Can robot-assisted gait training improve walking and activity abilities in persons with spinal cord injury? A...

Spinal cord injury (SCI) can lead to substantial impairments in walking and mobility, and traditional rehabilitation methods face limitations such as high labor intensity and insufficient training intensity and precision. While robot-assisted gait training is widely used, its therapeutic advantages over conventional rehabilitation remain controversial.

Through systematic reviews and meta-analysis, this study quantitatively synthesizes existing randomized controlled trial (RCT) evidence to determine the efficacy of robot-assisted gait training on walking and mobility abilities in persons with SCI.

A comprehensive search was conducted across PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Infrastructure (CNKI) databases from their inception to June 19, 2025. We included RCTs comparing robot-assisted gait training with conventional rehabilitation. Two researchers independently performed literature screening, data extraction, and risk of bias assessment. Meta-analysis was conducted using RevMan 5.4 software to calculate standardized mean differences (SMDs) and their 95% confidence intervals (CIs).

A total of 8 RCTs involving 241 participants were included. Meta-analysis results showed: (1) Regarding walking ability, the robot-assisted gait training group demonstrated significant improvements in the 6-min walk test distance (SMD = 0.57, 95% CI: 0.12-1.03, p = 0.01) and Spinal Cord Injury Walking Index II score (SMD = 0.49, 95% CI: 0.13-0.84, p = 0.007); (2) Regarding functional independence, the robot-assisted gait training group demonstrated superior improvement in functional independence scores (SMD = 0.39, 95% CI: 0.05-0.72, p = 0.02); (3) Regarding lower limb muscle strength, no significant difference was observed between the two groups in the improvement of lower limb motor scores (SMD = 0.03, 95% CI: -0.27-0.34, p = 0.84).

Robot-assisted gait training effectively improves functional walking endurance, gait independence, and overall function in persons with SCI. Its core mechanism lies in promoting task-specific motor learning and neuromuscular control, rather than enhancing muscle strength. It is recommended that this technology be adopted as a primary functional improvement strategy in clinical practice, combined with targeted strength training to optimize rehabilitation outcomes.