg (lower extremities)
prostheses race
The pilots executed various steps and movements
using motorised prostheses (Fig. 2b). The tasks were
as follows [7]:
a) Sofa. Sitting down and standing up five times;
challenge: lower extremity strength, power supply.
b) Hurdles. Passing the hurdles without knocking
them down; challenge: ability to bend and control
the movements of the knee joint.
c) Ramp & Door. Climbing a steep ramp, opening
and closing a door, going down the other side; chal-
lenge: ability to flex the knee and the ankle joints,
bending stability and motor power at the ramp.
d) Stones. Stepping onto each stone with one foot;
challenge: precision and balancing on one foot
while stepping to the next stone.
e) Tilted Path. Walking over ramps; challenge: in-
version/eversion of the ankle joint.
f) Stairs. Walking over the stairs three times while
balancing a cup on a saucer and apples on a plate;
placing only one foot alternatively on each step;
challenge: ability to bend the knee joint, strength,
precision, stability.
3.3. Functional electrical
stimulation bike race
Pilots with complete paraplegia were allowed to
compete in the race. Their motor nerves were artificially
stimulated in order to achieve muscle contraction. This
was used to push the pedals of the bike. Stimulating
electrodes were placed on the skin (they could be also
implanted) and an applied current caused the contrac-
tion of the muscles. The pilots controlled the power of
the stimulation by themselves. Only pilots with com-
plete spinal cord injuries were allowed to participate
using non-motorised bikes (Fig. 2c). Before the race,
the pilots trained in order to obtain enough muscle
endurance. They regulated the velocity of the bike in
relation to their endurance. Two pilots started at the
same time and competed at the race along a circular
track. The challenge was to skilfully stimulate the
muscles so that they achieved a high velocity without
becoming fatigued too quickly. The time limit was
eight minutes [7].
Hereby, the best way to compete was to ride a little
bit slower than average at the start fragment (as a kind
of warm-up, despite the warm-up before the race), to
maintain a steady velocity during the race, and the
velocity could be a little bit higher than average at the
end. In addition, deviations from the velocity trend
line should have been minimised [8].
3.4. Powered wheelchair race
The pilots competed on a track using motorised
wheelchairs, overcoming obstacles that are typical in
daily life. Motorised wheelchairs controlled by a joy-
stick, touchpad or similar technology were allowed in
the competition (Fig. 2d). The organisers wanted to
encourage the teams to overcome obstacles such as
narrow doorways, uneven pavement, steep slopes and
other problems. The tasks for the competitors were as
follows [7]:
a) Table. Driving up to a table, placing the thighs
halfway underneath it without moving the table;
challenge: size of the wheelchair.
b) Slalom. Passing between the slalom poles without
displacing them; challenge: size of the wheelchair,
precise maneuvering.
c) Ramp & Door. Climbing a steep ramp, opening
and closing a door, going down the other side; chal-
lenge: reaching down and pressing the door handle,
maneuvering in a confined space.
d) Rough terrain. Driving over the terrain; challenge:
gripping and performance of the wheels.
e) Tilted Path. Driving over the terrain; challenge:
drift and tipping stability, power.
f) Stairs. Driving over one time; challenge: ability to
climb stairs, power.
3.5. Powered exoskeleton race
Pilots with complete paraplegia resulting from spi-
nal cord injuries negotiated an obstacle course consist-
ing of typical everyday tasks. Exoskeletons are wearable,
motorised supports (orthoses) which allow people to do
at least a few general tasks they did when they were
healthy. People who were lying on a bed or sitting on
a chair now can walk independently. The pilots were
asked to guide their exoskeleton to correctly perform
the movements (Fig. 2e). The tasks for the competi-
tors were as follows [7]:
a) Sofa. Sitting down and standing up one time; chal-
lenge: range of motion in the knee and hip joints,
strength.
b) Slalom. Passing between the slalom poles without
displacing them; challenge: precision, agility.
c) Ramp & Door. Climbing a steep ramp, opening and
closing a door, going down the other side; chal-
Modern technology assists disabled competitors: the first “Cybathlon” special competition in Zürich 73
lenge: flexibility of the foot, knee, and hip joints,
stability when opening the door.
d) Stones. Stepping onto each stone with at least one
foot, and crutches could be placed beside the stones;
challenge: adapting step lengths and widths, preci-
sion.
e) Tilted Path. Walking over ramps; challenge: flexi-
bility of the foot joints, stability.
e) Stairs. Going up and down one time, and each
step had to be stepped on by at least one foot; chal-
lenge: ranges of the knee and hip joints, strength,
precision.
3.6. Brain–computer interface race
The pilots used brain–computer interfaces (BCI) in
the form of a cap with electrodes put on the head to
control avatars in a specially developed computer
game (Fig. 2f). BCIs can detect brain signals with the
help of electroencephalography (EEG). The partici-
pants had complete or severe loss of motor function
(paralysis) from the neck down due to a spinal cord
injury (SCI), stroke, neurological disease, or another
trauma. There were 16 pads (500 virtual meters). The
challenge was for the avatar to move correctly and
quickly only if the computer received the correct brain
signal at a specific moment. Otherwise, the avatar
were to slow down. There were the following com-
mands: 1) Rotate – the avatar rotated (danced) over
the playing pads (blue), 2) Jump – the avatar jumped
over spikes (purple), 3) Slide – the avatar slid under
“dangerous rays” (yellow), 4) No input – on the neu-
tral fields (gray), the pilot was asked “to think noth-
ing” to prevent the avatar from slowing down. The
time limit was four minutes [7].
4. Discussion
4.1. General comments
on the “Cybathlon”
The tasks for the upper and lower extremities were
accomplished with great accuracy and with significant
speed by all the participants. Also, the FES bike race
was done by almost all the competitors with good
times. During the other competitions, there were diffi-
culties during the races. Some participants using exo-
skeletons and wheelchairs had problems, especially in
climbing stairs. Not all competitors finished their races.
The exoskeletons and wheelchairs were usually proto-
types, so further technical improvement is needed.
Also, the prototypes are usually initially tested on non-
disabled subjects. They can compensate by maintaining
their balance using several muscles. On the other
hand, when a paralysed person uses an exoskeleton,
the machine needs to bear all their weight although
the person also uses crutches, which are mostly for
maintaining balance [9]. Exoskeletons are still in their
early stages of construction, so more tests involving
disabled people are needed. Wheelchairs that are
powered electrically usually have both wheels and
caterpillar technology. As a device with a computer
on board, it must have both proper construction and
proper software. The companies which develop their
devices also provide the money for their production.
University labs must make efforts to obtain scientific
grants or find sponsors. For example, the Zürich
Polytechnic students who built their wheelchair using
caterpillar technology contacted 37 sponsors [10].
“Cybathlon” was a kind of competition where both
the athletes and the manufacturers that produced the
competition devices were very valuable in obtaining the
final result. This is similar to the situation in motor sports
(automobile, motorbike), but in the “Cybathlon”, the
role of the manufacturers is currently even more im-
portant.
4.2. Improvement of the competition
The rules for these types of competitions must more
closely resemble the rules of sport disciplines for able-
bodied competitions. For example, during the FES
Bike Race, the rules stated: 1) The first to reach the
finish line is the winner (5 laps, 750 meters), and
2) the pilot who starts in the outside lane could change
to the inside lane after half a lap, as long as he/she
does not endanger the other pilot [7]. During the 800
m race in athletics, the competitors start at different
starting lines and are separated in their own lanes, but
after running 100 m, i.e., until the end of the first
bend, they change their lanes, moving towards the
innermost lane. The FES Bike Race competitors also
started from different starting lines at the elevation of
a ramp (Fig. 3). The outside ramp was positioned at
about 2.5 m to the front. But the difference in the
length of the inside and outside tracks was much
greater. Assuming that the radius of the inside track
(r.i) = 10.8 m and of the outside track (r.o) = 12.0 m,
the difference in the length of the curve was about
7.5 m, i.e., three times longer than the starting differ-
ence of the competitors’ positioning. Another possi-
W.S. ERDMANN et al.74
bility is to ride like 400-metre runners run in athletics,
i.e., without changing lanes, or riding like indoor bi-
cycle riders, i.e., starting from the opposite lines of
a track.
Another improvement would be the regulation of
the obstacles that had to be overcome and the regula-
tion of the objects that needed to be operated. There are
two reasons for this. First, if another institution wants
to organise the same competition, it would be better to
use the same facility and its equipment. The second
problem is training. In sport disciplines for able-bodied
competitors, all the facilities and equipment are the
same for every competition. Thus, the competitors can
train at home in the same surroundings they would find
during a competition in another place.
4.3. Parallel events
Along with the competition, there were also par-
allel events: 1) Hands-on demos; here, the spectators
could experience how it feels to play a computer game
with their thoughts, to grasp objects with an artificial
hand (Fig. 4a), to walk with an artificial lower ex-
tremity (Fig. 4b), to struggle with uneven terrain in
a wheelchair; 2) From Captain Hook to Iron Man; this
was an exhibition from the beginning of assistive aids
up to modern times; 3) “Let’s fätz” – Let’s get mov-
ing; this was an outdoor sports programme for both
children and adults; 4) Flight Simulation “Symbiotic
Drone”; visitors could fly like a drone using virtual
reality goggles and a special jacket that records body
movements [7].
5. Conclusions
The main creator of the event, Professor Robert
Riener from Zürich Polytechnic (ETH), said that assis-
tive technology should: a) be user-friendly; b) function
well; c) be affordable; and d) be used within a barrier-
free environment. Professor Riener anticipates the
further development of assistive technology. For
Fig. 3. Start of FES bikes from the ramps
a) b)
Fig. 4. During „Cybathlon” spectators could try devices for disabled people:
a) artificial hand, b) artificial lower leg
Modern technology assists disabled competitors: the first “Cybathlon” special competition in Zürich 75
example, exoskeletons will be integrated with cloth-
ing [11].
The competition was a success. It was decided for it
to be organised every four years. The next “Cybathlon”
championship for robot-assisted competitors with dis-
abilities is to take place in 2020. It should conform
more to typical sport competitions in order to provide
equal chances for all the participating teams to the
greatest extent possible.
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