Effects of robot-assisted training on balance function in patients with stroke: A systematic review and meta-analysis.
Lu Wang, Yu Zheng, Yini Dang and 7 others
PMID 33739436WHAT IT FOUND
Robot-assisted training improved balance scores in stroke patients compared to conventional therapy.
The benefit was significant in the acute and subacute phase, but not in chronic patients. Exoskeleton devices showed better results than end-effector devices.
Key findings
01Robot-assisted training significantly improved balance function compared with conventional therapy in the pooled analysis of 13 studies.
02The improvement in balance was significant for patients in the acute or subacute stage (less than 6 months post-stroke) but did not reach significance for chronic patients.
03Balance recovery was significantly better with exoskeleton robots, while the improvement with end-effector robots was not statistically significant compared to conventional therapy.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study included only 13 trials for the primary quantitative analysis, which limits the robustness of the conclusions. Therapists and patients could not be blinded to the treatment group, which introduces a risk of performance bias. The included studies used various robot devices and outcome measures, creating heterogeneity that may affect the generalizability of the pooled results. Follow-up data was limited and inconsistent across studies, so it is unclear whether the balance improvements are maintained long-term. The search was limited to English and Chinese languages, potentially missing relevant studies from other countries with advanced robotics. The definition of training intensity (total time) was arbitrary and did not account for the actual effort or complexity of the sessions.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume robot-assisted training is superior to conventional therapy for all stroke patients. The significant benefit was found only in the acute and subacute phases; for chronic patients, the difference was not statistically significant. Additionally, the type of robot matters, as end-effector devices did not show a significant advantage over conventional therapy in this analysis.