Stroke has an extremely high mortality and disability rate, making it a critical public health issue. Patients with stroke are often accompanied by lower limb motor dysfunction, which severely impairs their quality of life. In the past, one-on-one manual rehabilitation training was commonly administered to such patients, which consumes a large amount of human resources and makes it difficult to guarantee the training quality. In recent years, the advent of exoskeleton robots is expected to address this pain point. Exoskeleton robots can be classified into two major categories, fixed and mobile based on their structural forms and operational postures. However, it remains unclear whether these two distinctly designed robots are effective in improving lower limb motor function and quality of life in stroke patients, and whether there are differences in their therapeutic effects.

To investigate the effects and therapeutic benefits of stationary versus mobile exoskeleton robots in enhancing lower limb function and quality of life among stroke patients.

Forty stroke inpatients admitted to the Department of Rehabilitation Medicine at the First Medical Center of Chinese PLA General Hospital between 2021 and 2024 were enrolled as study participants. Using a random number table method, they were randomly assigned to either the fixed robot group (n=20) or the mobile robot group (n=20). In addition to conventional rehabilitation training, the fixed robot group underwent Lokomat robotic-assisted gait training for 20 minutes per session, five times weekly, over two consecutive weeks. The mobile robot group received Aikang robotic-assisted training under the same regimen: 20 minutes per day, five times per week, for two consecutive weeks, alongside standard rehabilitation. Outcome measures were collected before and after the intervention period and included the Fugl-Meyer Assessment of Lower Extremity (FMA-LE), peak torque (PT) of hip and knee flexion and extension, absolute error angle (AE) angular error of the affected knee joint, Functional Ambulation Category (FAC) scale, gait analysis parameters, and the Modified Barthel Index (MBI).

All 40 patients completed the entire trial protocol with no dropouts reported during the study. Intergroup comparisons: prior to training, there were no statistically significant differences between the two groups in FMA-LE scores, AE angle of the affected knee joint, MBI scores, PT of hip and knee flexion/extension, and FAC grades (P>0.05). After training, no statistically significant differences were found between the two groups in FMA-LE scores, MBI scores, PT of hip and knee flexion/extension, and FAC grades (P>0.05), whereas the AE angle of the affected knee joint in the fixed robot group was significantly lower than that in the mobile robot group (P<0.05). Intragroup comparisons: after training, both groups exhibited a significant increase in the lower extremity FMA-LE scores and MBI scores, with a significant improvement in the AE angle of the affected knee joint and the PT of hip and knee flexion/extension compared with the baseline (P<0.05). The FAC grades of both groups were significantly better than those at baseline (P<0.05). Gait analysis was conducted in only 7 patients in the fixed robot group and 8 patients in the mobile robot group. For gait parameters, intergroup comparisons showed no statistically significant differences in walking speed, step length and gait cycle between the two groups both before and after training (P>0.05). Intragroup comparisons indicated that walking speed was significantly increased after training in both groups (P<0.05); the fixed robot group had a significant increase in step length (P<0.05) and a significant reduction in gait cycle (P<0.05) compared with the baseline.

Both fixed exoskeleton robots and mobile exoskeleton robots can effectively improve the lower limb function and quality of life of stroke patients, and fixed exoskeleton robots have more advantages in improving patients' knee joint proprioception.