Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. X:X | DOI: 10.5507/bp.2026.031

The effect of high-intensity magnetic therapy combined with robot-assisted gait training in post-stroke patients

Ales Prihoda, Kristyna Wittlerova, Leos Navratil

Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic

Aims: To assess whether adding high-intensity magnetic therapy (HIMT) to robot-assisted gait training (RAGT) with a ReoAmbulator produces greater improvement in spasticity and gait than RAGT with standard inpatient care in chronic stroke patients with residual spasticity.

Methods: We conducted a two-arm quasi-randomised controlled trial (No. EK 24/01), in which 29 of 30 enrolled patients were analysed per protocol. The experimental group (EXP, n=18) received 15 sessions of HIMT applied to the paretic lower limb, starting 1-2 weeks before RAGT, together with 10 RAGT sessions and standard care, whereas the control group (CON, n=11) received 10 RAGT sessions and standard care only. The primary outcomes were the Modified Ashworth Scale (MAS) of knee extensors and plantar flexors and the Timed Up and Go test (TUG), and the secondary outcomes were RAGT walking speed, session duration and distance. Within-group changes were tested with the Wilcoxon signed-rank test, between-group differences in delta values with the Mann-Whitney U test, and effect sizes were quantified using Cohen's d and Cliff's δ.

Results: Baseline characteristics were comparable between groups (all P>0.05), and both groups improved in all outcomes (Wilcoxon P ≤0.031). Between-group deltas favoured EXP, with TUG improving by -7.9 vs -4.7 s (P<0.001, d=1.51), RAGT distance by +512 vs +324 m (P<0.001, d=1.55), MAS of knee extensors by -0.61 vs -0.27 (P=0.010, d=1.12) and MAS of plantar flexors by -0.56 vs -0.27 (P=0.008, d=1.15). Cohen's d exceeded 1.0 in five of the six outcomes.

Conclusion: Our findings suggest that adding HIMT to RAGT may produce greater improvements in spasticity and gait than RAGT with standard care alone in chronic stroke patients. The observed effect sizes (Cohen d>1.0 for the key outcomes) are consistent with the international literature on the antispastic action of repetitive peripheral magnetic stimulation. Because of the limited sample size and the quasi-randomised design, these results should be regarded as preliminary and require confirmation in a larger randomised controlled trial with long-term follow-up.

Keywords: stroke, spasticity, high-intensity magnetic therapy, robot-assisted gait training, ReoAmbulator

Received: August 9, 2026; Revised: October 6, 2026; Accepted: October 15, 2026; Prepublished online: November 3, 2026