
A new multi-centre study confirms that end-effector gait training significantly improves mobility in stroke patients. Learn how it compares to exoskeletons and standard therapy in post-stroke rehabilitation.

Walking disorders are a serious complication of a stroke – more than 75% of those affected lose the ability to walk. This has far-reaching effects on quality of life, autonomy and social participation. One of the main goals of neurological rehabilitation after a stroke is therefore restoring walking ability through targeted gait training. Intensive, repetitive and task-orientated training approaches have proven to be effective. Robot-assisted training plays a key role here, and research to increase the effectiveness of treatment and reduce the workload for therapists is ongoing.
The available robot-assisted devices can be divided into end-effector systems and exoskeletons. End-effector systems have limited contact with the body, while exoskeletons are orthotic systems that electromechanically simulate human walking movements. There is still interest in investigating the specific effects of different robot-assisted therapy devices on gait rehabilitation after a stroke. Some studies have already demonstrated the advantages of end-effector systems over exoskeletons.
This study, conducted across eight Italian rehabilitation centres, compared the clinical effects of robot-assisted gait training with conventional training in patients in the subacute stage after a stroke. The main focus was on improvement in walking speed as measured by the 10-metre walk test. The study compared the effects of end-effector systems versus exoskeletons in a subgroup comparison.
The results showed significant improvements in walking speed, endurance, balance and daily living activities in the group that received robot-assisted training compared to the conventional group. End-effector systems in particular proved to be more promising in terms of walking speed. Although further research is needed, the results suggest that people in the subacute stage after a stroke benefit significantly from robotic end-effector gait training.
The study once again underscores the potential of robot-assisted gait training as an effective rehabilitation strategy after a stroke and confirms the advantages of the end-effector system over exoskeletons. Future research should focus on larger, controlled studies to clarify optimal training protocols for maximum efficiency.

- Pournajaf S, Calabrò RS, Naro A, Goffredo M, Aprile I, Tamburella F, Filoni S, Waldner A, Mazzoleni S, Focacci A, Ferraro F, Bonaiuti D, Franceschini M, TreadStroke Group. Robotic versus Conventional Overground Gait Training in Subacute Stroke Survivors: A Multicenter Controlled Clinical Trial. J Clin Med. 2023 Jan 5;12(2):439. doi: 10.3390/jcm12020439. PMID: 36675371; PMCID: PMC9861649.
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