Assessment of the Robotic Devices for Overground Gait Training in Poststroke Patient: A Systematic Review and Meta-analysis.

Abstract

Stroke is a major cause of disability, impacting mobility worldwide. Overground robotic-assisted gait training uses wearable exoskeletons to improve walking. This systematic review and meta-analysis assess its effectiveness versus conventional gait training in enhancing gait velocity and balance in poststroke patients. Our search was conducted in the Pubmed, Cochrane, ScienceDirect, Scopus, and PEDro electronic databases for English journal articles about human randomized controlled trials of the last two decades, investigating overground robotic-assisted gait training effects on gait parameters of poststroke patients compared with conventional gait training. A comprehensive literature search identified seven randomized controlled trials with a total of 288 participants. Meta-analysis results indicated that overground robotic-assisted gait training significantly improved after intervention gait velocity (summary mean difference: 0.09 m/sec, 95% confidence interval 0.02-0.17), while other gait parameters, such as stride length and cadence, showed no statistically significant differences. The intervention was well-tolerated, with no major adverse events reported. Despite the positive impact on gait speed, challenges remain, including high device costs and the need for further research to optimize training parameters. These findings support the potential of overground robotic-assisted gait training as an effective tool for gait rehabilitation in stroke survivors, highlighting the need for larger studies with long-term follow-up to refine its clinical application.