care & love
When Carlos, a 45-year-old construction worker from Montreal, suffered a spinal cord injury in 2023, his doctors told him he might never walk unassisted again. For months, he struggled through physical therapy, his muscles weakening, his hope dwindling. Then his therapist mentioned robotic gait training —a technology that uses mechanical exoskeletons to support and guide patients through walking motions, retraining the brain and body to move again. "It sounded like something out of a sci-fi movie," Carlos recalls. "But when I tried it, I took my first steps in over a year. I cried. But then I asked: How much does this cost? Would I ever be able to access it regularly?"
Carlos's question cuts to the heart of a critical issue in rehabilitation technology: affordability . Robotic gait devices have revolutionized recovery for stroke survivors, spinal cord injury patients, and others with mobility impairments. But for many, the price tag remains a barrier. In this market research deep dive, we'll explore what these devices are, why they matter, the factors that drive their cost, and whether greater accessibility is on the horizon—including a closer look at regions like Canada, where demand for best robotic gait devices for physical therapy is growing.
At their core, robotic gait devices are specialized machines designed to assist or restore walking ability. They typically consist of a harness, leg braces (exoskeletons), and a treadmill or platform, all controlled by software that adapts to the user's movements. Unlike traditional physical therapy, which relies on manual assistance from therapists, these devices provide consistent, repetitive motion—key for rewiring neural pathways after injury or illness.
Robot-assisted gait training isn't just about walking again; it's about independence. For stroke patients, for example, studies show that early use of these devices can reduce long-term disability by 30% compared to standard therapy alone. "I've seen patients who could barely stand up after a stroke walk short distances within weeks of starting robotic training," says Dr. Elena Mendez, a rehabilitation specialist at Toronto's Kensington Health Centre. "But here's the catch: not every clinic can afford these machines, and not every patient can afford the sessions."
The most common types of devices on the market today include:
The global market for gait rehabilitation robots is booming, projected to hit $2.8 billion by 2028, up from $1.2 billion in 2023. Key players include Swiss company Hocoma (maker of Lokomat), U.S.-based Ekso Bionics, and Israeli firm ReWalk Robotics. These companies primarily sell to hospitals, rehabilitation centers, and specialized clinics, though a small but growing market for home-use devices is emerging.
So, how much do these machines cost? Let's break it down. Treadmill-based systems like the Lokomat start at around $300,000 and can exceed $500,000 with advanced features (e.g., real-time motion analysis). Overground exoskeletons, which are more portable, range from $70,000 to $150,000. For clinics, that's a significant investment—one that often requires grants, loans, or partnerships with healthcare systems to justify.
For patients, out-of-pocket costs vary widely. In the U.S., a single session can cost $100–$200, and a full course of treatment (20–30 sessions) can run $2,000–$6,000. In Canada, where public healthcare covers some rehabilitation, sessions may be free or low-cost in public hospitals, but waitlists can stretch to 6–8 months. Private clinics, which often have newer machines, charge $120–$180 per session—still steep for many families.
Canada is a interesting case study for affordability. With a public healthcare system, one might assume access is universal, but the reality is more complex. "Public hospitals in major cities like Toronto and Vancouver have 1–2 robotic gait devices, but rural areas often have none," explains Dr. James Chen, who researches rehabilitation technology at the University of Alberta. "Patients in smaller towns sometimes have to travel 3+ hours for treatment, which adds costs for travel and lodging."
When it comes to best robotic gait devices for physical therapy in Canada , clinics tend to prioritize durability and versatility. The Lokomat is a top choice for hospitals, thanks to its ability to adapt to patients with varying levels of impairment. Private clinics, meanwhile, often opt for mid-range systems like the Bionik M3, which costs around $180,000—cheaper than the Lokomat but still a major expense. "We chose the M3 because it's lighter and easier to use with stroke patients," says Gonzalez. "But even then, we only see about 15 patients a week on it—hardly enough to serve the demand."
Why are these devices so expensive? It's not just about profit margins. Several key factors contribute to their high price tags:
There's also the issue of scale . Unlike consumer electronics, which are mass-produced, robotic gait devices are niche products. Most manufacturers produce only 100–200 units per year, so there's little opportunity to lower costs through volume production.
The high cost of robotic gait devices creates a stark divide: those who can access them and those who cannot. This gap falls along predictable lines—socioeconomic status, geographic location, and insurance coverage.
In the U.S., where healthcare is largely private, insurance coverage for robot-assisted gait training for stroke patients is patchy. Medicare covers it in some cases (e.g., post-stroke rehabilitation), but only for a limited number of sessions. Private insurers often require pre-authorization, and many deny coverage for "experimental" treatments, even though the FDA has approved most major devices.
In low- and middle-income countries, the gap is even wider. "I visited a clinic in Mexico City last year that was using a 10-year-old Lokomat held together with duct tape," Dr. Mendez recalls. "They couldn't afford replacement parts, so therapists had to manually adjust the braces mid-session. It was heartbreaking."
Even in wealthy countries, marginalized groups suffer. "Indigenous communities in Canada have higher rates of stroke and diabetes-related mobility issues, but they're less likely to live near a clinic with robotic gait devices," says Dr. Chen. "It's a classic case of healthcare inequity: the people who need these tools most have the least access."
The good news? Experts believe prices will ｄｒｏｐ in the next decade, thanks to several emerging trends:
Companies are developing smaller, lighter devices that skip the treadmill and focus on portable exoskeletons. For example, China-based Fourier Intelligence's Focal One, released in 2024, weighs just 12 kg (26 lbs) and costs $45,000—less than half the price of a Lokomat. "These 'entry-level' devices won't ｒｅｐｌａｃｅ high-end systems, but they'll make robotic training accessible to smaller clinics and even home use," predicts industry analyst Mark Robertson of Rehab Tech Insights.
Innovators in places like India and Brazil are building low-cost prototypes using 3D-printed parts and open-source software. The "Walk Again" project, based in São Paulo, has developed a basic exoskeleton for $5,000—still not cheap, but a fraction of commercial models. "These aren't FDA-approved yet, but they're a proof of concept," says Dr. Mendez. "If they can meet safety standards, they could revolutionize access in low-resource settings."
Instead of buying devices outright, clinics are increasingly leasing them or paying per use. Companies like ReWalk Robotics now offer "pay-as-you-go" plans, where clinics pay $50 per patient session instead of a lump sum. "This lowers the barrier to entry," says Robertson. "A small clinic can start with one device and scale up as demand grows."
In Canada, advocacy groups are pushing for better coverage. In 2023, the province of Ontario announced a $20 million fund to equip rural hospitals with robotic gait devices, cutting waitlists by 40% in pilot regions. "It's a start," says Dr. Chen. "But we need similar programs nationwide, and we need to train more therapists to use these tools—otherwise, the devices will sit idle."
For Carlos, the construction worker from Montreal, robotic gait training was life-changing. After 25 sessions at a public hospital (he waited 7 months for a spot), he can now walk with a cane and has returned to part-time work. "I'm one of the lucky ones," he says. "But I think about all the people who can't wait that long, or can't afford private sessions. Walking isn't a luxury—it's how we connect with our families, our communities, our lives."
The market research is clear: robotic gait devices work, but their high cost limits their impact. As technology advances and policies evolve, there's hope that these tools will become as common as wheelchairs or walkers. Until then, the fight for affordability continues—for Carlos, for Maria, and for everyone who dreams of taking their next step, unaided.
In the end, this isn't just about machines. It's about ensuring that mobility—and the independence that comes with it—is accessible to all, regardless of income or zip code. And that, perhaps, is the most important "return on investment" of all.