PTRCTJournal of neuroengineering and rehabilitation2019

Robot-assisted gait training for balance and lower extremity function in patients with infratentorial stroke: a single-blinded randomized controlled trial.

Ha Yeon Kim, Joon-Ho Shin, Sung Phil Yang and 2 others

PMID 31358017

WHAT IT FOUND

Adding robot-assisted gait training to standard physical therapy improved balance scores by 6.5 points on the Berg Balance Scale.

This change exceeded the threshold for a meaningful clinical difference in patients with infratentorial stroke.

Key findings

01Robot-assisted gait training combined with conventional therapy produced significantly greater improvements in Berg Balance Scale scores than conventional therapy alone.

02The improvement in balance scores was 6.5 points, which is larger than the 6-point minimal detectable change required to be considered a real clinical effect.

03There were no significant differences between the two treatment approaches in walking speed or trunk control scores.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The sample size was very small (17 participants), which limits the generalizability of the findings. The crossover design lacked a washout period, leading to significant carry-over effects for most outcomes, which complicates the interpretation of which treatment caused the change. The study did not assess long-term effects or follow-up beyond 8 weeks. The duration and intensity of RAGT might have been too low to promote neuroplasticity, as suggested by the authors. Participants were in the subacute or chronic phase of recovery (mean time since stroke 15.3 months), so results may not apply to acute stroke patients.

Declared interests

The authors declared no competing interests. The study was supported by the National Rehabilitation Center in Korea.

The easy way to misread this

Do not assume this treatment improves walking speed or overall gait independence. The study found no significant difference between the robot-assisted group and the conventional therapy group in 10-meter walk test results or Functional Ambulation Category scores.

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