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已发表论文
外骨骼机器人步态训练及其对不完全性脊髓损伤患者肠道菌群 - 脑轴的影响：康复机制的叙述性综述
Received 30 May 2025
Accepted for publication 18 September 2025
Published 6 October 2025 Volume 2025:18 Pages 6411—6430
DOI https://doi.org/10.2147/JMDH.S543841
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Zhixia Zhang,1 Wei Huang2
1Health and Elderly Care Department, Shandong Institute of Commerce and Technology, Jinan City, Shandong Province, People’s Republic of China; 2Medical Department, Zaozhuang Vocational College, Zaozhuang City, Shandong Province, People’s Republic of China
Correspondence: Zhixia Zhang, Health and Elderly Care Department, Shandong Institute of Commerce and Technology, No. 4516, Tourism Road, Jinan City, Shandong Province, 250103, People’s Republic of China, Email zhangzhixia2006@126.com
Abstract: Exoskeleton robot-assisted gait training represents a significant advancement in neurorehabilitation for patients with incomplete spinal cord injury (iSCI). While its efficacy in improving motor function is increasingly documented, emerging evidence suggests these interventions may exert therapeutic effects through previously unrecognized physiological pathways involving the gut microbiota-brain axis. This review synthesizes current evidence regarding the bidirectional relationship between exoskeleton-based locomotor training and alterations in gut microbiome composition and function in the context of iSCI. Following spinal cord injury, significant dysbiosis occurs, characterized by reduced microbial diversity and altered taxonomic representation, which correlates with neuroinflammation, autonomic dysfunction, and impaired recovery. Exoskeleton-mediated gait rehabilitation appears to partially restore microbial homeostasis through multiple mechanisms, including autonomic nervous system regulation, altered intestinal transit time, modified intestinal barrier integrity, and immunomodulation. These microbiome modifications potentially facilitate neuroplasticity and functional recovery through microbiota-derived metabolites that traverse the blood-brain barrier or communicate via vagal afferents. The integration of metagenomic analysis with functional neuroimaging and detailed autonomic assessment in prospective studies represents a critical research direction. This emerging perspective extends beyond biomechanical rehabilitation, suggesting a comprehensive neurobiological effect that includes modulation of the microbiota-gut-brain axis, with significant implications for optimizing therapeutic strategies for individuals with incomplete spinal cord injury.
Keywords: exoskeleton robot, incomplete spinal cord injury, gut microbiota-brain axis, neuroplasticity, rehabilitation
1Health and Elderly Care Department, Shandong Institute of Commerce and Technology, Jinan City, Shandong Province, People’s Republic of China; 2Medical Department, Zaozhuang Vocational College, Zaozhuang City, Shandong Province, People’s Republic of China
Correspondence: Zhixia Zhang, Health and Elderly Care Department, Shandong Institute of Commerce and Technology, No. 4516, Tourism Road, Jinan City, Shandong Province, 250103, People’s Republic of China, Email zhangzhixia2006@126.com
Abstract: Exoskeleton robot-assisted gait training represents a significant advancement in neurorehabilitation for patients with incomplete spinal cord injury (iSCI). While its efficacy in improving motor function is increasingly documented, emerging evidence suggests these interventions may exert therapeutic effects through previously unrecognized physiological pathways involving the gut microbiota-brain axis. This review synthesizes current evidence regarding the bidirectional relationship between exoskeleton-based locomotor training and alterations in gut microbiome composition and function in the context of iSCI. Following spinal cord injury, significant dysbiosis occurs, characterized by reduced microbial diversity and altered taxonomic representation, which correlates with neuroinflammation, autonomic dysfunction, and impaired recovery. Exoskeleton-mediated gait rehabilitation appears to partially restore microbial homeostasis through multiple mechanisms, including autonomic nervous system regulation, altered intestinal transit time, modified intestinal barrier integrity, and immunomodulation. These microbiome modifications potentially facilitate neuroplasticity and functional recovery through microbiota-derived metabolites that traverse the blood-brain barrier or communicate via vagal afferents. The integration of metagenomic analysis with functional neuroimaging and detailed autonomic assessment in prospective studies represents a critical research direction. This emerging perspective extends beyond biomechanical rehabilitation, suggesting a comprehensive neurobiological effect that includes modulation of the microbiota-gut-brain axis, with significant implications for optimizing therapeutic strategies for individuals with incomplete spinal cord injury.
Keywords: exoskeleton robot, incomplete spinal cord injury, gut microbiota-brain axis, neuroplasticity, rehabilitation