Biomimetic Strategies in Orthosis Design: A Scoping Review of Biological Abstraction and Functional Translation

Orthoses are widely used to support or modulate neuromuscular and skeletal function; however, their clinical effectiveness is often limited by discomfort, poor adaptability, and suboptimal human-device interaction. Biomimetics has emerged as a structured design paradigm capable of enhancing orthotic performance by systematically translating biological principles into engineering solutions. This scoping review examined biomimetic strategies in the development of orthoses. A structured search was conducted across PubMed, IEEE Xplore, Web of Science, and Scopus (2000-2025). Of 453 identified records, 14 met the inclusion criteria. Biomimetic orthosis research emerged predominantly after 2012, with increased activity after 2021. Human-based biological models, particularly muscle-tendon systems, predominated. Most studies relied on functional abstraction and were implemented using cable-driven or electromechanical actuation. None of the included studies explicitly referenced established biomimetics standards (e.g., ISO 18458), and descriptions of biological analysis, abstraction, and transfer were frequently incomplete. Experimental validation was generally limited to prototype-level testing, small sample sizes, and short-term evaluations, with no longitudinal or multicenter studies identified. These findings reveal a structural imbalance between conceptual biomimetic inspiration and structured methodological implementation. Based on this analysis, a structured biomimetic workflow is proposed to enhance traceability, reporting clarity, and clinical translation in the development of orthosis.