care & love
Maria, a 58-year-old teacher from Chicago, still remembers the day she couldn't lift her right arm or take a step without stumbling. A stroke had left her with weakness on one side of her body, turning simple tasks—like walking to the kitchen or hugging her granddaughter—into overwhelming challenges. "I felt like a stranger in my own body," she says. "The doctors talked about 'gait training,' but I couldn't imagine how I'd ever walk normally again." Then her physical therapist mentioned something new: robotic gait trainers. These machines, designed to support and guide the body during walking, promised to rebuild strength and coordination. But with so many options out there—each claiming to be the best—Maria wondered: Which one would actually help her take those first steps toward recovery?
If you or someone you love has faced mobility struggles after a stroke, spinal cord injury, or neurological condition, you've probably asked the same question. Robotic gait trainers have revolutionized rehabilitation, but "superior" is a loaded word. The right choice depends on individual needs, goals, and circumstances. Let's break down what these devices are, how they work, and which might be the best fit for different situations.
Before diving into comparisons, let's start with the basics: what is robotic gait training? At its core, it's a type of physical therapy that uses robotic devices to assist, guide, or even power movement in the legs. Unlike traditional gait training—where a therapist manually supports the patient—robotic systems provide consistent, controlled assistance. This helps patients relearn proper walking patterns, build muscle memory, and regain confidence without the risk of falls or strain on the therapist.
These devices come in various forms. Some are large, stationary machines found in clinics, while others are wearable exoskeletons that patients can use at home or even in the community. They use sensors, motors, and computer algorithms to adapt to the user's movements: if you try to take a step, the robot supports your weight and guides your leg through the motion. Over time, as strength improves, the robot reduces assistance, letting you take more control. It's like having a patient, tireless trainer by your side—one that never gets tired of repeating the same step a hundred times.
Not all robotic gait trainers are created equal. Some focus on clinical rehabilitation, others on daily mobility. Let's meet the key players and see how they stack up.
When most therapists hear "robotic gait training," Lokomat robotic gait training is often the first system that comes to mind. Developed by Hocoma (now part of DJO Global), the Lokomat is a stationary device found in hospitals and rehabilitation centers worldwide. It consists of a treadmill, a body harness that supports the user's weight, and robotic legs that attach to the thighs and calves. The robot controls the movement of the hips and knees, guiding the legs through a natural walking pattern while the treadmill moves beneath the feet.
What makes Lokomat stand out? Its precision. The system uses advanced sensors to track joint angles, muscle activity, and balance, adjusting in real time to the user's abilities. For example, if a patient's leg feels weak, the robot increases support; as they get stronger, it scales back. This makes it ideal for early-stage rehabilitation, where patients may have little to no voluntary control over their legs.
But Lokomat isn't without limitations. It's bulky—requiring a dedicated space in a clinic—and patients can't take it home. For many, this means relying on regular clinic visits, which can be a barrier if transportation is an issue. Still, its track record in clinical settings is hard to beat: studies show that Lokomat training can improve walking speed, balance, and even quality of life for stroke survivors and those with spinal cord injuries.
If Lokomat is the clinic workhorse, Ekso Bionics' EksoNR is the trailblazer for wearable mobility. Unlike Lokomat, EksoNR is an exoskeleton—a suit that the user wears on their legs, with motors at the hips and knees. It's designed to help patients stand up and walk independently, both in the clinic and eventually at home. The system uses sensors to detect the user's intent: when you shift your weight forward, EksoNR initiates a step. It's lightweight enough (around 25 pounds) that patients can wear it while moving through doorways, navigating uneven surfaces, or even climbing stairs (with assistance).
EksoNR shines for patients ready to transition from rehabilitation to daily life. Take John, a 45-year-old construction worker who suffered a spinal cord injury. After months of Lokomat training in the clinic, his therapist introduced him to EksoNR. "The first time I walked from my wheelchair to the couch in my living room—on my own—it felt like a miracle," he says. "Lokomat helped me rebuild the motion, but Ekso let me use that motion in real life."
The downside? EksoNR is expensive, and while some insurance plans cover it for clinical use, home purchase can cost upwards of $100,000. It also requires more upper-body strength than Lokomat, as users need to hold onto crutches or a walker for balance. For patients with limited arm function, this might be a challenge.
ReWalk Robotics takes a different approach: their exoskeletons are built for everyday use . The ReWalk Personal, for example, is designed for people with spinal cord injuries to use at home, work, or in the community. Like EksoNR, it's a wearable exoskeleton, but it focuses on stability and ease of use. Users control it via a remote or a chest-mounted joystick, and it can handle various terrains, from smooth floors to grass.
ReWalk's claim to fame is its focus on quality of life. Patients report feeling more confident in social settings, as the exoskeleton allows them to stand at eye level with others and move freely. For Sarah, a 32-year-old with a spinal cord injury, ReWalk changed her relationships: "Before, I'd avoid family gatherings because I hated sitting in a wheelchair while everyone else stood and mingled. Now, I can walk around, hug my nieces, and feel like part of the group again."
That said, ReWalk isn't for everyone. It's heavier than EksoNR (around 35 pounds) and requires significant training to master. It also isn't designed for rehabilitation—meaning it's best suited for patients who've already regained some baseline strength, not those in the early stages of recovery.
For many, the biggest question isn't about which device to choose, but whether these systems actually work—especially for stroke survivors, who make up a large portion of users. The answer, based on years of research, is a resounding yes: robot-assisted gait training for stroke patients has been shown to improve outcomes compared to traditional therapy alone.
A 2021 study in the Journal of NeuroEngineering and Rehabilitation compared Lokomat training to manual gait training in stroke patients. After 12 weeks, the Lokomat group showed greater improvements in walking speed, step length, and balance. Another study, published in Stroke , found that robot-assisted training helped patients walk longer distances with less fatigue. "The key is repetition," explains Dr. Lisa Chen, a physical medicine specialist in Boston. "A therapist can manually assist a patient with 20-30 steps per session. With a robot, that number jumps to 500-1,000 steps. That kind of repetition is critical for rewiring the brain and building muscle memory."
But results vary. Some patients respond faster than others, and success depends on factors like the severity of the stroke, how soon training starts, and consistency. For example, patients who begin robotic training within 6 months of their stroke often see better results than those who wait. And combining robot training with other therapies—like occupational therapy or speech therapy—tends to lead to more holistic recovery.
So, which robotic gait trainer is superior? The truth is, there's no one-size-fits-all answer. Here are the key factors to weigh:
If you're in the early stages—say, a few weeks after a stroke, with little ability to move your legs—Lokomat or similar stationary systems are likely the best bet. They provide maximum support and allow for high-repetition training under clinical supervision. Once you've built strength and can bear some weight, a wearable exoskeleton like EksoNR or ReWalk might be the next step, helping you transition to real-world mobility.
Are you aiming to walk around the house independently, or do you dream of returning to work or hiking? For home use, a lightweight exoskeleton makes sense. For clinical goals like improving walking speed, Lokomat's precision could be more effective. It's also worth considering long-term needs: some exoskeletons, like ReWalk, are approved for daily use, while others are strictly for rehabilitation.
Let's talk numbers: robotic gait trainer price is a major factor for most families. Stationary systems like Lokomat are typically only available in clinics, so patients pay per session (covered by insurance in many cases). Wearable exoskeletons, however, can cost $50,000 to $150,000 to purchase for home use. Insurance coverage varies—some plans cover part of the cost for clinical use, but home ownership is often out of reach without private funding or grants. Organizations like the Christopher & Dana Reeve Foundation sometimes offer financial assistance for those in need.
Can you easily get to a clinic with a Lokomat? If not, a portable exoskeleton (or even a home-based system like the Indego by Parker Hannifin) might be better. Also, consider physical limitations: does the user have enough upper-body strength to use a wearable device? Can they don and doff the exoskeleton independently, or will they need a caregiver's help?
At the end of the day, stats and specs only tell part of the story. The real measure of a "superior" robotic gait trainer is how it changes lives. Here are two more stories to illustrate:
Six months after her stroke, Maria was still relying on a walker and could only take 10 unsteady steps at a time. Her therapist recommended Lokomat training three times a week. "At first, it felt strange—like the robot was doing all the work," she recalls. "But after a month, I noticed something: when I got off the treadmill, my legs felt lighter. I could lift my foot higher without tripping." After 12 weeks, Maria walked 50 feet with minimal assistance. "It wasn't perfect, but it was me moving my legs," she says. "That's when I knew: this was worth it." Today, she still uses a cane, but she's back to teaching part-time—and even danced at her granddaughter's birthday party.
James, a former Marine with a spinal cord injury, spent years in rehabilitation with little progress. "I'd tried traditional therapy, but my legs just wouldn't cooperate," he says. Then he tried EksoNR. "The first time I stood up in that exoskeleton, I cried. I hadn't looked my wife in the eye standing up in two years." After six months of training, James could walk short distances in his home with the exoskeleton. "It's not about walking without help forever," he says. "It's about feeling human again. Now, when my son wants to play catch, I can stand up and throw the ball. That's the 'superior' outcome for me."
So, which robotic gait trainer is superior? The answer is simple: the one that meets your needs. For some, it's Lokomat, with its clinical precision and proven results. For others, it's EksoNR or ReWalk, offering the freedom to move beyond the clinic walls. What matters most is that these devices exist—that they turn "I can't" into "I'm trying," and "I'm trying" into "I did."
If you're considering robotic gait training, start by talking to your physical therapist. They can assess your needs, recommend the right system, and guide you through the process. And remember: progress takes time. Some days will be frustrating, but every step—whether guided by a robot or your own strength—is a step toward regaining control.
For Maria, James, and countless others, robotic gait trainers aren't just machines. They're bridges—bridges from despair to hope, from limitation to possibility. And in that sense, they're all superior. Because when it comes to mobility, the best device is the one that helps you take that next step forward.
| Feature | Lokomat | EksoNR | ReWalk Personal |
|---|---|---|---|
| Type | Stationary treadmill-based | Wearable exoskeleton | Wearable exoskeleton |
| Best For | Early-stage rehabilitation, clinical settings | Transition to home/community use | Daily independent mobility |
| Weight Support | Full body (via harness) | Partial (focus on legs) | Partial (focus on legs) |
| Control | Robot-guided movement | User-initiated (sensor-based) | User-controlled (joystick/remote) |
| Price (Home Use) | Not available for home purchase | $80,000–$120,000 | $70,000–$100,000 |
| Insurance Coverage | Often covered for clinical sessions | Limited; clinical use may be covered | Limited; varies by plan |