BACKGROUND: Hemiplegia, a prevalent stroke-related condition, is often studied for motor dysfunction; however, spasticity remains under-researched. Abnormal muscle tone significantly hinders hemiplegic patients' walking recovery. OBJECTIVES: To determine whether early suspension-protected training with a personal assistant machine for stroke patients enhances walking ability and prevents muscle spasms. METHODS: Thirty-two early-stage stroke patients from Shenzhen University General Hospital and the China Rehabilitation Research Center were randomly assigned to the experimental group (n = 16) and the control group (n = 16). Both groups underwent 4 weeks of gait training under the suspension protection system for 30 minutes daily, 5 days a week. The experimental group used the personal assistant machine during training. Three-dimensional gait analysis (using the Cortex motion capture system), Brunnstrom staging, Fugl-Meyer Assessment for lower limb motor function, Fugl-Meyer balance function, and the modified Ashworth Scale were evaluated within 1 week before the intervention and after 4 weeks of intervention. RESULTS AND CONCLUSIONS: After the 4-week intervention, all outcome measures showed significant changes in each group. The experimental group had a small but significant increase in the modified Ashworth Scale score (p < 0.05, d 0.15), while the control group had a large significant increase (p < 0.05, d 1.48). The experimental group demonstrated greater improvements in walking speed (16.5 to 38.44 cm/s, p < 0.05, d 4.01), step frequency (46.44 to 64.94 steps/min, p < 0.05, d 2.32), stride length (15.50 to 29.81 cm, p < 0.05, d 3.44), and peak hip and knee flexion (d 1.82 to 2.17). After treatment, the experimental group showed significantly greater improvements than the control group in walking speed (38.44 versus 26.63 cm/s, p < 0.05, d 2.75), stride length, peak hip and knee flexion (d 1.31 to 1.45), step frequency (64.94 versus 59.38 steps/min, p < 0.05, d 0.85), and a reduced support phase (bilateral: 24.31% versus 28.38%, p < 0.05, d 0.88; non-paretic: 66.19% versus 70.13%, p < 0.05, d 0.94). For early hemiplegia, personal assistant machine-assisted gait training under the suspension protection system helps establish a correct gait pattern, prevents muscle spasms, and improves motor function.

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