Effects of control strategies on gait in robot-assisted post-stroke lower limb rehabilitation: a systematic review.
Silvia Campagnini, Piergiuseppe Liuzzi, Andrea Mannini and 2 others
PMID 35659703WHAT IT FOUND
No consistent gait outcome pattern matched exoskeleton control strategies after stroke.
Most studies were small and technical, so this review does not show that any control strategy improves walking.
Key findings
01This review included 30 papers and 258 participants, but only three were randomized controlled trials.
02There was no clear association between control strategy and the gait outcomes chosen, except that reference-template matching was more often used with force control.
03Position control was more common in assistive studies, and force control was more common in therapeutic studies.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Most included studies had small cohorts, ranging from 1 to 50 patients per study. Only three randomized controlled trials and one controlled trial were included. The review could not combine results statistically because study designs, devices, participants and outcomes were too different. The search was limited to English papers. The included papers were selected for technical control details and quantitative gait measures, so the review may not show how patients felt or what they could do in daily life. The review did not use a tool to judge methodological quality of the included studies.
Declared interests
Funding was named as Rete IRCCS delle Neuroscienze e della Neuroriabilitazione and Ministero della Salute. The supplied text does not report author conflicts of interest.
The easy way to misread this
Do not read this as evidence that a particular exoskeleton control strategy improves walking after stroke. The review found no clear link between control strategy and gait outcomes, and most included studies were small and varied.