Effect of robot-assisted gait training combined with electroacupuncture on lower limb motor function and brain network characteristics in stroke: an EEG study.

Only outcome assessors were blinded; participants and therapists were not described as blinded. The study was single-center and enrolled only non-acute stroke patients who could stand with balance and follow instructions, so it may not apply to more severely impaired or acute patients. The intervention lasted only 3 weeks, and the authors state this may not have been long enough for brain changes to translate into measurable motor gains. Many EEG outcomes were tested, and the significant EEG findings were within-group changes rather than differences between the two groups. No correlation analysis was done between EEG changes and clinical function, so brain changes were not linked to patient improvement. The study did not use whole-brain analysis or real-time neuroimaging, so it cannot directly show that the intervention caused the observed brain changes. Daily living independence was measured at baseline but not reported after treatment, so the trial does not show whether patients became more independent in everyday tasks. Stroke type, lesion location, and other patient differences were not analyzed as factors that might affect response. The authors state the sample size, although larger than planned, was still insufficient.

Funded by the Construct Program of the Key Discipline in Zhejiang Rehabilitation Medical Center, the Key Scientific Research and Development Program of Zhejiang Province, and a China Disabled Persons' Federation science and technology project. The supplied text gives no author conflict-of-interest declaration.

Do not conclude that electroacupuncture improved walking or leg function. The primary outcome and the walking and balance scores showed no significant difference between the electroacupuncture plus robot group and the robot-only group. Both groups also received usual medication and rehabilitation, so the improvements cannot be credited to either added treatment alone. The EEG changes were within-group only and not correlated with clinical improvement.