[Gait Training Using Robotic Devices in Subjects With Stroke: An Overview of Systematic Reviews and Meta-analysis]

Gait training using robotic devices in stroke patients is a widely researched treatment modality. Therefore, there is a lot of heterogeneous information that needs to be synthesized, sorted, and classified. The aim of this work was to synthesize and analyze the scientific evidence on the application of robotic devices for gait training in people with stroke.

This overview of systematic reviews and meta-analysis was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Searches were performed in four electronic databases: PubMed, Scopus, Web of Science, and Cochrane Library Plus. Systematic reviews and meta-analyses that included randomized controlled trials (RCTs) that investigated the effects of robotic devices in combination or not with another physiotherapy treatment on gait recovery in stroke patients were included.

Thirteen studies with a total of 101 RCTs were included. Data regarding the participants, outcome measures, training protocols and main results were extracted. The A Messurement Tool to Assess Systematic Review (AMSTAR-2) scale and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system of certainty of evidence were applied. Only one study had a high certainty of evidence; while four had a moderate certainty, six were classified as having a low certainty and two had a critically low quality.

Robotic gait training combined with physiotherapy improves walking speed after stroke, especially with end-effector devices. However, benefits do not reach clinically meaningful functional thresholds, and applicability is limited due to insufficient evidence, high costs, and limited accessibility. The PROSPERO Registration: CRD42021237915, https://www.crd.york.ac.uk/PROSPERO/view/CRD42021237915.