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The theoretical context is necessary to understand the process that frames the gender perspective. It must be studied from the pillars of human rights, those that are inherent to the human being and that do not discriminate against age, sex, social status, etc. Being considered Universal, human rights do not contemplate political ideologies, economic systems, or cultural differences; furthermore, as it is irrevocable, it is not possible to delegate or renounce them; human rights are indivisible, that is, they are related and interconnected with each other, but they are formed as a whole. In addition, due to their nature, they are legally enforceable and recognized by the states, therefore, they require respect and compliance.

The purpose of this review paper is to address the substantial challenges of the outdated exoskeletons used for rehabilitation and further study the current advancements in this field. The shortcomings and technological developments in sensing the input signals to enable the desired motions, actuation, control and training methods are explained for further improvements in exoskeleton research.

Search platforms such as Web of Science, IEEE, Scopus and PubMed were used to collect the literature. The total number of recent articles referred to in this review paper with relevant keywords is filtered to 143.

Exoskeletons are getting smarter often with the integration of various modern tools to enhance the effectiveness of rehabilitation. The recent applications of bio signal sensing for rehabilitation to perform user-desired actions promote the development of independent exoskeleton systems. The modern concepts of artificial intelligence and machine learning enable the implementation of brain–computer interfacing (BCI) and hybrid BCIs in exoskeletons. Likewise, novel actuation techniques are necessary to overcome the significant challenges seen in conventional exoskeletons, such as the high-power requirements, poor back drivability, bulkiness and low energy efficiency. Implementation of suitable controller algorithms facilitates the instantaneous correction of actuation signals for all joints to obtain the desired motion. Furthermore, applying the traditional rehabilitation training methods is monotonous and exhausting for the user and the trainer. The incorporation of games, virtual reality (VR) and augmented reality (AR) technologies in exoskeletons has made rehabilitation training far more effective in recent times. The combination of electroencephalogram and electromyography-based hybrid BCI is desirable for signal sensing and controlling the exoskeletons based on user intentions. The challenges faced with actuation can be resolved by developing advanced power sources with minimal size and weight, easy portability, lower cost and good energy storage capacity. Implementation of novel smart materials enables a colossal scope for actuation in future exoskeleton developments. Improved versions of sliding mode control reported in the literature are suitable for robust control of nonlinear exoskeleton models. Optimizing the controller parameters with the help of evolutionary algorithms is also an effective method for exoskeleton control. The experiments using VR/AR and games for rehabilitation training yielded promising results as the performance of patients improved substantially.

Robotic exoskeleton-based rehabilitation will help to reduce the fatigue of physiotherapists. Repeated and intention-based exercise will improve the recovery of the affected part at a faster pace. Improved rehabilitation training methods like VR/AR-based technologies help in motivating the subject.

The paper describes the recent methods for signal sensing, actuation, control and rehabilitation training approaches used in developing exoskeletons. All these areas are key elements in an exoskeleton where the review papers are published very limitedly. Therefore, this paper will stand as a guide for the researchers working in this domain.

This paper aims to explore the intersection of cultural processes and immigration in parental understanding of adolescent mental health and mental health seeking behaviors among African immigrants in Western countries. The present study examines the perspectives of Congolese immigrant parents on adolescent mental health in Brussels, Belgium, and Raleigh, North Carolina, USA – two geographic regions with relatively large Congolese migrant populations. This study highlights a needed understanding of cultural and acculturative context in shaping the beliefs of Congolese immigrants and explores potential barriers of seeking health services. Additionally, it recognizes health issues among this underrepresented and underserved population.

Fifteen Congolese immigrant parents, eight in the USA and seven in Belgium, participated in structured qualitative interviews using an adapted version of Kleinman Questions and behavioral scenarios on depression, post-traumatic stress disorder and oppositional defiant disorder. Interviews were audio recorded, and participants were assigned pseudonyms to de-identify responses. English interviews were transcribed verbatim by a trained team of undergraduate research assistants, and French interviews were transcribed verbatim by the first author and a graduate research assistant. Following transcription, the first and second authors used a rapid analytic approach (Hamilton, 2013). The first and second authors conducted a matrix analysis to observe thematic patterns.

Parents interpreted adolescent behavior to be more problematic when the scenarios were overtly outside of their cultural realm of values and beliefs. Parents preferred methods of intervention through religious practices and/or family and community efforts rather than seeking mental health services in their host countries as a secondary option. The authors’ findings provide an understanding of the values and beliefs of this underrepresented demographic, which may be useful to guide health professionals on how to support this community in a culturally responsive way.

Limitations to the current study include the structured nature of the interview guide that did not allow for in-depth qualitative exploration. Interviewed participants had lived in their host countries for more than 10+ years. Thus, the authors’ findings are not reflective of new immigrants’ experiences. Parents’ perspectives were likely shaped by exposure to Western beliefs related to support for mental health (e.g. knowledge of psychologists). Future studies should focus on recent refugees due to exposure to traumatic events and experiences reflective of the Democratic Republic of Congo’s (DRC’s) current socio-political situation, and how these are understood in the context of adolescent mental health. Further, due to the hypothetical nature of the scenarios, the authors cannot be sure that participants would engage in the identified approaches with their children. Additionally, hearing from the youth’s perspective would provide a clearer insight on how mental health and seeking professional help is viewed in a parent–child relationship. Finally, the data for this study were collected in 2019, prior to the COVID-19 pandemic. Although the authors cannot speak directly to Congolese refugee and immigrant experiences during this significant historical period, given the rise in mental health concerns in refugee populations more broadly (Logie et al., 2022), the authors’ findings speak to how parents may have responded to increased mental health symptoms and point to additional barriers that these populations may have faced in accessing support. The authors’ study emphasizes the need for dedicating resources and attention to this population, especially the development of culturally tailored messaging that invites community members to support the mental health needs of their community.

The authors’ findings provide important implications for mental health professionals. This study provides a clearer understanding of how Congolese immigrant parents view mental health and help-seeking within their cultural frame. Although parents may seek professional help, a distrust of mental health services was expressed across both cohorts. This suggests that mental health professionals should acknowledge potential distrust among this population and clarify their role in supporting the mental health of adolescent immigrants. Clinicians should inquire about familial cultural beliefs that are parent- and child-centered and modify their interventions to fit these belief structures.

This paper addresses the gap in knowledge about mental health perspectives of Sub-Saharan African immigrant populations, specifically those from the DRC.