Effect of smart powered hip exoskeleton on lower limb motor function in stroke patients_West China Medical Journal

Authors：

JIA Lingyun ¹ , KANG Xiaoyu ² , XIA Xiaoqian ¹ , ZHANG Linyao ¹ , WANG Qianhui ³ , WU Xiaoli ^1,4 , YE Changqing ^1,4 , CHEN Yudong ^1,4 , GAO Fei ^1,4 , LI Hanzhi ^1,4 , WANG Yizheng ^1,4 , ZHOU Kaiping ^1,4 ,  LIU Lixu ^1,4

1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, P. R. China;
2. Department of Neurological Physical Therapy, Beijing Bo’ai Hospital, China Rehabilitation Research Center, Beijing 100068, P. R. China;
3. The Second Clinical Medical College of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P. R. China;
4. Neurorehabilitation Center, Beijing Bo’ai Hospital, China Rehabilitation Research Center, Beijing 100068, P. R. China;

Corresponding?author：

LIU Lixu, Email: liulixu2004@163.com

Keywords：

Stroke; smart powered hip exoskeleton; lower limb motor function

DOI：

10.7507/1002-0179.202504249

Video：

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Objective To explore the effect of smart powered hip exoskeleton-assisted gait training on lower limb motor function in stroke patients. Methods Stroke patients hospitalized at the China Rehabilitation Research Center (Beijing Bo’ai Hospital) between December 2023 and March 2025 were enrolled. The patients were randomly assigned to either the exoskeleton group or the conventional gait training group (control group). All patients received conventional rehabilitation therapy, including occupational therapy and physiotherapy. Additionally, the exoskeleton group underwent gait training with a smart hip-powered exoskeleton. The control group received conventional gait training using traditional rehabilitation methods. Functional assessments were conducted before treatment, after 2 weeks and 4 weeks of treatment using the following scales: Fugl-Meyer Assessment Scale for Lower Extremity (FMA-LE), Fugl-Meyer Balance Assessment Scale (FMA-B), Modified Ashworth Scale (MAS), 6-Minute Walk Test, Modified Barthel Index (MBI). Patients in the exoskeleton group underwent subjective satisfaction assessment after 4 weeks of treatment. Results A total of 29 patients were included. Among them, there were 15 cases in the exoskeleton group and 14 cases in the control group. There was no statistically significant difference in gender, age, stroke type, disease duration, and hemiplegic side between the two groups (P>0.05). There was no statistically significant difference in motor function indicators between the two groups before and after treatment (P>0.05). After 4 weeks of treatment, FMA-LE, FMA-B, and MBI scores in both groups were higher than before treatment (P<0.05). After 2 weeks of treatment, the FMA-LE score in the foreign group showed an improvement (P<0.05), while the control group showed an improvement until 4 weeks later (P<0.05). After 2 weeks of treatment, there was a statistically significant difference in the improvement rate of FMA-LE between the two groups (Z=?2.076, P=0.041). After 4 weeks of treatment, the subjective satisfaction of patients in the exoskeleton group was relatively high, with an average score of 33.07±4.96. Conclusions Smart powered hip exoskeleton-assisted gait training combined with conventional rehabilitation can improve lower limb motor function, balance, activities of daily living, and walking capacity in post-stroke patients. The exoskeleton demonstrated superior efficacy in enhancing lower limb function compared to conventional training. Patients demonstrated high acceptance of the exoskeleton-assisted gait training in terms of safety and comfort.

Citation： JIA Lingyun, KANG Xiaoyu, XIA Xiaoqian, ZHANG Linyao, WANG Qianhui, WU Xiaoli, YE Changqing, CHEN Yudong, GAO Fei, LI Hanzhi, WANG Yizheng, ZHOU Kaiping, LIU Lixu. Effect of smart powered hip exoskeleton on lower limb motor function in stroke patients. West China Medical Journal, 2025, 40(6): 859-864. doi: 10.7507/1002-0179.202504249 Copy

1.	Feigin VL, Brainin M, Norrving B, et al. World Stroke Organization (WSO): global stroke fact sheet 2022. Int J Stroke, 2022, 17(1): 18-29.
2.	Mohan DM, Khandoker AH, Wasti SA, et al. Assessment methods of post-stroke gait: a scoping review of technology-driven approaches to gait characterization and analysis. Front Neurol, 2021, 12: 650024.
3.	Winstein C, Lewthwaite R, Blanton SR, et al. Infusing motor learning research into neurorehabilitation practice: a historical perspective with case exemplar from the accelerated skill acquisition program. J Neurol Phys Ther, 2014, 38(3): 190-200.
4.	常萬鵬, 張鐘文, 楊鈺琳, 等. 康復外骨骼機器人對腦卒中下肢運動功能障礙療效的 Meta 分析. 中國組織工程研究, 2024, 28(2): 321-328.
5.	States RA, Salem Y, Pappas E. Overground gait training for individuals with chronic stroke: a cochrane systematic review. J Neurol Phys Ther, 2009, 33(4): 179-186.
6.	Lee HY, Park JH, Kim T. Comparisons between Locomat and walkbot robotic gait training regarding balance and lower extremity function among non-ambulatory chronic acquired brain injury survivors. Medicine (Baltimore), 2021, 100(18): e25125.
7.	Zhang L, Lin F, Sun L, et al. Comparison of efficacy of lokomat and wearable exoskeleton-assisted gait training in people with spinal cord injury: a systematic review and network meta-analysis. Front Neurol, 2022, 13: 772660.
8.	Khan AS, Livingstone DC, Hurd CL, et al. Retraining walking over ground in a powered exoskeleton after spinal cord injury: a prospective cohort study to examine functional gains and neuroplasticity. J Neuroeng Rehabil, 2019, 16(1): 145.
9.	Leow XRG, Ng SLA, Lau Y. Overground robotic exoskeleton training for patients with stroke on walking-related outcomes: a systematic review and meta-analysis of randomized controlled trials. Arch Phys Med Rehabil, 2023, 104(10): 1698-1710.
10.	Jarrassé N, Proietti T, Crocher V, et al. Robotic exoskeletons: a perspective for the rehabilitation of arm coordination in stroke patients. Front Hum Neurosci, 2014, 8: 947.
11.	Galle S, Malcolm P, Collins SH, et al. Reducing the metabolic cost of walking with an ankle exoskeleton: interaction between actuation timing and power. J Neuroeng Rehabil, 2017, 14(1): 35.
12.	Lee HJ, Lee SH, Seo K, et al. Training for walking efficiency with a wearable hip-assist robot in patients with stroke: a pilot randomized controlled trial. Stroke, 2019, 50(12): 3545-3552.
13.	Rudberg AS, Berge E, Laska AC, et al. Stroke survivors’ priorities for research related to life after stroke. Top Stroke Rehabil, 2021, 28(2): 153-158.
14.	支亮, 王玉龍, 張清芳, 等. 腦卒中患者偏癱步態中的推進力缺陷. 中國組織工程研究, 2024, 28(35): 5709-5715.
15.	彭小柯, 趙國順, 韓詩雨, 等. 外骨骼機器人對腦卒中患者平衡和下肢功能的影響 Meta 分析. 康復學報, 2025, 35(2): 197-204.
16.	王石艷, 楊杭, 高真真, 等. 腦卒中恢復期患者 Fugl-Meyer 下肢運動評估的最小臨床重要性差值分析. 浙江臨床醫學, 2023, 25(2): 207-209.
17.	Fujii R, Tamari M, Nonaka Y, et al. Influence of gait exercise using a walking-assist robot for swing-leg motion in hemiplegic stroke patients: a preliminary study focusing on the immediate effect. Jpn J Compr Rehabil Sci, 2022, 13: 49-55.
18.	Lin Y, Huang SW, Kuan YC, et al. Hybrid robot-assisted gait training for motor function in subacute stroke: a single-blind randomized controlled trial. J Neuroeng Rehabil, 2022, 19(1): 99.
19.	Louie DR, Mortenson WB, Durocher M, et al. Efficacy of an exoskeleton-based physical therapy program for non-ambulatory patients during subacute stroke rehabilitation: a randomized controlled trial. J Neuroeng Rehabil, 2021, 18(1): 149.
20.	張雪. 下肢外骨骼康復訓練機器人對腦卒中后偏癱患者下肢運動功能的影響. 廣州: 南方醫科大學, 2020.
21.	葛盼麗, 王志祥, 王雪, 等. 下肢康復機器人聯合骨盆帶控制對腦卒中偏癱患者步行能力及日常生活活動能力的影響. 機器人外科學雜志(中英文), 2025, 6(3): 410-415.
22.	Zurawski E, Behm K, Dunlap C, et al. Interrater reliability of the modified ashworth scale with standardized movement speeds: a pilot study. Physiother Can, 2019, 71(4): 348-354.
23.	Zhang Y, Zhao W, Wan C, et al. Exoskeleton rehabilitation robot training for balance and lower limb function in sub-acute stroke patients: a pilot, randomized controlled trial. J Neuroeng Rehabil, 2024, 21(1): 98.
24.	Calafiore D, Negrini F, Tottoli N, et al. Efficacy of robotic exoskeleton for gait rehabilitation in patients with subacute stroke: a systematic review. Eur J Phys Rehabil Med, 2022, 58(1): 1-8.

1. Feigin VL, Brainin M, Norrving B, et al. World Stroke Organization (WSO): global stroke fact sheet 2022. Int J Stroke, 2022, 17(1): 18-29.
2. Mohan DM, Khandoker AH, Wasti SA, et al. Assessment methods of post-stroke gait: a scoping review of technology-driven approaches to gait characterization and analysis. Front Neurol, 2021, 12: 650024.
3. Winstein C, Lewthwaite R, Blanton SR, et al. Infusing motor learning research into neurorehabilitation practice: a historical perspective with case exemplar from the accelerated skill acquisition program. J Neurol Phys Ther, 2014, 38(3): 190-200.
4. 常萬鵬, 張鐘文, 楊鈺琳, 等. 康復外骨骼機器人對腦卒中下肢運動功能障礙療效的 Meta 分析. 中國組織工程研究, 2024, 28(2): 321-328.
5. States RA, Salem Y, Pappas E. Overground gait training for individuals with chronic stroke: a cochrane systematic review. J Neurol Phys Ther, 2009, 33(4): 179-186.
6. Lee HY, Park JH, Kim T. Comparisons between Locomat and walkbot robotic gait training regarding balance and lower extremity function among non-ambulatory chronic acquired brain injury survivors. Medicine (Baltimore), 2021, 100(18): e25125.
7. Zhang L, Lin F, Sun L, et al. Comparison of efficacy of lokomat and wearable exoskeleton-assisted gait training in people with spinal cord injury: a systematic review and network meta-analysis. Front Neurol, 2022, 13: 772660.
8. Khan AS, Livingstone DC, Hurd CL, et al. Retraining walking over ground in a powered exoskeleton after spinal cord injury: a prospective cohort study to examine functional gains and neuroplasticity. J Neuroeng Rehabil, 2019, 16(1): 145.
9. Leow XRG, Ng SLA, Lau Y. Overground robotic exoskeleton training for patients with stroke on walking-related outcomes: a systematic review and meta-analysis of randomized controlled trials. Arch Phys Med Rehabil, 2023, 104(10): 1698-1710.
10. Jarrassé N, Proietti T, Crocher V, et al. Robotic exoskeletons: a perspective for the rehabilitation of arm coordination in stroke patients. Front Hum Neurosci, 2014, 8: 947.
11. Galle S, Malcolm P, Collins SH, et al. Reducing the metabolic cost of walking with an ankle exoskeleton: interaction between actuation timing and power. J Neuroeng Rehabil, 2017, 14(1): 35.
12. Lee HJ, Lee SH, Seo K, et al. Training for walking efficiency with a wearable hip-assist robot in patients with stroke: a pilot randomized controlled trial. Stroke, 2019, 50(12): 3545-3552.
13. Rudberg AS, Berge E, Laska AC, et al. Stroke survivors’ priorities for research related to life after stroke. Top Stroke Rehabil, 2021, 28(2): 153-158.
14. 支亮, 王玉龍, 張清芳, 等. 腦卒中患者偏癱步態中的推進力缺陷. 中國組織工程研究, 2024, 28(35): 5709-5715.
15. 彭小柯, 趙國順, 韓詩雨, 等. 外骨骼機器人對腦卒中患者平衡和下肢功能的影響 Meta 分析. 康復學報, 2025, 35(2): 197-204.
16. 王石艷, 楊杭, 高真真, 等. 腦卒中恢復期患者 Fugl-Meyer 下肢運動評估的最小臨床重要性差值分析. 浙江臨床醫學, 2023, 25(2): 207-209.
17. Fujii R, Tamari M, Nonaka Y, et al. Influence of gait exercise using a walking-assist robot for swing-leg motion in hemiplegic stroke patients: a preliminary study focusing on the immediate effect. Jpn J Compr Rehabil Sci, 2022, 13: 49-55.
18. Lin Y, Huang SW, Kuan YC, et al. Hybrid robot-assisted gait training for motor function in subacute stroke: a single-blind randomized controlled trial. J Neuroeng Rehabil, 2022, 19(1): 99.
19. Louie DR, Mortenson WB, Durocher M, et al. Efficacy of an exoskeleton-based physical therapy program for non-ambulatory patients during subacute stroke rehabilitation: a randomized controlled trial. J Neuroeng Rehabil, 2021, 18(1): 149.
20. 張雪. 下肢外骨骼康復訓練機器人對腦卒中后偏癱患者下肢運動功能的影響. 廣州: 南方醫科大學, 2020.
21. 葛盼麗, 王志祥, 王雪, 等. 下肢康復機器人聯合骨盆帶控制對腦卒中偏癱患者步行能力及日常生活活動能力的影響. 機器人外科學雜志(中英文), 2025, 6(3): 410-415.
22. Zurawski E, Behm K, Dunlap C, et al. Interrater reliability of the modified ashworth scale with standardized movement speeds: a pilot study. Physiother Can, 2019, 71(4): 348-354.
23. Zhang Y, Zhao W, Wan C, et al. Exoskeleton rehabilitation robot training for balance and lower limb function in sub-acute stroke patients: a pilot, randomized controlled trial. J Neuroeng Rehabil, 2024, 21(1): 98.
24. Calafiore D, Negrini F, Tottoli N, et al. Efficacy of robotic exoskeleton for gait rehabilitation in patients with subacute stroke: a systematic review. Eur J Phys Rehabil Med, 2022, 58(1): 1-8.

West China Medical Journal

Effect of smart powered hip exoskeleton on lower limb motor function in stroke patients

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