Treatment dosage effects of treadmill-based exoskeletal robotic-assisted gait training in individuals with pediatric brain injuries: a systematic review and meta-analysis.
Tzuchi Lin, Yiting Tsai, Yunchuan Chang and 2 others
PMID 41287899WHAT IT FOUND
Treadmill robotic gait training improved walking speed and standing ability in children with brain injuries, but not endurance or walking scores compared to conventional therapy.
Benefits were clearest when combined with conventional therapy and delivered at high frequency.
Key findings
01Robotic gait training significantly improved gait speed and standing ability compared to control groups, but did not significantly improve 6-minute walk test endurance or GMFM Dimension E walking performance.
02Subgroup analyses showed that combining robotic training with conventional physical therapy yielded larger effect sizes for gait speed and endurance than robotic training alone, although the differences between subgroups were not statistically significant.
03Dose-response meta-regression indicated that longer session duration and higher total number of sessions were associated with improved endurance, while excessive initial body weight support and high session frequency were associated with reduced walking performance scores.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The majority of participants (77.5%) had cerebral palsy, limiting the generalizability of findings to children with other types of brain injuries like traumatic brain injury or stroke. There was high heterogeneity in the control interventions (conventional physical therapy), with variations in content, intensity, and dosage across studies. Most included studies had moderate to serious risk of bias, particularly regarding blinding of therapists and participants, which is difficult in robotic interventions. The review lacked long-term follow-up data, so it is unclear if the benefits of RAGT are sustained after the intervention ends. Data on body weight support progression during sessions was rarely reported, making it difficult to give precise guidance on how to adjust support over time.
Declared interests
The authors declared no conflicts of interest. The study was funded by a grant from Taipei Medical University Hospital.
The easy way to misread this
Do not interpret the significant within-group improvements as proof that RAGT is superior to conventional therapy. The between-group analysis showed no significant benefit for endurance or overall walking performance scores compared to controls, meaning the gains may be achievable with conventional physical therapy alone.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →