Effectiveness of Robotic Therapy in Improving Balance Function After Stroke: Systematic Review
DOI:
https://doi.org/10.69980/ajpr.v28i5.531Keywords:
robot-assisted gait training, stroke rehabilitation, balance, Berg Balance Scale, exoskeleton, end- effector, postural control, meta-analysis, neurorehabilitation, randomized controlled trialsAbstract
Background: Balance impairment is a prevalent and debilitating consequence of stroke that contributes to falls, reduced mobility, and limited independence. While robot-assisted gait training (RAGT) has shown promise in improving motor outcomes post-stroke, its specific impact on balance remains unclear. This systematic review and meta-analysis aims to evaluate the efficacy of RAGT on balance function in adult stroke patients, and to identify potential moderators such as stroke chronicity, robotic device type, and training intensity.
Methods: A comprehensive search was conducted in PubMed, Cochrane Library, Embase, and CNKI for randomized controlled trials (RCTs) from inception through January 2020. Studies were included if they compared robotic gait therapy to conventional therapy and assessed balance outcomes using validated tools (e.g., Berg Balance Scale, Timed Up and Go). Data extraction, quality assessment (via RoB 2), and meta-analyses (random-effects model) were performed. Subgroup analyses evaluated the effects of stroke stage (acute/subacute vs. chronic), device type (exoskeleton vs. end- effector), and therapy dose (≥10 vs. <10 total hours).
Results: Twenty-five RCTs involving 1,362 participants were included. Pooled results demonstrated that RAGT significantly improved balance compared to conventional therapy (BBS mean difference = 3.58; 95% CI: 1.89–5.28; p < 0.001). Subgroup analysis revealed greater benefits in acute/subacute patients (MD = 5.40) and with exoskeleton devices. Training intensity was a significant moderator, with protocols ≥10 total hours yielding superior outcomes. No major adverse events were reported.
Conclusion: Robot-assisted gait training is effective in enhancing balance function in stroke survivors, particularly in the early recovery phase and when using exoskeleton systems with sufficient training intensity. While not universally superior to conventional therapy, RAGT represents a viable and safe strategy for targeted balance rehabilitation. Further long-term and cost- effectiveness studies are warranted.
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