TOPLINE:

Adults with chronic heart failure with reduced ejection fraction (HFrEF) who wore a lightweight exosuit during exercise showed significant improvements in the 6-minute walk distance and daily step counts, which were not statistically significant in those who received nonassisted conventional exercise training.

METHODOLOGY:

• Researchers conducted an exploratory randomized trial in adults with chronic heart failure to compare the effects of exercise assisted by a robotic suit with conventional nonassisted training.
• Myosuit is a lightweight wearable exosuit that provides adjustable support for hip and knee extension during walking, sit-to-stand transitions, and stair climbing.
• Overall, 30 adults with stable HFrEF who could rise from a chair and walk at least 10 m were randomly assigned to receive either assisted training using Myosuit or conventional nonassisted training. The mean age of patients was 56.4 years, and 70% were male.
• Patients received training three times a week for 8 weeks under medical supervision. Both groups followed a progressive program targeting moderate effort, with treadmill walking in the first 2 weeks and stair climbing added from week 3 onward.
• The primary endpoint was a change in the 6-minute walk distance without the device after 8 weeks. Other outcomes included daily step count, scores on a quality-of-life questionnaire, and levels of blood biomarkers, all measured at baseline, after 4 weeks, and after 8 weeks.

TAKEAWAY:

• At 8 weeks, the 6-minute walk distance without the device increased by 27.2 m in the Myosuit group (P = .022), with a nonsignificant increase in the conventional training group and no difference between the groups after baseline adjustment. With the device on, the distance increased by 41.3 m in the Myosuit group (P = .005).
• The daily step count increased significantly by 1846 steps in the Myosuit group (P = .002), whereas the increase was not statistically significant in the conventional training group. Differences between the groups were not significant.
• The score indicating quality of life improved in both groups (P < .05 for both). Scores on anxiety and depression scales remained low.
• The E/e’ ratio (early mitral inflow velocity to early diastolic mitral annular velocity) reduced by 3.4 points in the Myosuit group (P = .006), whereas levels of cardiac biomarkers did not change in either group. Overall, 67% of patients reported improvement in stability, and 83% reported good interaction with the device.

IN PRACTICE:

“The observed increases in 6MWD [6-minute walk distance], improvements in daily activity, and reduction in E/e’ suggest that robotic support may facilitate exercise performance by off-loading musculoskeletal strain and stabilizing gait, thereby improving training efficiency,” the researchers of the study reported.

“The approach could be particularly valuable for frail or highly symptomatic patients, but confirmation in larger studies with longer follow-up is needed to assess physiological impact and real-world applicability,” they wrote.

SOURCE:

The study was led by Felix Schoenrath, MD, Deutsches Herzzentrum der Charité, Berlin, Germany. It was published online on December 13, 2025, in JACC: Heart Failure.

LIMITATIONS:

The study had a small sample and an exploratory design. It was conducted at a single center, and the follow-up duration was short. While 56% of patients reported having discomfort with the device, another 45% found the device heavy.

DISCLOSURES:

Several authors reported receiving institutional grants, speaker fees, consulting fees, travel grants, and research funding and having other financial ties with multiple pharmaceutical and healthcare companies, including Novartis, Abbott, and Pfizer.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.