Effect of robotic exoskeleton training on lower limb function, activity and participation in stroke patients: a systematic review and meta-analysis of randomized controlled trials

作者：Juncong Yang, Yongxin Zhu, Haojie Li, Kun Wang, Dan Li, Qi Qi · 发表于：Frontiers in Neurology · 年份：2024 · DOI：10.3389/fneur.2024.1453781 · 被引用次数：22 · 研究领域：Stroke Rehabilitation and Recovery、Prosthetics and Rehabilitation Robotics、Acute Ischemic Stroke Management

Background The current lower limb robotic exoskeleton training (LRET) for treating and managing stroke patients remains a huge challenge. Comprehensive ICF analysis and informative treatment options are needed. This review aims to analyze LRET’ s efficacy for stroke patients, based on ICF, and explore the impact of intervention intensities, devices, and stroke phases. Methods We searched Web of Science, PubMed, and The Cochrane Library for RCTs on LRET for stroke patients. Two authors reviewed studies, extracted data, and assessed quality and bias. Standardized protocols were used. PEDro and ROB2 were employed for quality assessment. All analyses were done with RevMan 5.4. Results Thirty-four randomized controlled trials (1,166 participants) were included. For function, LRET significantly improved motor control (MD = 1.15, 95%CI = 0.29–2.01, p = 0.009, FMA-LE), and gait parameters (MD = 0.09, 95%CI = 0.03–0.16, p = 0.004, Instrumented Gait Velocity; MD = 0.06, 95%CI = 0.02–0.09, p = 0.002, Step length; MD = 4.48, 95%CI = 0.32–8.65, p = 0.04, Cadence) compared with conventional rehabilitation. For activity, LRET significantly improved walking independence (MD = 0.25, 95%CI = 0.02–0.48, p = 0.03, FAC), Gait Velocity (MD = 0.07, 95%CI = 0.03–0.11, p = 0.001) and balance (MD = 2.34, 95%CI = 0.21–4.47, p = 0.03, BBS). For participation, social participation (MD = 0.12, 95%CI = 0.03–0.21, p = 0.01, EQ-5D) was superior to conventional rehabilitation. Based on subgroup analyses, LRET...