{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T15:44:34Z","timestamp":1769010274211,"version":"3.49.0"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"T-ROBOTICS","award":["G01210547"],"award-info":[{"award-number":["G01210547"]}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"crossref","award":["RS-2023-00208884"],"award-info":[{"award-number":["RS-2023-00208884"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"Robot-assisted gait training (RAGT) is a promising technique for improving the gait ability of elderly adults and patients with gait disorders by enabling high-intensive and task-specific training. Gait functions involve multiple brain regions and networks. Therefore, RAGT is expected to affect not just gait performance but also neuroplasticity and cognitive ability. The purpose of this preliminary study was to verify the feasibility of the proposed RAGT design and to assess and compare the effect sizes of various measurement variables, including physical, cognitive, and neuroimaging induced by RAGT. Twelve healthy adults without any neurological or musculoskeletal disorders participated in this study. All participants wore a wearable exoskeleton robot and underwent 10 RAGT sessions. Functional data related to physical and cognitive abilities and neuroimaging data obtained from a magnetic resonance imaging (MRI) scanner and a functional near-infrared spectroscopy (fNIRS) device were acquired before and after the training sessions to assess the effect sizes of variables affected by RAGT. All participants underwent 10 sessions of RAGT without any adverse incidents, and the feasibility of the proposed RAGT design, consisting of preferred speed walking, fast speed walking, inclined walking, and squats, was validated. Variables related to physical and cognitive abilities significantly improved, but those related to neuroplasticity did not. The effect size of physical ability was \u201cvery large,\u201d whereas that of cognitive ability was \u201cmedium-to-large.\u201d The effect sizes of functional and structural neuroplasticity showed \u201cmedium\u201d and \u201cvery small,\u201d respectively. The effect size of the RAGT varied depending on the measured variables, with the effect size being the greatest for physical ability, followed by cognitive ability, functional neuroplasticity, and structural neuroplasticity. The proposed RAGT design affects cognitive and neuroplastic effects beyond the physical effect directly affected by RAGT. This study highlights that while RAGT can positively influence cognitive outcomes beyond physical benefits, more intensive interventions may be required to elicit significant neuroplastic changes. This preliminary study offers useful information for researchers interested in designing robot-assisted training by investigating the potential extent of neuroplastic effects.<\/jats:p>\nTrial registration:<\/jats:bold> KCT0006738<\/jats:ext-link>.<\/jats:p>","DOI":"10.1371\/journal.pone.0315145","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T19:04:18Z","timestamp":1733425458000},"page":"e0315145","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Comparing effects of wearable robot-assisted gait training on functional changes and neuroplasticity: A preliminary study"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9439-0166","authenticated-orcid":true,"given":"Jungsoo","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kassymzhomart","family":"Kunanbayev","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donggon","family":"Jang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dae-Shik","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,12,5]]},"reference":[{"issue":"4","key":"pone.0315145.ref001","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1589\/jpts.22.419","article-title":"Relationship between age-associated changes of gait and falls and life-space in elderly people","volume":"22","author":"H Shimada","year":"2010","journal-title":"Journal of Physical Therapy Science"},{"issue":"1","key":"pone.0315145.ref002","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1001\/jama.2010.1923","article-title":"Gait speed and survival in older adults","volume":"305","author":"S Studenski","year":"2011","journal-title":"Jama"},{"issue":"9","key":"pone.0315145.ref003","first-page":"1549","article-title":"A wearable hip assist robot can improve gait function and cardiopulmonary metabolic efficiency in elderly adults","volume":"25","author":"H-J Lee","year":"2017","journal-title":"IEEE transactions on neural systems and rehabilitation engineering"},{"key":"pone.0315145.ref004","first-page":"1","article-title":"Robot-assisted gait training (Lokomat) improves walking function and activity in people with spinal cord injury: a systematic review","volume":"14","author":"KY Nam","year":"2017","journal-title":"Journal of neuroengineering and rehabilitation"},{"issue":"4","key":"pone.0315145.ref005","doi-asserted-by":"crossref","first-page":"620","DOI":"10.3390\/medicina60040620","article-title":"A Comprehensive Review: Robot-Assisted Treatments for Gait Rehabilitation in Stroke Patients.","volume":"60","author":"Y-H Park","year":"2024","journal-title":"Medicina"},{"key":"pone.0315145.ref006","doi-asserted-by":"crossref","first-page":"2797","DOI":"10.1007\/978-3-319-74558-9_172","article-title":"Robot-Assisted Gait Training for Children and Youth with Cerebral Palsy","author":"HJ van Hedel","year":"2020","journal-title":"Cerebral Palsy"},{"key":"pone.0315145.ref007","doi-asserted-by":"crossref","first-page":"101837","DOI":"10.1016\/j.arr.2022.101837","article-title":"Efficacy of rehabilitation robot-assisted gait training on lower extremity dyskinesia in patients with Parkinson\u2019s disease: A systematic review and meta-analysis","volume":"85","author":"X Xue","year":"2023","journal-title":"Ageing Research Reviews"},{"issue":"3","key":"pone.0315145.ref008","doi-asserted-by":"crossref","first-page":"181","DOI":"10.2340\/16501977-0674","article-title":"Systematic review of outcome measures used in the evaluation of robot-assisted upper limb exercise in stroke","volume":"43","author":"M Sivan","year":"2011","journal-title":"Journal of rehabilitation medicine"},{"key":"pone.0315145.ref009","first-page":"1","article-title":"Association of gait with global cognitive function and cognitive domains detected by MoCA-J among community-dwelling older adults: a cross-sectional study","volume":"21","author":"W Hao","year":"2021","journal-title":"BMC geriatrics"},{"issue":"1","key":"pone.0315145.ref010","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12877-020-1433-3","article-title":"The association between cognition and gait in a representative sample of very old people\u2013the influence of dementia and walking aid use","volume":"20","author":"J \u00d6hlin","year":"2020","journal-title":"BMC geriatrics"},{"key":"pone.0315145.ref011","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.gaitpost.2017.01.024","article-title":"What can gait tell us about dementia? 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