Effectiveness of Robot-Assisted Lower Limb Rehabilitation on Balance in People with Stroke: A Systematic Review, Meta-analysis, and Meta-regression

 If this is effective, where is the protocol publicly located so survivors can find it and bring it to their doctor/therapist attention? Top down does not work, hospitals do not have a research analyst whose only job is to follow stroke research and get it implemented in the hospital.

Effectiveness of Robot-Assisted Lower Limb Rehabilitation on Balance in People with Stroke: A Systematic Review, Meta-analysis, and Meta-regression

Part of the book series: Communications in Computer and Information Science ((CCIS,volume 2084))

Included in the following conference series:

• Nordic Conference on Digital Health and Wireless Solutions​

• Riku Yli-Ikkelä,
• Aki Rintala,
• Anna Köyhäjoki,
• Harto Hakonen,
• Hilkka Korpi,
• Mirjami Kantola,
• Sari Honkanen,
• Outi Ilves,
• Tuulikki Sjögren,
• Juha Karvanen &
• Eeva Aartolahti
  

Abstract

The objective of this study was to evaluate the effectiveness of robot-assisted lower-limb rehabilitation on balance in stroke patients and to explore the covariates associated with these effects.

A systematic literature search was carried out in four databases (MEDLINE (Ovid), CINAHL, PsycINFO, and ERIC) for studies published from inception to 25^th of March 2022. Studies on robot-assisted lower-limb rehabilitation with a randomized controlled trial (RCT) design, participants with stroke, a comparison group with conventional training, and balance-related outcomes were included. Studies were assessed for Cochrane Risk of Bias 2 and quality of evidence. Meta-analysis and meta-regression were performed.

A total of 48 (RCT) with 1472 participants were included. The overall risk of bias in the included studies was unclear (n = 32), high (n = 15) or low (n = 1). Compared to conventional rehabilitation, robot-assisted lower-limb rehabilitation interventions were more effective for balance improvement (Hedges’ g = 0.25, 95% CI: 0.10 0.41). In meta-regression, a relationship between the training effect was observed with the time since stroke, explaining 56% of the variance (p = 0.001), and with the ankle robots, explaining 16% of the variance (p = 0.048). No serious adverse events related to robot-assisted training were reported.

Robot-assisted lower-limb rehabilitation may improve balance more than conventional training in people with stroke, especially in the acute stage. Robot-assisted lower-limb rehabilitation seems to be a safe rehabilitation method for patients with stroke. To strengthen the evidence, more high-quality RCTs with adequate sample sizes are needed.

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