Medical exoskeleton robot technology is poised to revolutionize the rehabilitation field for mobility-impaired individuals—a critical social issue affecting millions worldwide. According to World Health Organization (WHO) statistics, 1.1 billion people, representing 15% of the global population, live with some form of disability. Among these, StatPearls reports mobility impairments resulting from spinal cord injuries and strokes pose particularly severe challenges that significantly impact patients’ quality of life.
Against this backdrop, Indian startup Astrek Innovations has developed Unik Exo, an innovative solution that redefines conventional medical exoskeleton concepts. Through their unique approach combining lightweight design with modular architecture, they’ve achieved a groundbreaking price point—one-third that of existing products—while demonstrating 90-95% improvement rates in patient functional recovery.
In 2024, the company participated in the Okinawa Institute of Science and Technology Graduate University (OIST) Innovation Accelerator program, solidifying their technological advantages through proof-of-concept trials in the Japanese market. They are now accelerating strategic initiatives for full-scale business expansion across Japan, India, and the United States, working toward establishing their position in the global market.
Addressing the Growing Crisis of Mobility Impairment
Each year, more than 17,000 Americans are affected by spinal cord injuries, while approximately 1.5 million suffer brain injuries, resulting in nearly 5.4 million Americans—1 in 50 people—living with paralysis. This severe situation extends globally, with impacts expanding further as societies age. WHO statistics reveal that over 15 million people worldwide live with spinal cord injuries, primarily caused by traumatic accidents such as traffic incidents and falls.
Astrek Innovations’ Unik Exo is a rehabilitation exoskeleton robot designed for patients with lower limb impairments due to stroke, spinal cord injury, neuromuscular diseases, and other conditions. According to the company’s co-founder and CSO Vishnu Sankar, the device “can solve 90-95% of the problems patients face.”
The challenges confronting complete paraplegic patients (those who have completely lost motor and sensory functions throughout their body due to brain or spinal cord damage, with complete loss of lower limb function) are beyond imagination.
In cases of complete spinal cord injury, patients must continue lower limb rehabilitation for life. Complete recovery is impossible, and without proper exercise, many internal organ dysfunctions will occur.
Stroke, neonatal encephalopathy (brain damage), migraines, dementia, diabetic neuropathy (nerve damage), meningitis, epilepsy, neurological complications from premature birth, autism spectrum disorder, and nervous system cancers are among the most prominent neurological conditions contributing to patients’ health deterioration. (Sankar)
Complications such as poor blood circulation, bladder dysfunction, osteoporosis, pressure sores, and blood clots pose serious threats to these patients. The range of conditions targeted by medical exoskeleton robots is extensive.
Medical exoskeleton robots deliver benefits far beyond simple mobility assistance, providing physical effects including improved muscle strength, reduced spasticity, and prevention of pressure sores, alongside psychological benefits that enhance patients’ confidence and independence. The moment when patients don exoskeleton robots, stand up, and walk is described by healthcare professionals as an “awe-inspiring” experience.
A 2021 study reported improved patient mood during rehabilitation phases, with reduced fatigue and enhanced quality of life observed. Other patients value the ability to make eye contact and converse with others while wearing exoskeleton robots.
Research demonstrates that using exoskeleton robots results in “improved gait patterns that approached those of healthy subjects by training completion.” Exoskeleton robots can provide more walking repetitions compared to conventional rehabilitation methods.
CEO Robin Kanattu Thomas explains their development motivation:
Modern medicine is incredibly advanced, yet the rehabilitation field lags decades behind. We wanted to bring change to that situation. Imagine having to rely on others to support your body—even for brushing your teeth or standing up.
While physical limitations are challenging, the mental impact of losing independence in even the simplest tasks can be even more difficult. Many people around us face this struggle daily.
Revolutionary Modular Design and Overwhelming Cost Performance
The medical exoskeleton robot market is experiencing rapid growth projected by multiple research institutions, with expectations to reach $3.8 billion by 2027 and $12.5 billion by 2030. The lower limb exoskeleton robot segment leads the market, expected to reach $2.85 billion by 2027.
Rising elderly populations and increasing global prevalence of mobility impairments driven by spinal cord injuries, strokes, and neurological disorders are significantly boosting demand for medical exoskeleton robots. In this rapidly growing market, Unik Exo’s most compelling features are its lightweight design and modular architecture.
While conventional exoskeleton robots require 20-25 minutes for setup, Unik Exo can be worn in 2-5 minutes. Sankar recalls that this time reduction was “the most appreciated aspect” by medical professionals at Japanese hospitals already using Cyberdyne exoskeleton robots.
There’s a very clear difference between other exoskeleton robots in the market and our ‘Unik Exo’—the modular structure. Currently, no other exoskeleton robots in the market have this feature. This is one of the key functions we always emphasize.
When a patient only needs knee joint rehabilitation, they can use just the knee portion and remove unnecessary parts. It’s “plug-and-play”—other parts can be attached later as needed. If only hip support is required, the hip section can be combined. (Sankar)
Price advantage represents one of Astrek Innovations’ most powerful competitive elements. While major U.S. competitors Exo Bionics and ReWalk sell products for $120,000-$150,000, Unik Exo is planned for $30,000-$35,000.
Modular design allowed us to significantly reduce manufacturing costs. We maintained quality while lowering prices. (Sankar)
This price advantage holds crucial significance for expanding market access. Exorbitant costs associated with importing devices from Europe or the US create major barriers, increasing treatment costs and reducing the number of patients who can benefit.
Co-founder and COO Jithin Vidya Ajith comments:
Astrek’s goal is fostering equality of opportunity and accessibility for people living with disabilities. We believe technology has the power to improve these conditions and are committed to exploring ways to advance this goal.
One important advantage of medical exoskeleton robots is their ability to support targeted muscle strengthening. They can be programmed to provide resistance for specific movements, addressing particular muscle group strengthening needs. This function is especially beneficial for patients who have experienced muscle atrophy due to prolonged immobility.
Medical exoskeleton robots play crucial roles in improving patient mobility, providing essential support for standing, walking, and movement. This reduces patients’ dependence on caregivers and assistive devices like wheelchairs, improving quality of life and dignity.
Furthermore, exoskeleton robots provide safe, controlled rehabilitation environments, significantly reducing risks of falls and injuries during treatment. This safety improvement represents an important benefit for both patients and healthcare professionals.
Kerala’s Innovation Ecosystem
Image credit: Kerala Startup Mission
The company was founded in 2018 by Robin Kanattu Thomas (CEO), Jithin Vidya Ajith (COO), Alex M Sunny (CTO), and Vishnu Sankar (CSO). The first prototype began as a project at Vimal Jyothi Engineering College under Kannur University. Encouraged by its potential, the team received grants from Kerala Startup Mission (KSUM), a government entrepreneurship promotion organization, and launched their company at Maker Village in Kalamassery, Kerala.
Astrek Innovations’ growth has been supported by Kerala’s robust startup ecosystem. According to Startup Genome, Kerala maintains a vibrant startup ecosystem growing at 20% annually, fostering over 3,500 startups. KSUM has supported over 6,400 startups, operates 63 incubators, facilitated $665 million in funding, and created 65,000 jobs.
Kerala experienced a 147% surge in ecosystem value in 2025, highlighting significant increases in startup formation. This positive momentum indicates stronger investor interest, enhanced policy support, and deeper integration into global startup networks.
The company leverages Kerala’s rich life sciences and biotechnology infrastructure. The Biotechnology Incubation Center “BioNest” provides incubator facilities and state-of-the-art biotechnology equipment platforms to nurture emerging biotech and life science startups.
Unik Exo’s design and development are conducted entirely in-house, making this internalization a source of competitive advantage. From control dashboard software to patient data management systems, firmware and software development are completely internalized.
For hospitals, we provide highly customizable dashboards to control devices. Everything can be controlled from that dashboard, and patient data is displayed. If upgrades are needed, our team can handle everything. We have a very strong team behind us that can work on everything. (Sankar)
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The company’s technology development capabilities are supported by a small but highly specialized team structure. Their products incorporate cutting-edge motion capture systems that provide real-time feedback on user status to doctors and caregivers. Currently supporting weights up to 120kg, the device operates on battery or external power.
Material innovation continues as well. Initially using metal components, demand for lighter, more efficient materials led to the current adoption of hybrid structures combining composite materials for weight reduction with medical-grade aluminum for durability.
However, composite materials present unique challenges. Unlike metals, composite materials lack uniform density, making precision machining difficult. The company continues improving processing techniques for enhanced reliability. Currently, 30% of the exoskeleton is metal-based, with the remaining 70% utilizing advanced composite materials.
Meanwhile, for critical components like batteries and motors, they strategically utilize external procurement.
Currently, what we need most are excellent battery manufacturers who can customize batteries and very good motors—customized motors. We source motors from China and batteries from Japan and Taiwan.
During my stay in Japan, I attended the BIO Asia-Taiwan biotech conference and began discussions about partnerships with multiple battery manufacturers and OEMs. Indian battery manufacturers have issues, so we believe collaboration with Japanese and Taiwanese manufacturers is necessary. (Sankar)
The company is currently working on its fifth iteration of improvements, steadily enhancing product completeness. A crucial element in global expansion is adapting to regional anthropometric data.
Body type data differs significantly between Japanese and Indian people. We needed to adjust our devices according to that data. In the future, we plan to further improve wearing ease. Users shouldn’t take more than 2-3 minutes to wear the device. It should feel like a natural extension of the body. (Sankar)
Connecting Japanese Success to Global Expansion
Photo credit: OIST
In 2024, the company participated in the OIST Innovation Accelerator. This program, established in cooperation with Okinawa Prefecture in 2018, has notable alumni startups including EF Polymer, REPS Japan, HerLifeLab, and GenomeMiner, which have successfully secured private investments or brought products to market.
Through this program, Sankar stayed in Okinawa for approximately one year developing business operations. In Okinawa, he built networks with seven hospitals and conducted proof-of-concept trials, receiving written purchase intentions from multiple hospitals.
Existing devices required over 20 minutes just for setup and wearing. Our device takes only a few minutes, so doctors most highly valued this time reduction. At one hospital, supporting one patient in a rehabilitation session required up to three people, but using our device, one physiotherapist can simultaneously support two patients.
In Okinawa, we built networks with seven hospitals. Since I was in Okinawa, I could easily access these hospitals and maintained constant interest. Leveraging geographical advantages during my stay, I was able to conduct intensive clinical validation. (Sankar)
To date, they have received a letter of interest from a medical device distributor regarding sales for Japanese and Taiwanese markets, and received written interest from Okinawa Rehabilitation Center Hospital. These achievements form a solid foundation for full-scale business deployment.
Once we complete device upgrades and everything, we plan to start sales immediately. We plan to sell products in Japan and expand to other global markets from there. By selling products from Japan, we need to collect more data from various markets because patient categories may differ. (Sankar)
In 2023, they won the “Best Product of the Year” award at Robotworld 2023 in Seoul and received recognition from the UAE government, among growing international acclaim. Within India, they have already obtained DRDO certification (Indian Defence Research and Development Organisation certification) and patents, with ongoing efforts to acquire additional patents.
Astrek Innovations positions Japan as the “foundation for global market construction” while simultaneously pursuing expansion in multiple markets. Currently focusing on India and Japan as primary markets, they also envision U.S. market expansion. They have already established a corporation in the UAE.
Customer strategies for each market are clearly defined. Hospitals with physical medicine and rehabilitation departments, physiotherapy clinics, and neuro-rehabilitation clinics form the main customer base. Particularly in the US, they focus on specialized rehabilitation center networks for veterans injured in military service.
US has veteran clinics—specialized rehabilitation centers for those injured in military service that form large networks. These facilities represent one of our primary target customers. A characteristic of this market is strong demand for our devices exists everywhere worldwide. In Japan, US, or India, patients and medical institutions seek such technology.
Actually, hospitals and patients need devices like this, but the problem is existing competitive products cannot provide complete solutions. What’s lacking are truly comprehensive solutions where devices reduce medical staff burden, take care of patients, and doctors just monitor progress and record data.
Currently, we’re pursuing deployment as medical devices, but in the future, we plan to develop them for use as assistive devices, creating devices patients can use wherever they want—offices, homes, anywhere. (Sankar)
Aiming to Establish Position in the $3.8 Trillion Market
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Global expansion requires medical device approval from each country. The company currently pursues multiple certifications in parallel. In Japan, PMDA (Pharmaceuticals and Medical Devices Agency) and the Ministry of Health, Labour and Welfare oversee medical device regulations, while they aim for FDA approval in the US and CE certification in Europe.
The certification process is complex, but they adopt strategies to understand each market’s requirements in detail and clear them step by step. Particularly in the Japanese market, Cyberdyne’s precedent works advantageously. Insurance system adaptation is critically important for expanding patient access, requiring understanding of and appropriate responses to differences in medical insurance systems across countries.
We’re currently obtaining ISO13485 certification for company and product safety checks and product certifications. Once we receive these certifications, we can sell in corresponding markets. Products are completely ready.
Currently, we’re providing to some hospitals in India, but selling elsewhere requires these licenses and certifications. One major difference between India and other countries is that India lacks insurance systems like other countries. In India, most medical costs become patients’ out-of-pocket expenses. (Sankar)
Meanwhile, in Japan, existing exoskeleton robot insurance categories due to Cyberdyne’s track record were discovered. In the US, Medicare began covering Exo Bionics and ReWalk products from July 2024, with similar coverage targeted.
We’re having conversations with insurance agencies and stakeholders to participate in those insurance systems. When starting sales in new markets, we first need to enter insurance systems. Certification and insurance—these are the two main things we really need when entering other markets.
In Japan, we’re naturally beginning concrete efforts toward insurance coverage. In the US, we need FDA certification, and in Europe, CE certification, so we’re working on these as well. (Sankar)
The team appeared on Monorama Online Elevate, the Indian business pitch reality show.
Currently, the company is progressing with seed round fundraising. They have received support from KSUM, Chile’s startup support program (Start-Up Chile), BIRAC (India’s government-affiliated Biotechnology Industry Research Assistance Council), Indian Angel Network, and others, securing total investments of $141,000.
Investment is the most important thing for all startups and companies. We’re actively fundraising. We’ve already secured multiple grants in Japan, and we might secure investments by year-end. We’re also talking with US investors who will support our U.S. market expansion. (Sankar)
What the company emphasizes in investor relationships is strategic partnerships beyond mere funding. This perspective demonstrates understanding of the importance of local networks and know-how in global expansion.
We’re not thinking about market domination. We’re thinking about entering markets first and making steady progress. We aim to complete all certification acquisition by the end of 2025 and target sales of approximately 100 units across UAE, Japan, India, and the US by the end of 2027. (Sankar)
The exoskeleton robot market is projected to grow to $3.3 billion (approximately $3.8 trillion) by 2027. Sankar shows optimistic views about market opportunities.
Even though Mercedes, Audi, and McLaren exist, Toyota and Suzuki still sell cars. Markets don’t become monopolized by single companies—they always exist. We’re not worried about competition despite competitors.
As long as markets exist and people in need exist, we’ll have no problems selling our products. We don’t just want to build assistive devices—we want to create a world where disabilities don’t limit possibilities. (Sankar)
Through innovation in medical rehabilitation, Astrek Innovations aims to improve quality of life for patients worldwide. This startup born from Kerala’s innovation ecosystem holds potential to bring new currents to the global medical exoskeleton robot market.
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