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Electromechanical-assisted training for walking after stroke.

Jan Mehrholz1, Joachim Kugler1, Marcus Pohl2

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The Cochrane Database of Systematic Reviews
|May 14, 2025
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Summary
This summary is machine-generated.

Electromechanical-assisted gait training likely improves independent walking post-stroke. Nine patients require treatment to prevent one dependency, though effects on walking speed and capacity are less certain.

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Area of Science:

  • Neurorehabilitation
  • Clinical Trials
  • Evidence-Based Medicine

Background:

  • Walking difficulties are a common and significant impairment following stroke.
  • Electromechanical and robotic gait-training devices are increasingly used in stroke rehabilitation.
  • Previous evidence on these technologies requires updating to reflect current research.

Purpose of the Study:

  • To evaluate the effectiveness of electromechanical- and robot-assisted gait training compared to standard physiotherapy for improving walking in stroke survivors.
  • To assess the impact of these technologies on walking velocity, capacity, patient acceptability, and mortality.

Main Methods:

  • A comprehensive systematic review and meta-analysis of randomized controlled trials (RCTs) and cross-over trials.
  • Searches conducted across multiple databases (CENTRAL, MEDLINE, Embase) up to December 2023.
  • Inclusion of 101 studies involving 4224 participants, assessing independent walking using the Functional Ambulation Category (FAC).

Main Results:

  • Electromechanical-assisted gait training likely enhances the odds of achieving independent walking (moderate-certainty evidence).
  • This training probably does not significantly increase walking velocity or capacity in the short term (moderate to high-certainty evidence).
  • No increased risk of dropout or death from all causes was observed (high-certainty evidence).

Conclusions:

  • Electromechanical-assisted gait training, combined with physiotherapy, offers probable benefits for independent walking post-stroke.
  • Nine patients need treatment to prevent one instance of walking dependency.
  • Further research is recommended to optimize treatment duration, frequency, and long-term benefits, considering the time post-stroke.