Efficacy of Overground Robotic Gait Training on Balance in Stroke Survivors: A Systematic Review and Meta-Analysis

Abstract

Strokes often lead to a deficit in motor control that contributes to a reduced balance function. Impairments in the balance function severely limit the activities of daily living (ADL) in stroke survivors. The present systematic review and meta-analysis primarily aims to explore the efficacy of overground robot-assisted gait training (o-RAGT) on balance recovery in individuals with stroke. In addition, the efficacy on ADL is also investigated. This systematic review identified nine articles investigating the effects of o-RAGT on balance, four of which also assessed ADL. The results of the meta-analysis suggest that o-RAGT does not increase balance and ADL outcomes more than conventional therapy in individuals after stroke. The data should not be overestimated due to the low number of studies included in the meta-analysis and the wide confidence intervals. Subgroup analyses to investigate the influence of participant’s characteristics and training dosage were not performed due to lack of data availability. Further well-designed randomized controlled trials are needed to investigate the efficacy of o-RAGT on balance in individuals with stroke.

Effect of exoskeleton robot-assisted training on gait function in chronic stroke survivors: a systematic review of randomised controlled trials

“…Third, considering the trial’s design, a small simple size might fail to obtain a significant difference. A similar study conducted by Lorusso et al 45 also strengthened these relevant issues.…”

Clinical efficacy of overground powered exoskeleton for gait training in patients with subacute stroke: A randomized controlled pilot trial

“…[ 16 ] However, due to the small number of studies, a recent meta-analysis concluded that there is still insufficient scientific evidence to support its efficacy on gait function and ADL and that additional studies including subgroup analyses are needed. [ 17 ]…”

“…[16] However, due to the small number of studies, a recent meta-analysis concluded that there is still insufficient scientific evidence to support its efficacy on gait function and ADL and that additional studies including subgroup analyses are needed. [17] Subacute stroke phase is the optimal period for an active multidisciplinary rehabilitation program. Therefore, because it is closely related to prognosis, promotes neuroplasticity, and facilitates functional recovery, intensive subacute stroke rehabilitation has been emphasized.…”

Overground Robotic Gait Trainer mTPAD Improves Gait Symmetry and Weight Bearing in Stroke Survivors

“…These size and mobility constraints restrict the robotic platforms to treadmills, which may limit improvements to overground gait. While overground robotic gait training may have increased improvement potential, it has not been shown to be better than traditional gait therapy due to the small number of trials and participants [ 42 ]. However, more work is needed to determine if overground robotic gait trainers can impact stroke survivors’ functional and kinetic measures [ 42 , 43 ].…”