Effect of robot-assisted gait training on improving cardiopulmonary function in stroke patients: a meta-analysis.

The primary outcome (peak oxygen uptake) was based on only two studies of 93 patients, so the estimate is fragile and could shift with additional data. The 6-minute walking improvement of 19.26 m fell below the 34.4 m threshold the authors identify as the smallest clinically meaningful change. Most patients were in the subacute phase (2 weeks to 6 months post-stroke); only one study included patients within 48 hours of stroke, so the findings do not extend to the acute period. Intervention durations were short (2 to 6.5 weeks) compared with the 8 to 12 weeks typically used in aerobic training programmes. Four of the 17 included studies were rated high risk of bias and four more had some concerns; blinding and allocation concealment were not always reported. The funnel plot for the 6-minute walking test was asymmetrical, suggesting possible publication bias. No study reported long-term follow-up beyond 12 weeks, so the durability of any benefit is unknown.

Funded by the Shanghai University of Traditional Chinese Medicine, the Shanghai Shenkang Center, the National Science Foundation for Young Scientists of China, and the Medical Key Specialized Project of Baoshan District. No industry funding or conflicts of interest were declared.

Do not read the 6-minute walking result as a clinically meaningful gain. The 19.26 m improvement did not reach the 34.4 m threshold the authors identify as the smallest clinically significant difference, and the primary outcome (peak oxygen uptake) rests on only two studies of 93 patients.