Best exoskeleton robots for balance and gait training

For many people—whether recovering from a stroke, living with a spinal cord injury, or navigating the natural changes of aging—simple movements like standing, walking, or even maintaining balance can feel overwhelming. Each unsteady step might bring fear of falling, and the loss of mobility can chip away at independence, confidence, and quality of life. Traditional rehabilitation methods, while valuable, often have limits: they may rely heavily on manual assistance from therapists, struggle to provide consistent support, or fail to adapt to individual progress. But in recent years, a breakthrough technology has emerged to change this landscape: lower limb exoskeletons. These wearable robotic devices are not just tools—they're partners in rehabilitation, designed to support, guide, and empower users as they rebuild strength, coordination, and the ability to move with purpose. In this article, we'll explore how these exoskeletons work, which models stand out for balance and gait training, and why they're becoming a cornerstone of modern rehabilitation.

Before diving into exoskeletons, it's important to grasp why balance and gait issues are so impactful. Gait—the way we walk—involves a complex interplay of muscles, nerves, bones, and the brain. When this system is disrupted—by injury, disease, or age—movement becomes labored or unsafe. For example, a stroke might damage the part of the brain that controls leg muscles, leading to weakness or spasticity. A spinal cord injury could interrupt signals between the brain and limbs, making voluntary movement difficult. Even healthy older adults may experience reduced muscle mass, joint stiffness, or sensory changes that throw off balance, increasing fall risk.

The consequences go beyond physical discomfort. Studies show that people with gait impairments are more likely to avoid social activities, leading to isolation. They may struggle with daily tasks like cooking, shopping, or caring for themselves, relying more on others. Over time, this loss of independence can contribute to anxiety, depression, and a sense of helplessness. Traditional therapies, such as physical therapy exercises or gait training with walkers, can help, but they often require constant supervision and may not provide the precise, repeatable support needed to retrain the nervous system effectively. This is where robotic gait training steps in—offering a new level of precision, consistency, and adaptability.

At their core, lower limb exoskeletons are wearable machines designed to mimic, support, or enhance human leg movement. They consist of rigid or semi-rigid frames that attach to the legs, powered by motors, hydraulics, or pneumatics, and controlled by sophisticated sensors and software. For rehabilitation, their primary goal is to assist with gait training by providing the right amount of support at the right time—whether that means lifting a weak leg, stabilizing a wobbly knee, or guiding the body through a natural walking pattern.

What makes these devices so effective for balance and gait? Unlike a cane or walker, which only provide external support, exoskeletons work with the body. They use sensors to detect the user's intended movement—like shifting weight to take a step—and respond by activating motors to assist that motion. This "assist-as-needed" approach helps retrain the brain and muscles to work together again, reinforcing correct movement patterns. For someone with limited mobility, this can mean the difference between struggling to stand and taking a steady first step; between fearing a fall and walking with confidence. Robotic gait training, as this process is called, has been shown in clinical studies to improve walking speed, step length, and balance in patients with stroke, spinal cord injuries, and other neurological conditions. It also reduces the physical strain on therapists, allowing them to focus on personalized care rather than manual lifting.

Not all exoskeletons are created equal. Some are designed for clinical use in rehabilitation centers, while others are built for home use or even daily mobility. When it comes to balance and gait training, the best models prioritize adaptability, safety, and user-centric design. Below are five standout exoskeletons that have earned praise from therapists, users, and researchers alike.

1. Lokomat (Hocoma)

A pioneer in robotic gait training, the Lokomat is one of the most widely used exoskeletons in clinical settings worldwide. Developed by Swiss company Hocoma (now part of DJO Global), it's designed to help patients with neurological conditions—like stroke, spinal cord injury, or multiple sclerosis—relearn to walk. The Lokomat consists of a robotic exoskeleton that attaches to the legs, paired with a treadmill and overhead harness system for safety. What sets it apart is its ability to deliver highly repetitive, consistent gait training: users can complete hundreds of steps in a session, far more than they might manage with manual therapy alone.

The Lokomat's software allows therapists to adjust parameters like step length, speed, and the amount of assistance provided, tailoring each session to the user's progress. For balance training, it can introduce slight perturbations—small, controlled shifts—to challenge the user's stability, helping them build confidence and reaction skills. Many clinics report that patients using the Lokomat show faster improvements in walking ability and balance compared to traditional therapy. As one therapist noted, "The Lokomat takes the guesswork out of gait training. We can focus on correcting specific movement patterns, and patients get the repetition they need to rewire their brains."

2. EksoNR (Ekso Bionics)

Ekso Bionics' EksoNR is a lightweight, battery-powered exoskeleton built for both clinical rehabilitation and, in some cases, home use. Unlike the Lokomat, which is treadmill-based, the EksoNR is portable, allowing users to walk over ground—making it ideal for practicing real-world mobility, like navigating hallways, doorways, or uneven surfaces (with supervision, of course). This over-ground training is crucial for building practical balance skills, as it requires users to adapt to different terrains, just as they would in daily life.

The EksoNR uses intuitive controls: users initiate steps by shifting their weight, and the exoskeleton responds with smooth, natural movement. It offers multiple modes, including "Passive Mode" for early-stage patients who need full support, and "Active Mode" for those ready to contribute more effort. For balance training, therapists can adjust the exoskeleton's stance width or introduce obstacles to challenge users, helping them learn to recover from trips or missteps. Users often praise its comfort and ease of use; one stroke survivor shared, "With the EksoNR, I could walk to the end of the hallway and back on my first day. It didn't feel like a machine—it felt like having someone steadying me, but better, because it never got tired."

3. ReWalk Personal (ReWalk Robotics)

ReWalk Robotics is a leader in exoskeletons for individuals with spinal cord injuries, and their ReWalk Personal model is designed to help users transition from rehabilitation to independent daily mobility. While its primary focus is on enabling walking, it also plays a vital role in balance training. The ReWalk Personal is a wearable exoskeleton that straps around the user's torso and legs, with motors at the hips and knees. It uses tilt sensors to detect when the user shifts their weight forward, triggering a step, and includes a remote control for starting and stopping movement.

For balance, the ReWalk Personal provides constant stability by supporting the user's torso and legs, reducing the risk of falls. Over time, as users become more comfortable, they can practice walking on different surfaces—carpets, tiles, even slight inclines—to build adaptability. Many users report not just physical benefits, but emotional ones too. "Before ReWalk, I was in a wheelchair 24/7," said one user with paraplegia. "Now, I can stand at the dinner table with my family, walk to the mailbox, and even go shopping. It's not just about walking—it's about feeling like part of the world again."

4. HAL (Hybrid Assistive Limb, CYBERDYNE)

Developed by Japanese company CYBERDYNE, the HAL exoskeleton is unique in its approach: it uses "bioelectric signals" from the user's muscles to anticipate movement. When you think about lifting your leg, your brain sends electrical signals to your muscles; HAL detects these signals through sensors on the skin and activates its motors to assist the movement. This makes the exoskeleton feel incredibly intuitive, almost like an extension of the body.

HAL is available in several models, including the HAL for Rehabilitation, which is used in clinics to help patients with stroke, spinal cord injury, or muscle weakness regain mobility. For balance training, HAL's ability to "read" the user's intentions in real time helps correct unsteady movements before they lead to a loss of balance. Therapists can adjust the level of assistance, gradually reducing it as the user's strength and coordination improve. One study involving stroke survivors found that HAL training led to significant improvements in balance scores and walking speed, with users reporting less fatigue during daily activities. As one participant put it, "HAL feels like it's listening to my body. When I start to wobble, it gently steadies me, so I don't panic. It's given me the courage to try things I thought I'd never do again."

5. Indego (Parker Hannifin)

The Indego exoskeleton, developed by Parker Hannifin, is known for its sleek, lightweight design—weighing just 27 pounds, it's one of the most portable clinical exoskeletons on the market. Like the EksoNR, it's designed for over-ground walking, making it great for practicing functional mobility. The Indego features a unique "split-belt" design, allowing for independent movement of each leg, which is helpful for users with asymmetrical weakness (common after stroke).

For balance training, the Indego's adjustability is key. Therapists can modify step height, width, and speed to challenge users without overwhelming them. It also includes a "balance mode" that encourages users to shift their weight and correct their posture, building core strength and stability. Many clinics appreciate its ease of setup—users can be fitted and walking within minutes—and its durability, even with daily use. As one therapist noted, "The Indego is a game-changer for patients who need to practice real-world balance. We can take them from the clinic to the parking lot, and they learn to navigate curbs, cracks in the sidewalk—things they'll actually encounter at home. That's when the 'aha' moments happen: 'I can do this!'"

*Prices are approximate and vary by configuration, region, and whether purchased new or used. Clinical models are typically leased or purchased by healthcare facilities.

Choosing the right exoskeleton depends on the user's specific needs, the setting (clinic vs. home), and long-term goals. Here are some critical features to consider:

• Adjustability: The exoskeleton should fit users of different heights, weights, and body types. Look for adjustable leg lengths, strap sizes, and joint ranges of motion.
• Safety Systems: Overhead harnesses (for treadmill models), emergency stop buttons, and automatic shutdown if a fall is detected are non-negotiable for preventing injuries.
• Assistance Modes: "Assist-as-needed" technology allows the exoskeleton to reduce support as the user improves, encouraging active participation in training.
• Data Tracking: Built-in software that records step count, walking speed, and balance metrics helps therapists monitor progress and adjust treatment plans.
• Portability and Battery Life: For over-ground or home use, a lightweight design and long battery life (ideally 2–3 hours per charge) are important for practicality.
• User-Friendliness: The exoskeleton should be easy to don and doff (put on and take off), with intuitive controls that don't require extensive training to operate.

The impact of lower limb exoskeletons extends far beyond physical mobility. For many users, these devices are a gateway to reclaiming independence and dignity. Physically, the benefits include improved muscle strength, better coordination, increased walking endurance, and reduced fall risk. Studies show that users often experience less pain and fatigue, as the exoskeleton takes pressure off joints and muscles. Psychologically, the effects are equally profound: regaining the ability to walk—even for short distances—boosts self-esteem, reduces anxiety, and fosters a sense of hope. Family members also report relief, as they worry less about their loved one's safety and enjoy seeing them engage more actively in daily life.

Clinically, exoskeletons are helping therapists achieve better outcomes with fewer resources. By automating repetitive tasks, they free up therapists to focus on personalized care, like addressing specific balance deficits or working on upper-body strength. For healthcare systems, this efficiency can mean shorter hospital stays and reduced long-term care costs. As one rehabilitation director put it, "Exoskeletons aren't replacing therapists—they're supercharging what therapists can do. We're seeing patients walk out of our clinic who, just a few years ago, would have left in a wheelchair. That's transformative."

While exoskeletons offer exciting possibilities, they're not a one-size-fits-all solution. Before beginning training, it's important to consult with a healthcare team—typically a physical therapist, occupational therapist, and physician—to assess if an exoskeleton is appropriate. Factors like the severity of the condition, bone health (to avoid fractures), and cognitive ability (to follow instructions) will be evaluated. For example, someone with severe osteoporosis may not be a candidate, while someone with mild to moderate stroke symptoms might thrive.

Cost is another consideration. Most clinical exoskeletons are expensive, and while some insurance plans or government programs cover rehabilitation sessions using exoskeletons, coverage varies widely. Home-use models may be covered in some cases, but users should research their options thoroughly. Training is also a factor: both users and therapists need time to learn how to use the device safely and effectively. Finally, it's important to set realistic expectations: exoskeleton training is a tool, not a miracle cure. Progress takes time, and results depend on consistent practice, underlying health, and individual effort.

As technology advances, exoskeletons are becoming more accessible, affordable, and sophisticated. Future models may include AI-powered software that learns a user's movement patterns and adapts in real time, or lighter, more flexible materials that make exoskeletons as comfortable as clothing. There's also growing interest in using exoskeletons for preventive care—helping older adults build balance and strength before falls occur, rather than just treating injuries after the fact.

Perhaps most exciting is the potential for exoskeletons to bridge the gap between rehabilitation and daily life. Imagine a stroke survivor graduating from clinical training to a lightweight, home exoskeleton that helps them walk to the grocery store or garden. Or an older adult using an exoskeleton to maintain mobility and independence well into their 80s or 90s. These scenarios are no longer science fiction—they're on the horizon, thanks to the ongoing innovation in lower limb exoskeletons.

Balance and gait challenges can feel like an insurmountable barrier, but exoskeleton robots are proving that mobility is not lost forever—it can be reclaimed, step by step. Whether in a clinical setting or at home, these devices offer more than physical support; they offer the chance to stand taller, walk farther, and live more fully. As one user put it, "The exoskeleton didn't just help me walk—it helped me remember who I was before the injury: active, independent, alive." For anyone struggling with balance or gait issues, or for the therapists and families supporting them, exoskeletons represent a powerful reminder: with the right tools, progress is possible. If you or a loved one is facing mobility challenges, talk to a healthcare provider about whether exoskeleton-assisted training could be part of the journey back to movement.