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Observational Study
. 2025 Mar;48(2):208-220.
doi: 10.1080/10790268.2023.2273587. Epub 2023 Nov 7.

Gait training using a wearable robotic hip device for incomplete spinal cord injury: A preliminary study

Kenichi Yoshikawa  1 , Hirotaka Mutsuzaki  2   3 , Kazunori Koseki  1 , Koichi Iwai  4 , Ryoko Takeuchi  3 , Yutaka Kohno  2   5
Affiliations
Observational Study

Gait training using a wearable robotic hip device for incomplete spinal cord injury: A preliminary study

Kenichi Yoshikawa et al. J Spinal Cord Med. 2025 Mar.

Abstract

Context/objective: To explore changes in gait functions for patients with chronic spinal cord injury (SCI) before and after standard rehabilitation and rehabilitation with a wearable hip device, explore the utility of robot-assisted gait training (RAGT), and evaluate the safety and dose of RAGT.

Design: Single-arm, open-label, observational study.

Setting: A rehabilitation hospital.

Participants: Twelve patients with SCI.

Interventions: Standard rehabilitation after admission in the first phase. RAGT for two weeks in the second phase.

Outcome measures: Self-selected walking speed (SWS), step length, cadence, and the 6-minute walking distance were the primary outcomes. Walking Index for SCI score, lower extremity motor score, and spasticity were measured. Walking abilities were compared between the two periods using a generalized linear mixed model (GLMM). Correlations between assessments and changes in walking abilities during each period were analyzed.

Results: After standard rehabilitation for 66.1 ± 36.9 days, a period of 17.6 ± 3.3 days of RAGT was safely performed. SWS increased during both periods. GLMM showed that the increase in cadence was influenced by standard rehabilitation, whereas the limited step length increase was influenced by RAGT. During RAGT, the increase in step length was related to an increase in hip flexor function.

Conclusions: Gait speed in patients with SCI increased after rehabilitation, including RAGT, in the short-term. This increase was associated with improved muscle function in hip flexion at the start of RAGT.Trial Registration: This study was registered with the UMIN Clinical Trials Registry (UMIN-CTR; UMIN000042025).

Keywords: Robot-assisted gait training; Spinal cord injury; Walking ability.

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Figures

Figure 1
Figure 1
a) Overview of GAIT TRAINER HWA-01. b) A patient with SCI training with GAIT TRAINER HWA-01. SCI, spinal cord injury.
Figure 2
Figure 2
Study overview and detail of standard rehabilitation and HWAT. Times 1, 2, and 3 indicate the timing of measurements. Standard rehabilitation was performed in phase 1, and standard rehabilitation with HWAT was performed in phase 2. HWAT, gait training with an HWA-01; PT, physical therapy; OT, occupational therapy.
Figure 3
Figure 3
Average walking distance, walking time, and fatigue for each HWAT session. HWAT, gait training with an HWA-01; BRPE, Borg Rating Scale of Perceived Exertion.
See this image and copyright information in PMC

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