Simulating space walking: a systematic review on anti-gravity technology in neurorehabilitation.
Mirjam Bonanno, Maria Grazia Maggio, Angelo Quartarone and 2 others
PMID 39272129WHAT IT FOUND
Anti-gravity treadmill training, sometimes combined with conventional physiotherapy, was reported to improve gait, balance, or endurance in some of 16 studies of stroke, Parkinson’s disease, multiple sclerosis, and cerebral palsy, but evidence quality was low and no dose recommendation was possible.
Key findings
01The review included 16 studies but could not combine their results numerically because methods, outcomes, and participants varied widely.
02In stroke and cerebral palsy studies, authors reported improvements in gait speed, balance, endurance, and fall risk after anti-gravity treadmill training.
03The authors could not give specific clinical recommendations about dose or parameters because robust large randomised trials were lacking.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The review included only 16 studies, and sample sizes ranged from 6 to 50 participants per study, so the evidence base is small. The studies were too heterogeneous in design, outcomes, and participants for quantitative synthesis, so no overall effect size was produced. Many studies were pilot or non-controlled designs, and seven included studies did not have a control group. Randomisation procedures and rater blinding were often not specified. Training protocols varied widely, and three studies did not explicitly describe the training protocol used. Risk of bias was moderate in many non-randomised studies, and one randomised trial had concerns related to blinding. Follow-up was short or not long-term, and treatment adherence was low in many studies. Only one study included people with multiple sclerosis, so findings for that group are limited. A-GT was sometimes combined with conventional physiotherapy, so the contribution of each component cannot be separated.
Declared interests
No author conflict-of-interest declaration is reported in the supplied text. The publication types list Research Support, Non-U.S. Gov't.
The easy way to misread this
Do not read this review as proof that anti-gravity treadmill training works better than conventional physiotherapy. The studies were too heterogeneous to pool, many samples were small, and A-GT was sometimes combined with conventional physiotherapy, so the effect of the treadmill alone cannot be separated.