Exploring the Feasibility and Patient Acceptance of RAGT for Overground Ambulation in Adults With Guillain-Barré Syndrome: A Scoping Review.

Only four studies met the inclusion criteria and together they reported on 19 adults; two were single case reports, so this is a description of what has been tried, not evidence that it works. No included study compared robot-assisted gait training with conventional rehabilitation, so the functional gains reported could come from the therapy patients were already receiving or from the natural recovery course of GBS. The studies used different robots, different doses and different points in the disease course, so they cannot be compared with one another and no device or protocol can be recommended over another. Only 2 of the 26 patients in the feasibility study had an inflammatory polyneuropathy, so most of that study's data comes from other neurologic conditions. Patient acceptance was not measured in the GBS patients themselves; the review reasons about it from stroke, spinal cord injury and multiple sclerosis populations, which the authors say cannot be directly extrapolated to GBS. The costs quoted are high: the review notes a Lokomat price of EUR 881,292 in 2022 and an overground robotic exoskeleton price of USD 150,000, excluding maintenance and repair.

The authors state they have no financial or nonfinancial disclosures to make in relation to this project. No funding source is reported in the text. Three manufacturers are named as suppliers of the devices used in the reviewed studies (Hocoma, Tyromotion and CUREXO), but the paper does not say whether they funded or contributed to this work.

Do not read the improvements reported in these studies as evidence that robot-assisted gait training improves walking in Guillain-Barré syndrome. None of the four studies compared it with conventional rehabilitation, and two were single case reports, so any gains could come from the therapy the patients were already receiving or from natural recovery. One of the reported patients was already walking with supervision or independently before the robot was introduced.