The basic motor pattern for stepping is generated in the spinal cord, while fine control of walking involves various brain regions, including cerebral motor cortex, cerebellum, and brain stem. Hemiplegia ( stroke),paraplegia ( spinal cord injury), cerebral palsy, motor neuron diseases, muscular dystrophies are leading causes of walking disability. In post stroke patients the function of cerebral cortex is impaired with no spinal cord involvement while in vertebral fracture/dislocation spinal cord is involved with completely intact cerebral cord function. The complex interactions of the neuromusculoskeletal system forms a strong base for robotic rehabilitation.

The main goal is independent walking. Recently treadmill training, with and without body weight support, was introduced for the rehabilitation of patients. To restore gait, most clinicians prefer a task-specific repetitive approach, and in recent years the better outcomes  have been reached with repeated walking programs with growing intensities. The treadmill training requires a considerable effort by the therapist to set the paretic limbs and to control weight shift. This may limit therapy intensity especially in more severely disabled patients. In order to reduce dependence on therapists, automated electromechanical gait machines were developed. Gait machines consist either of an electromechanical solution (end-effectors) with two driven foot plates simulating the phases of gait, or of a robot-driven exoskeleton orthotic. The role of electromechanical devices is that, in contrast with the action of one physical therapist alone, they can provide nonambulatory patients’ intensive, high repetitive, practice of complex gait cycles. The use of electromechanical-assisted gait training devices was reported to be safe and well accepted by most patients.





Robot driven electromechanical exoskeletons