Effects of unilateral lower limb exoskeleton robot on gait improvement and brain function in patients with chronic stroke: a randomized clinical trial.

The trial was small, with 30 enrolled and 24 analysed, and the authors note this increases the risk of missing real effects. Follow-up was only after 2 weeks of treatment, with no long-term assessment, so durability is unknown. Participants had to be right-handed, have MMSE scores above 21, be able to walk with at least some assistance, and have stroke duration 1 month to 1 year, so results may not apply to more severely impaired, left-handed, cognitively impaired or longer-standing stroke. All patients received multiple conventional therapies, including ADL training, physical factor therapy, massage and acupuncture, so the effect of any single component cannot be separated from the robot addition. Brain activation changes were within the robot group only, with no significant difference between groups, so fNIRS does not show a clear between-group neural effect. The supplied text does not name a single primary outcome, so the main result is inferred from the stated hypothesis about gait and plantar pressure.

The work was funded by the Anhui Provincial Department of Education, an incubation program of the National Natural Science Foundation of China, an Anhui provincial quality project of college, a project of the Anhui Institute of Translational Medicine, and an Anhui Province Postdoctoral Research Funding Project. The supplied text does not report competing interests.

Do not read the gait gains as proof that the robot alone works. Every patient also received conventional rehabilitation, including ADL training, physical factor therapy, massage and acupuncture, and the robot group received these plus robot training. The study also had only 24 analysed patients and no long-term follow-up.