Expert Consensus on Clinical Application of Lower Limb Rehabilitation Robots

With the gradual increase in the application of lower limb robots in motor function rehabilitation, there is a need to standardize the clinical application of lower limb rehabilitation robots in China. This consensus integrates the characteristics of lower limb rehabilitation robots applications in the treatment for patients with hemiplegia, paraplegia, cerebral palsy, and other common lower limb dysfunctions in China. In addition, referencing the latest research, this consensus elaborates on the working principles, classification, clinical application (indications and contraindications, working parameters and operating procedures, safety), and recommendations on clinical application (hemiplegia, paraplegia, musculoskeletal diseases, childhood diseases and other systemic diseases) when using lower limb rehabilitation robots in the current context. Lower limb rehabilitation robots are well-suitable for patients with walking difficulties and long-term bedridden condition. According to the patient's posture during rehabilitation training, they can be classified into sitting or supine robots, upright robots, and assisted upright robots. The treatment parameters of lower limb robots are determined by the patient's weight and lower limb's length, range of motion, and muscle strength, among which guiding force, walking speed, and anti-gravity are important parameters that need to be adjusted. There are many factors that affect the safety using of lower limb rehabilitation robots, and it is usually necessary to evaluate the safety by monitoring the occurrence of adverse events during robot training. Studies have shown that combining lower limb rehabilitation robot training with conventional rehabilitation therapy or emerging rehabilitation technologies such as virtual reality and transcranial direct current stimulation improves motor function in stroke patients with hemiplegia. However, determining whether its training effect is superior to conventional rehabilitation therapy requires further clinical study (high-level evidence). Studies have also shown that lower limb rehabilitation robot training can improve walking function (medium to high-level evidence), cardiopulmonary function (low to medium-level evidence), lower urinary tract function (low-level evidence), and balance function (low to medium-level evidence) in paraplegic patients. Medium-level evidence suggests that paraplegic patients with lower limb spasms can undergo lower limb rehabilitation robot tra