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Gait training using powered robotic exoskeleton for a person with spinal cord injury: a case report

Spinal Cord Series and Cases volume 11, Article number: 23 (2025) Cite this article

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Abstract

Introduction

Robotic Exoskeleton-assisted gait training is an emerging approach in spinal cord injury (SCI) rehabilitation. This case report evaluates the effectiveness of Powered-Robotic exoskeleton-based gait training in an individual with chronic paraplegia.

Case presentation

A 31-year-old male with T12 SCI due to fall underwent a four-week structured rehabilitation program incorporating powered robotic exoskeleton training (Exo-Rehabilitation) alongside conventional therapy. The patient participated in 15 sessions over four weeks of intervention, with progressive gait training phases, transition from assisted weight-bearing to independent crutch-assisted walking. Functional, neurological and psychological outcomes were assessed pre and post intervention. Clinical measures include, Function in sitting test (FIST), Walking Index for Spinal cord injury (WISCI-II), ISNSCI lower extremity motor scores (LEMS), Spinal Cord Independence measure (SCIM III), 6-min walk test (6MWT) and Quebec User Evaluation of Satisfaction with Assistive Technology 2.0 (QUEST 2.0). Patient reported outcomes and attendance were also recorded. The patient demonstrated better, sitting balance, and functional mobility, with enhanced psychological well-being and adherence to rehabilitation.

Discussion

Robotic Exoskeleton-assisted gait training may be safe and a feasible approach to improve mobility, balance, and functional independence in SCI patients. Robotic overground exoskeleton-based gait training may represent a significant step forward in bridging the gap between conventional therapy and advanced technology, offering new hope for functional recovery and independence in individuals with Chronic SCI.

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Fig. 1: International classification of functioning, disability, and health (ICF) framework.
Fig. 2: Exoskeleton-assisted gait training in different phases.
Fig. 3: Progression of exoskeleton training parameters across 15 sessions.
Fig. 4: Changes in SCIM-III scores pre- and post-intervention.
Fig. 5: Patient’s attendance after introduction of robotic gait training.
Fig. 6: International spinal cord injury QOL data set – scores over time.
Fig. 7: The Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) scoring after intervention.

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Acknowledgements

Thanks to all team members who participated in this work.

Author information

Authors and Affiliations

  1. Spine and Rehabilitation Centre, Sri Balaji Action Medical Institute, New Delhi, India

    Sunpreet Singh Hanspal, Harvinder Singh Chhabra, Ankush Gera & Gouree Sengar

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  1. Sunpreet Singh Hanspal
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  2. Harvinder Singh Chhabra
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  3. Ankush Gera
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  4. Gouree Sengar
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Contributions

SSH (Sunpreet Singh Hanspal) conceptualized and designed the study, managed the patient, and drafted the manuscript. HSC (Dr. Harvinder Singh Chhabra) supervised the clinical process and critically reviewed the manuscript for intellectual content. AG (Ankush Gera) contributed to data acquisition and helped in interpretation of results. GS (Gouree Sengar) assisted in data analysis and manuscript editing. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sunpreet Singh Hanspal.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

All methods were performed in accordance with Institutional guidelines and regulations. The case report was determined not to require formal Ethics Committee (EC) or Institutional Review Board (IRB) review as it was a retrospective analysis of a single case. Written informed consent was obtained from the participant prior to participation in the exoskeleton-based rehabilitation program.

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Written informed consent was obtained from the participant for publication of the case report and all accompanying identifiable images.

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Hanspal, S.S., Chhabra, H.S., Gera, A. et al. Gait training using powered robotic exoskeleton for a person with spinal cord injury: a case report. Spinal Cord Ser Cases 11, 23 (2025). https://doi.org/10.1038/s41394-025-00716-y

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