Empirical study on how lower limb exoskeleton robots improve older adults’ physical performance through psychological mechanisms

Objective This study aims to explore how lower limb exoskeleton robots enhance physical performance in older adults and clarify the mediating role of psychological factors during human-robot interaction exercises. Methods The study focused on healthy older adults in the community and used a randomized controlled trial design along with qualitative research methods. A total of 60 participants aged 60–75 were selected and divided into an lower limb exoskeleton robots intervention group and a control group. Through an 8-week standardized exercise intervention, data on physiological performance indicators such as participants’ walking speed, stride length, gait variability coefficient, 6-min walking distance, and balance sway values, as well as psychological indicators such as perceived fatigue, exercise self-efficacy, and balance confidence, were collected. Qualitative research was also conducted, delving into the real psychological experiences and subjective perceptions of older adults using lower limb exoskeleton robots, and explaining the deeper mechanisms behind the quantitative results. Results After the intervention, the intervention group showed significant improvements in walking speed, stride length, and gait stability compared to the control group ( p < 0.05). Exercise self-efficacy and balance confidence significantly increased while perceived exertion significantly decreased ( p < 0.01). Mediation analysis indicated that exercise self-efficacy and perceived exertion served as a chain mediator between the use of lower limb exoskeleton robots and physical performance in older adults. Conclusion Lower limb exoskeleton robots can not only enhance physical abilities through mechanical support but also improve psychological perception and strengthen exercise confidence, creating a positive cycle of ‘device assistance—psychological empowerment—improved physical performance’. This provides new theoretical support and practical pathways for elderly rehabilitation and healthy aging interventions.