What question did this study set out to answer?

This research aimed to evaluate how effective robotic-assisted gait training is for improving gait, balance, and endurance in individuals with spinal cord injuries.

April 8, 2026Open Access

The impact of robot-assisted training on gait, balance, and endurance in patients with partial spinal cord injuries: insights from rehabilitation

Puntos clave

This research aimed to evaluate how effective robotic-assisted gait training is for improving gait, balance, and endurance in individuals with spinal cord injuries.
Conducted a randomized controlled trial at specialized rehabilitation centers.
Enrolled 75 participants aged 19–40 with chronic partial spinal cord injury.
Divided participants into three groups for different training frequencies: once weekly, twice weekly, and conventional rehabilitation.
Assessed functional outcomes using tests like the 10-Meter Walk Test and 6-Minute Walk Test.
Included a subgroup analysis of athletic backgrounds and training frequencies.
The L2 group showed a 44.8% decrease in Timed Up and Go Test times.
A 122.5% increase in 6-Minute Walk Test distance was observed in the L2 group.
Improvements exceeded established minimal clinically important differences.
Higher training frequencies significantly outperformed conventional rehabilitation, especially for AIS D patients.

Resumen

This study evaluated the effectiveness of robotic-assisted gait training in improving gait function, balance, and endurance in individuals with chronic spinal cord injury (SCI). It compared robotic-assisted therapy with conventional rehabilitation and examined the impact of training frequency. A randomized controlled trial was conducted at specialized SCI rehabilitation centers. Seventy-five participants aged 19–40 with chronic partial SCI American Spinal Injury Association Impairment Scale (AIS) grades B, C, or D were enrolled in this randomized controlled trial. A pre-registered athletic subgroup consisting of 45 individuals with intensive competitive sports backgrounds (≥ 4 sessions/week pre-injury) was designated for subgroup analysis. The remaining 30 participants were physically active non-athletes (2–3 sessions/week pre-injury). Participants were divided into three groups: L1 (robotic-assisted gait training once weekly), L2 (robotic-assisted gait training twice weekly), and C (conventional rehabilitation). Functional outcomes were assessed using the 10-Meter Walk Test (10MWT), 6-Minute Walk Test (6MWT), Walking Index for Spinal Cord Injury II (WISCI II), Lower Extremity Motor Score (LEMS), Timed Up and Go Test (TUG), and stabilometry before and after the intervention. The L2 group demonstrated the greatest improvements: TUG time decreased by 7.7 ± 3.0 s (17.2 ± 2.5 s PRE vs. 9.5 ± 1.8 s POST; −44.8%, η² = 0.18), and 6MWT distance increased by 43.5 ± 16.2 m (35.5 ± 4.8 m PRE vs. 79 ± 14 m POST; +122.5%, η² = 0.25). These absolute improvements substantially exceed established MCID thresholds and were accompanied by clinically meaningful gains in quality of life. Robotic-assisted therapy, particularly at higher training frequencies, significantly outperformed conventional rehabilitation, especially in AIS D patients. Robotic-assisted gait training effectively improves gait function, endurance, and balance, with enhanced benefits observed at higher training frequencies. Higher training frequency demonstrated clinically meaningful improvements across all participants. While improvements were observed across the cohort, future adequately powered trials are needed to systematically investigate whether athlete-specific training histories influence responsiveness to different Lokomat frequencies.

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