Effectiveness of Keeogo Exoskeleton-Assisted Rehabilitation on Functional Mobility in Older Adults with Multimorbidity: A Single-Arm Pilot Study.

Background: Mobility impairment is a common consequence of multimorbidity in older adults, especially among those with diabetes mellitus and hypertension. Although robotic exoskeletons have shown promising results in neurological rehabilitation, evidence regarding their use in non-neurological multimorbid populations remains scarce. Objective: To evaluate the feasibility and effectiveness of Keeogo exoskeleton-assisted rehabilitation, in combination with conventional therapy, on functional mobility in older adults with multimorbidity. Patients and Methods: This single-arm pilot study recruited 13 participants aged 51-89 years with at least two physician-diagnosed chronic conditions and lower-limb weakness. Participants completed eight sessions of conventional therapy plus Keeogo-assisted training over a 4-week period. Functional outcomes were assessed pre- and post-intervention using the Short Physical Performance Battery (SPPB), Barthel Index (BI), Timed Up and Go (TUG), and Five-Time Sit-to-Stand Test (FTSST). Results: Significant improvements were observed in SPPB scores (from 2.23 to 4.15, p = 0.0019), BI scores (from 52.69 to 60.00, p = 0.044), TUG (from 149.75 to 85.37 seconds, p = 0.006), and FTSST (from 65.14 to 33.85 seconds, p = 0.006). Subgroup analyses showed greater functional gains among participants with ≥3 chronic conditions, diabetes, or hypertension. No adverse events were reported. Conclusion: Keeogo exoskeleton-assisted rehabilitation combined with conventional therapy was feasible and associated with short-term gains in functional mobility and independence in older adults with multimorbidity. Further randomized controlled trials with larger cohorts are warranted to confirm efficacy, evaluate long-term outcomes, and determine cost-effectiveness.