Wearable robotic exoskeletons have emerged as promising technologies for enhancing gait rehabilitation and providing mobility assistance in individuals with neurological and musculoskeletal disorders. This narrative review summarizes recent advances in wearable robots—including both rigid exoskeletons and soft exosuits—and evaluates their clinical application across diverse conditions such as stroke, spinal cord injury, cerebral palsy, and Parkinson’s disease. For rehabilitation purposes, these devices enable repetitive, task-specific gait training that promotes motor learning, reduces therapist burden, and facilitates improvements in walking speed, balance, and endurance. Rigid exoskeletons provide substantial joint support and are particularly effective for patients with severe gait impairments, whereas soft exosuits offer lightweight assistance suited to individuals with milder deficits or fatigue, albeit with limited capacity to deliver high-torque support. Beyond rehabilitation, wearable robots are increasingly used as assistive devices to compensate for permanent gait limitations and restore mobility in daily life. However, widespread clinical adoption remains constrained by several challenges, including a lack of standardized protocols; limited evidence from large-scale, multicenter studies; and practical issues such as device weight, comfort, and ease of use in community settings. Recent developments—such as adaptive control algorithms, volition-adaptive assistance, and artificial intelligence integration—are addressing these barriers by enabling more personalized and responsive support. With continued research investment, user-centered design, and supportive policies, wearable exoskeletons hold considerable potential to improve independence, participation, and quality of life for individuals across a broad spectrum of mobility impairments.

Background: Wearable devices for robot-assisted gait training (RAGT) provide overground gait training for the rehabilitation of neurological injuries. We aimed to evaluate the effectiveness and safety of RAGT in patients with a neurologic deficit. Methods: Twenty-eight patients receiving more than ten sessions of overground RAGT using a joint-torque-assisting wearable exoskeletal robot were retrospectively analyzed in this study. Nineteen patients with brain injury, seven patients with spinal cord injury and two patients with peripheral nerve injury were included. Clinical outcomes, such as the Medical Research Council scale for muscle strength, Berg balance scale, functional ambulation category, trunk control tests, and Fugl–Meyer motor assessment of the lower extremities, were recorded before and after RAGT. Parameters for RAGT and adverse events were also recorded. Results: The Medical Research Council scale scores for muscle strength (36.6 to 37.8), Berg balance scale (24.9 to 32.2), and functional ambulation category (1.8 to 2.7) significantly improved after overground RAGT (p < 0.05). The familiarization process was completed within six sessions of RAGT. Only two mild adverse events were reported. Conclusions: Overground RAGT using wearable devices can improve muscle strength, balance, and gait function. It is safe in patients with neurologic injury.

Pediatric gait disorders are often chronic and accompanied by various complications, which challenge rehabilitation efforts. Here, we retrospectively analyzed the feasibility of overground robot-assisted gait training (RAGT) using a joint-torque-assisting wearable exoskeletal robot. In this study, 17 children with spastic cerebral palsy, cerebellar ataxia, and chronic traumatic brain injury received RAGT sessions. The Gross Motor Function Measure (GMFM), 6-min walk test (6 MWT), and 10-m walk test (10 MWT) were performed before and after intervention. The oxygen rate difference between resting and training was performed to evaluate the intensity of training in randomly selected sessions, while the Quebec User Evaluation of Satisfaction with assistive Technology 2.0 assessment was performed to evaluate its acceptability. A total of four of five items in the GMFM, gait speed on the 10 MWT, and total distance on the 6 MWT showed statistically significant improvement (p < 0.05). The oxygen rate was significantly higher during the training versus resting state. Altogether, six out of eight domains showed satisfaction scores more than four out of five points. In conclusion, overground training using a joint-torque-assisting wearable exoskeletal robot showed improvement in gross motor and gait functions after the intervention, induced intensive gait training, and achieved high satisfaction scores in children with static brain injury.

Kim JS, et al. Brain Neurorehabil. 2019 Oct;13(1):e3. https://doi.org/10.12786/bn.2020.13.e3

Technological advances in neonatology led to the improvement of the survival rate in preterm babies with very low birth weights. However, intraventricular hemorrhage (IVH) has been one of the major complications of prematurity. IVH is relevant to neurodevelopmental disorders, such as cerebral palsy, language and cognitive impairments, and neurosensory and psychiatric problems, especially when combined with brain parenchymal injuries. Additionally, severe IVH requiring shunt insertion is associated with a higher risk of adverse neurodevelopmental outcomes. Multidisciplinary and longitudinal rehabilitation should be provided for these children based on the patients’ life cycles. During the infantile period, it is essential to detect high-risk infants based on neuromotor examinations and provide early intervention as soon as possible. As babies grow up, close monitoring of language and cognitive development is needed. Moreover, providing continuous rehabilitation with task-specific and intensive repetitive training could improve functional outcomes in children with mild-to-moderate disabilities. After school age, maintaining the level of physical activity and managing complications are also needed.