Robotic-Assisted Gait Training Effect on Function and Gait Speed in Subacute and Chronic Stroke Population: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Eur Neurol. 2019;81(3-4):103-111. doi: 10.1159/000500747. Epub 2019 Jun 5.

Abstract

Background: The review is intended to provide the effectiveness of robotic-assisted gait training (RAGT) for functional gait recovery in poststroke survivors through a systematic review and to provide evidence for gait speed improvements through the meta-analysis of randomized controlled trials (RCTs).

Summary: In this systematic review, PubMed, Web of Science, Wiley Online Library, Science Direct, Science Robotics, Scopus, UpToDate, MEDLINE, Google Scholar, -CINHAL, EMBASE, and EBSCO were reviewed to identify relevant RCTs. Articles included in the study were thoroughly examined by 2 independent reviewers. The included RCTs were having a PEDro score between 6 and 8 points. The initial database review yielded 1,371 studies and, following further screening; 9 studies finally were selected for systematic review and meta-analysis. Out of the 9 studies, 4 were on chronic stroke and 5 were on subacute stroke. The meta-analysis of gait speed showed an effect size value ranging between -0.91 and 0.64, with the total effect size of all the studies being -0.12. During subgroup analysis, the subacute stroke total effect size was identified as -0.48, and the chronic stroke total effect size was noted as 0.04. Meta-analysis revealed no significant differences between RAGT and conventional gait training (CGT). Key Messages: Our systematic review revealed that the RAGT application demonstrated a better or similar effect to that of CGT in a poststroke population. A meta-analysis of gait speed involving all the studies identified here indicated no significant differences between RAGT and CGT. However, the subanalysis of chronic stroke survivors showed a slight positive effect of RAGT on gait speed.

Keywords: Gait speed; Robotic-assisted gait training; Stroke.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Exercise Therapy / instrumentation
  • Exercise Therapy / methods
  • Gait / physiology
  • Gait Disorders, Neurologic / rehabilitation*
  • Humans
  • Randomized Controlled Trials as Topic
  • Recovery of Function
  • Robotics*
  • Stroke / complications
  • Stroke / physiopathology
  • Stroke Rehabilitation / instrumentation*
  • Stroke Rehabilitation / methods
  • Walking Speed / physiology