PTRCTJournal of neuroengineering and rehabilitation2024

Effects of robot-assisted gait training using the Welwalk on gait independence for individuals with hemiparetic stroke: an assessor-blinded, multicenter randomized controlled trial.

Satoshi Hirano, Eiichi Saitoh, Daisuke Imoto and 3 others

PMID 38745235

WHAT IT FOUND

Welwalk robot gait training added to conventional physical therapy did not improve overall gait independence in subacute hemiparetic stroke.

A difference appeared only in a small cerebral infarction subgroup, so it is not proof the robot works.

Key findings

01The primary outcome of gait independence did not differ significantly between groups.

02At 25 weeks, 23 participants in the Welwalk group and 18 participants in the control group achieved gait independence, with no significant difference.

03In the cerebral infarction subgroup, 8 participants in the Welwalk group and 3 participants in the control group achieved gait independence at the end of the observation period, with a significant difference.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The study was conducted in eight Japanese convalescent rehabilitation wards with a defined length-of-stay system, so it may not match other settings. Age differed significantly at baseline between groups in the full analysis set. Training intensity was not measured, and sites could differ in how much assistance therapists provided. Physical therapy content other than Welwalk time was not specified, so gait training time may have differed between groups. Blinded assessments were limited in frequency because outside evaluators had to travel to each facility, so timing of gait independence may be imprecise. The cerebral infarction result is a subgroup analysis, and baseline characteristics were not standardized by stroke type.

Declared interests

Toyota Motor Corporation is named as the funder. The supplied text does not list further author conflicts.

The easy way to misread this

Do not conclude that Welwalk improves gait independence overall or should be used for cerebral infarction based on the subgroup result. The primary outcome did not show a significant difference, and the cerebral infarction finding was a subgroup analysis.

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