Balance Rehabilitation through Robot-Assisted Gait Training in Post-Stroke Patients: A Systematic Review and Meta-Analysis

Brain Sci., 2023 · DOI: 10.3390/brainsci13010092 · Published: January 3, 2023

Assistive Technology Neurology Rehabilitation

Simple Explanation

Balance problems are common after a stroke, making it harder to move and increasing the risk of falls. Robot-assisted gait training (RAGT) is often used with traditional training. This study looks at whether RAGT is better than traditional methods for improving balance in people who have had a stroke. The review found that RAGT is as effective as traditional therapy. Combining RAGT with traditional therapy might lead to better results than using either method alone. More research is needed to determine if and when RAGT is better than traditional therapy, particularly focusing on robot-assisted balance training.

Study Duration

Not specified

Participants

Post-stroke patients

Evidence Level

Systematic Review and Meta-Analysis

Key Findings

1
The study found that the Berg Balance Scale (BBS) score improved more in patients treated with RAGT compared to conventional therapy, with a pMD of 2.17 (95% CI 0.79; 3.55).
2
The Timed Up and Go (TUG) test also showed a pre-post mean difference in favor of RAGT, but this result was not statistically significant, with a pMD of −0.62 (95%CI −3.66; 2.43).
3
Meta-regression analyses indicated that longer treatment duration was associated with greater improvement in the TUG test (β = −1.019, 95% CI −1.827; −0.210, p-value = 0.0135).

Research Summary

This systematic review and meta-analysis aimed to determine the efficacy of robot-assisted gait training (RAGT) on balance rehabilitation in post-stroke survivors by analyzing randomized clinical trials that used Berg Balance Scale (BBS) or Timed Up and Go test (TUG) for balance evaluation. The results indicated that RAGT is equally effective as traditional therapy in improving balance, and the combination of both RAGT and traditional therapy may lead to better outcomes than either method alone. The study suggests a need for future research focusing on robot-assisted balance training and trials with more strict inclusion criteria to definitively determine when RAGT is superior to traditional therapy.

Practical Implications

Clinical Practice

RAGT and conventional treatment should be performed together when both are available for post-stroke patients with balance impairment.

Research

Robot-assisted balance training should be more scientifically investigated to rapidly insert it into common clinical activities.

Study Design

Future trials should have more structured inclusion criteria, considering age and time from stroke, for more patient-specific rehabilitation protocols.

Study Limitations

1
High heterogeneity between studies confounded the results due to varying protocols.
2
Lack of clear evidence on which RAGT protocol leads to better balance improvement.
3
Inability to perform sub-group analysis considering acute, sub-acute, and chronic patients due to varying inclusion criteria regarding time from stroke.

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