The Effects of Clinical Applications of Robot-Assisted Therapy Methods: End-Effector, Fixed Exoskeleton, and Wearable Exoskeleton on Functional Activities in Stroke Patients

Background and Objectives: This study was conducted to investigate the effects of robot-assisted gait rehabilitation approaches using commonly used end-effector, fixed exoskeleton, and wearable exoskeleton on gait and balance abilities in patients with early post-stroke (≤3 months). Materials and Methods: Sixty patients admitted to a rehabilitation center with confirmed stroke by a medicine specialist were assigned to three groups such as the end-effector group (EG 1), the fixed exoskeleton group (EG 2), and the wearable exoskeleton group (EG 3). The primary endpoint was pre-specified as the change in timed up-and-go gait test (TUG) from baseline to week 6, and all other outcomes were treated as secondary. The functional gait category (FAC), 10-m walk test (10MWT), six-minute walk test (6MWT), timed up-and-go gait test (TUG), dynamic gait index (DGI), and Berg Balance Scale (BBS) were measured at four time points (baseline, 2 weeks, 4 weeks, and 6 weeks). Results: A significant main effect of time was observed for all outcome variables, but neither the main effect of group nor the interaction between group and time was significant for any outcome variable. Within-group analyses revealed that FAC, 6MWT, DGI, and BBS increased over time in all groups, whereas 10MWT and TUG decreased. Conclusions: All three robot-assisted gait rehabilitation approaches in patients with early post-stroke were associated with significant improvements in gait and balance abilities over 6 weeks. However, statistically significant differential trajectories were not detected across robot types in this sample.