Volume 30, Issue 173, July 2026

Patient-Related Predictors of Response to Lower Limb Exoskeleton-Assisted Gait Rehabilitation: A Review

Rafał Gołacki^1♦, Bartosz Burda¹, Radosław Januszczak¹, Aleksandra Kaczmarek², Julianna Cholewa³, Sylwia Szelc³, Wiktoria Śliwa³, Karolina Szymonek⁴, Katarzyna Gołacka⁵, Paweł Szymonek⁶

¹Uniwersytecki Szpital Kliniczny Nr 4 w Lublinie, ul. Dra K. Jaczewskiego 8, 20-090 Lublin, Poland
²University Clinical Hospital in Białystok, ul. M. C. Skłodowskiej 24a, 15-276 Białystok, Poland
³Medical University of Lublin, Faculty of Medicine, 19 Chodźki St, 20- 093 Lublin, Poland
⁴Wojewódzki Szpital Specjalistyczny im. Stefana Kardynała Wyszyńskiego w Lublinie, al. Kraśnicka 100, 20-718 Lublin, Poland
⁵SP ZOZ MSWiA w Lublinie, ul. Grenadierów 3, 20-331 Lublin, Poland
⁶SPZOZ w Lubartowie, ul. Cicha 14, 21-100 Lubartów, Poland

^♦Corresponding author
Rafał Gołacki, Uniwersytecki Szpital Kliniczny Nr 4 w Lublinie, ul. Dra K. Jaczewskiego 8, 20-090 Lublin, Poland

ABSTRACT

Introduction: Gait impairments are a main cause of disability. Conventional rehabilitation often requires an intense effort from the physiotherapist with repetitive, specific movements. Lower limb exoskeletons have become a useful tool for gait rehabilitation. They enable training repetitive movements and enhance neuroplasticity by providing controlled movement patterns. Several studies reported improvements in gait speed, walking distance, and other functional outcomes due to the use of these devices. Due to heterogeneity in patient populations, intervention protocols, and reported outcomes, we sought to study how to improve therapy fit and identify the patients who will benefit most from such a treatment option. It is essential to identify predictors of response to exoskeleton-assisted gait rehabilitation to improve decision-making and optimize treatment strategies. Methodology: We reviewed the selected literature in the databases: PubMed and Science Direct between January and March 2026. We focused on studies published from 2021 onward that were relevant to the study’s topic. We emphasize systematic reviews and clinical trials. Result and discussion: Relatively few studies, particularly randomized trials and subgroup analyses, directly investigated predictors of treatment response. Baseline functional status, severity of impairment, and recovery phase were the most consistently identified positive response factors. Future research will help physicians better identify good responders for exoskeleton rehabilitation.

Keywords: exoskeleton, lower limb, gait rehabilitation, predictors

Medical Science, 2026, 30, e130ms3883

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Published: 25 July 2026