Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
J Rehabil Med. 2021 Apr 1;53(4):jrm00174. doi: 10.2340/16501977-2815.
To investigate the effectiveness of robot-assisted therapy on balance function in stroke survivors.
PubMed, the Cochrane Library, Embase and China National Knowledge Infrastructure databases were searched systematically for relevant studies.
Randomized controlled trials reporting robot-assisted therapy on balance function in patients after stroke were included.
Information on study characteristics, demographics, interventions strategies and outcome measures were extracted by 2 reviewers.
A total of 19 randomized trials fulfilled the inclusion criteria and 13 out of 19 were included in the meta-analysis. Analysis revealed that robot-assisted therapy significantly improved balance function assessed by berg balance scale (weighted mean difference (WMD) 3.58, 95% confidence interval (95% CI) 1.89-5.28, p < 0.001) compared with conventional therapy. Secondary analysis indicated that there was a significant difference in balance recovery between the conventional therapy and robot-assisted therapy groups in the acute/subacute stages of stroke (WMD 5.40, 95% CI 3.94-6.86, p < 0.001), while it was not significant in the chronic stages. With exoskeleton devices, the balance recovery in robot-assisted therapy groups was significantly better than in the conventional therapy groups (WMD 3.73, 95% CI 1.83-5.63, p < 0.001). Analysis further revealed that a total training time of more than 10 h can significantly improve balance function (WMD 4.53, 95% CI 2.31-6.75, p < 0.001). No publication bias or small study effects were observed according to the Cochrane Collaboration tool.
These results suggest that robot-assisted therapy is an effective intervention for improving balance function in stroke survivors.
研究机器人辅助疗法对脑卒中幸存者平衡功能的疗效。
系统检索 PubMed、Cochrane 图书馆、Embase 和中国知网数据库中有关脑卒中后患者应用机器人辅助疗法改善平衡功能的相关研究。
纳入采用机器人辅助疗法治疗脑卒中后患者平衡功能的随机对照试验。
由 2 位评价员提取研究特征、人口统计学、干预策略和结局测量指标等信息。
共有 19 项随机试验符合纳入标准，其中 13 项纳入 meta 分析。分析结果显示，与常规疗法相比，机器人辅助疗法可显著改善平衡功能（Berg 平衡量表评分：加权均数差 3.58，95%置信区间 1.89-5.28，P<0.001）。进一步亚组分析显示，在脑卒中的急性期/亚急性期，常规疗法与机器人辅助疗法组间的平衡恢复差异有统计学意义（WMD 5.40，95% CI 3.94-6.86，P<0.001），而在慢性期差异无统计学意义。对于外骨骼设备，机器人辅助疗法组的平衡恢复明显优于常规疗法组（WMD 3.73，95% CI 1.83-5.63，P<0.001）。分析还显示，总训练时间超过 10 h 可显著改善平衡功能（WMD 4.53，95% CI 2.31-6.75，P<0.001）。根据 Cochrane 协作网工具，未发现发表偏倚或小样本研究效应。
这些结果表明，机器人辅助疗法是改善脑卒中幸存者平衡功能的有效干预措施。
