Portable hip exoskeleton improves walking economy for stroke survivors

Increased metabolic cost of walking after stroke limits mobility and quality of life for millions of individuals. Existing portable assistive devices, primarily targeting the ankle joint, have failed to alleviate this burden. Here, we tested a portable, lightweight hip exoskeleton providing bilateral assistance during walking for individuals with chronic post-stroke hemiparesis. The exoskeleton significantly reduced the net metabolic cost of walking by 18 ± 2% (mean ± standard error, p = 0.0002) in seven participants during treadmill walking-a reduction sufficient to potentially lessen fatigue and extend walking duration- compared to walking without the device. This improvement was associated with a 29 ± 6% reduction in positive biological hip work (p = 0.0052), indicating effective offloading of the hip joints. These results provide the first evidence that portable hip exoskeleton assistance can improve walking economy in stroke survivors, offering a promising therapeutic strategy to enhance real-world mobility and functional recovery in this large clinical population.