Joint leader
In 2023, we featured Dr Aiqin Liu’s research as part of Further Together, highlighting her work on knee rehabilitation and the development of wearable technology to support patients beyond clinical settings.
Since publication, Dr Liu has undertaken several follow‑up activities to expand testing and inform future trials. From 2025 onwards, Dr Liu has been engaging with patients and clinicians across the UK, USA, China, Australia, New Zealand and Japan, using international surveys and stakeholder workshops to broaden end-user research.
This focused on identifying the key challenges and barriers associated with the use and adoption of rehabilitation technologies.
Patients consistently raised the same issues, such as limited access to physiotherapy, high costs, and a lack of support once they leave the clinic. These insights have directly informed how the device has evolved.
Patients place greater value on technology that fits into everyday life and helps them feel more confident doing their exercises outside of clinical settings.
— Dr Aiqin Liu
Read the original research storyImpact
- Knowledge discovery: created a device that supports patients and clinicians to check knee health and performance
Key information
- Major funders: Michael Beverley Innovation Fellowship, UK Research and Innovation, UKRI Impact Acceleration Account
- Disciplines: HealthTech, sports and exercise science, biology
- Investigators: Dr Aiqin Liu, Professor Shane Xie
From clinic‑based monitoring to everyday use
The move from clinic‑based physiotherapy monitoring to developing a device people can use independently every day was driven mainly by clinical need identified by both patients and clinicians.
There is increasing demand for cost‑effective, remote rehabilitation solutions, particularly for people with knee osteoarthritis, to help with surgical preparation, improve long‑term outcomes, and ease pressure on NHS services.
Knee pain is a chronic condition that requires consistent, day‑to‑day rehabilitation. However, due to limited clinical resources, many patients receive only a small number of supervised physiotherapy sessions.
Inadequate monitoring during home exercise can lead to incorrect execution, which may slow recovery, worsen joint damage, and increase long‑term healthcare costs. In addition, age‑related muscle loss and weakness frequently limit patients’ ability to engage effectively in rehabilitation, contributing to further muscle wasting, functional decline, and disability.
The device also provides clinicians with meaningful, objective biomechanical data on patients’ daily rehabilitation, enabling more accurate monitoring and evidence-based adjustments to rehabilitation programmes.
What patients think so far
Since 2023, patient engagement with the device has been explored through focus group discussions and patient surveys. Overall, feedback has been very positive, particularly regarding the device’s monitoring capabilities and assistive features, which increased confidence during rehabilitation and supported patients to understand whether exercises are being performed correctly at home.
At the same time, patients consistently emphasised the importance of usability, accessibility and affordability when considering long‑term use. Cost, limited access to rehabilitation services, and a lack of education and training were identified as significant barriers, reinforcing the need for technology that is practical, realistic and usable in everyday life.
Developing a device capable of monitoring and supporting patients’ everyday rehabilitation exercises empowers patients to self‑manage their condition while ensuring exercises are performed safely and effectively.
Advancing the technology
Alongside this patient engagement work, the development of the technology has also progressed. Dr Liu and the research team have now advanced to a third‑generation exoskeleton prototype, alongside a fully validated wearable sensing system.
Together, these developments form the basis for upcoming laboratory-based evaluation studies with patients and future clinical research. Patients are currently being recruited for a laboratory‑based evaluation, aiming to collect more detailed user experience data and patient responses to the device in a controlled setting, alongside real-world feedback expected by this year.
The project has also made early progress towards commercialisation. Dr Liu is working with the University’s commercialisation team to explore patent protection for the core technologies underpinning the device.
In parallel, an industry partnership has been established with Steeper, one of the UK’s largest orthotics companies, to support future manufacturing development and commercialisation planning.
Building clinical and NHS partnerships
Dr Liu is collaborating with Leeds Teaching Hospitals NHS Trust and Leeds Community Healthcare NHS Trust to explore the feasibility of integrating the wearable sensor technology into existing knee assessment and rehabilitation pathways.
These collaborations focus on using objective knee function data to support clinical decision‑making, enhance patient monitoring, and align the technology with established NHS digital health pathways.
New funding and wider ambitions
Since the original article, the research has been supported through additional funding. In 2024, Dr Liu was awarded an Academy of Medical Sciences Networking Grant, supporting further investigation of clinical needs and the development of international research and clinical partnerships.
Additional funding through the Michael Beverley Innovation Fellowship enabled updated market analysis, which identified an expanded potential market beyond knee pain rehabilitation, including neuro‑rehabilitation applications. More recently, a grant application was submitted to Arthritis UK to support the next proof‑of‑concept study. This proposed work focuses on laboratory‑based evaluation of the latest device prototype with knee patients.
Exploring Tai Chi and functional movement
Building on earlier work, Dr Liu is collaborating with physiotherapists from Leeds Community Healthcare NHS Trust to explore the feasibility of integrating Tai Chi–based movements into existing knee rehabilitation programmes. This work aims to assess how Tai Chi and other functional movement principles can complement conventional physiotherapy.
The longer‑term aim is to develop an evidence‑based, Tai Chi‑informed knee rehabilitation framework that could be formally evaluated and, if successful, considered for adoption within NICE guidance.
What’s next?
The long‑term vision is to fundamentally transform knee osteoarthritis rehabilitation through scalable digital health technologies that support remote monitoring, personalised feedback and virtual consultation.
“This approach will support a sustainable healthcare model to empower older adults to remain physically active, independent, and engaged in meaningful daily activities, ultimately improving quality of life and reducing pressure on health and social care systems”, explains Dr Liu.
This project was sponsored by the UKRI Impact Acceleration Account.
It is part of the Further Together updates series.