The effectiveness of robotic-assisted gait training on walking speed for stroke survivors: Meta-analysis

Background: Most stroke survivors have walking difficulties after the event, so regaining the ability to walk again is the main goal of rehabilitation intervention. The robotic-assisted device is widely used in rehabilitation settings and may have an advantage over conventional physical therapy in regaining walking capacity. Objectives: The objectives of this study were to investigate whether the robotic-assisted gait training (RAGT) alone improves walking capacity (e.g., gait velocity) compared with conventional gait training (e.g., over-ground gait training) in stroke survivors. Methods: An electronic Medline database (e.g., PubMed, Ovid, ISI of knowledge) search was done to identify trials. The searching process was limited to randomized clinical trials and recent studies from 2000 to 2017. All trials that did not use conventional physical therapy as a control group and did not use RAGT as an intervention were excluded from the study. Results: A total of 4 studies met our inclusion criteria, and they were included in the meta-analysis with 182 participants. Convention physical therapy training did significantly better than robotic-assisted training P = 0.003. Therefore, the conventional physical therapy group regained 30% (confidence interval 19%-41%) more in gait velocity than the robotic-assisted gait group. Conclusion: That robotic-assisted training alone did not show any improvement in gait velocity compared with regular physical therapy training. However, further research may address the use of robotic-assisted devices plus conventional physical therapy to compare the combined benefits with those of conventional physical therapy alone.