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Published on: May 16, 2025
Unilateral Exoskeleton Training for Balance/Gait in Hemiplegic Stroke: Pilot Study
Shaoting Zhou1, Sen Wang2, Xueying Qu1
1Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, China, tongji.edu.cn.
Objective:
The aim of this study is to evaluate the effects of a unilateral-lower limb exoskeleton rehabilitation training robot on balance and lower limb function after stroke.
Methods:
In this pilot study, stroke patients with hemiplegic at Tongji University Yangzhi Rehabilitation Hospital (between October 2022 and December 2023) were randomly assigned to either the robot group or the control group. The primary measure was the Berg balance scale (BBS), whereas secondary measures included the 10-m walking time test, 6-min walk test, three-dimensional gait analysis, and pain levels using the Hospital Anxiety and Depression Scale (HADS) and visual analogue scale (VAS).
Results:
Among 36 post-stroke hemiplegia patients (25 males; 18 per group), the robot group significantly outperformed the traditional group. The robot group improved BBS scores (5.50 ± 2.09 vs. 3.11 ± 1.50, p < 0.001), 6-min walking distance (15.89 ± 8.64 m vs. 9.73 ± 5.83 m, p = 0.017), and 10-m walking time reduction (8.82 ± 3.22 s vs. 6.83 ± 1.81 s, p = 0.030). Gait parameters also showed greater gains: hip flexion (3.57°±2.30° vs. 1.72°±2.15°, p = 0.018), knee flexion (5.28°±4.89° vs. 2.63°±2.37°, p = 0.046), and ankle dorsiflexion (4.81°±5.57° vs. 1.09°±4.19°, p = 0.030). Depression scores improved more in the robot group (2.89 ± 1.75 vs. 1.61 ± 1.20, p = 0.015). No significant differences occurred in anxiety or pain VAS scores (p > 0.05).
Conclusion:
Integrating a unilateral-lower limb exoskeleton rehabilitation robot with traditional therapy significantly enhances lower limb recovery in stroke patients with hemiplegia. Future large-scale randomized controlled trials and follow-up evaluations are needed to validate the current findings.
