Application of lower limb exoskeleton robots in elderly patients with ICU-acquired weakness: a prospective clinical study

This study aimed to investigate the application effects of lower-limb exoskeleton robots in elderly patients with intensive care unit-acquired weakness (ICU-AW). A total of 114 elderly patients with ICU-AW admitted to Yangzhou Second People’s Hospital between May 2023 and May 2025 were enrolled and randomly assigned using a random number table to either a control group (n = 57) or an experimental group (n = 57). The control group received conventional rehabilitation interventions, while the experimental group underwent lower-limb exoskeleton robot-assisted training in addition to conventional rehabilitation. Outcome measures compared before and after the intervention included scores on the Chelsea Critical Care Physical Assessment Tool (CPAx), Medical Research Council (MRC) muscle strength scale, and Barthel Index (BI); muscle quality parameters (fat fraction, cross-sectional area, T2 mapping); bone mineral density (T-score and classification); serum levels of creatine kinase (CK), osteocalcin (OC), and alkaline phosphatase (ALP); and the incidence of complications. Compared with baseline, both groups showed significant increases in CPAx, MRC, and BI scores, muscle cross-sectional area, T-scores, and serum OC levels, along with significant decreases in fat fraction, muscle water content T2, prevalence of osteoporosis, and serum CK and ALP levels (all P < 0.05). The improvements in all these outcome measures were significantly greater in the experimental group than in the control group (all P < 0.05). The overall complication rate was significantly lower in the experimental group [7.02% (4/57)] compared with the control group [21.05% (12/57)] (P = 0.031). Rehabilitation training using a lower-limb exoskeleton robot effectively improved muscle quality and bone mineral density in patients with ICU-AW, promoted physical functional recovery, enhanced quality of life, and demonstrated a favorable safety profile.