Robot-Assisted Gait Training Enhances Phase-Specific Torque Generation, Balance, and Motor Recovery in Hemiplegia

Gait dysfunction is a common and disabling consequence of stroke, frequently associated with impaired lower-limb torque generation and reduced balance. Robot-assisted gait training (RAGT) has emerged as a promising intervention; however, its phase-specific biomechanical effects remain incompletely characterized. This pilot mechanistic study investigated the effects of Walkbot-assisted gait training on phase-specific lower-limb torque and clinical outcomes in individuals with unilateral hemiplegia. Fifteen patients with hemiplegia underwent Walkbot-assisted gait training. Joint torque values were normalized to body mass (Nm/kg). Phase-specific torque was analyzed during the swing and stance phases for the affected and unaffected limbs. Pre-post differences were evaluated using the Wilcoxon signed-rank test. Functional balance and motor impairment were assessed using the Berg Balance Scale (BBS) and the Fugl-Meyer Assessment-Lower Extremity (FMA-LE). Significant torque increases were observed in both gait phases. Median swing-phase torque increased from 0.261 to 0.361 Nm/kg in the affected limb and from 0.254 to 0.334 Nm/kg in the unaffected limb (p ≤ 0.017). Stance-phase torque increased from 0.197 to 0.454 Nm/kg in the affected limb and from 0.158 to 0.471 Nm/kg in the unaffected limb. Clinical outcomes improved significantly, with median BBS scores increasing from 22.0 to 34.0 and FMA-LE scores from 14.0 to 24.0 (p = 0.001). Walkbot-assisted gait training was associated with significant phase-specific torque gains, accompanied by improvements in balance and lower-limb motor recovery.