Effectiveness of Robot-Assisted Gait Training in Stroke Rehabilitation: A Systematic Review and Meta-Analysis.

Robotic-assisted gait training (RAGT) is a promising adjunct to conventional rehabilitation for stroke survivors. However, its additive benefit over standard therapy remains to be fully clarified. This systematic review and meta-analysis evaluated the effectiveness of combining RAGT with conventional rehabilitation in improving gait-related outcomes among individuals with stroke. We searched PubMed, Embase, CINAHL, and Cochrane CENTRAL through September 2024 for randomized controlled trials (RCTs) comparing combined RAGT and conventional rehabilitation versus conventional rehabilitation alone in adults post-stroke. Data were synthesized using a random-effects model, and subgroup analyses examined effects by intervention duration, stroke chronicity, and robotic system type. Twenty-three RCTs (n = 907) were included. The combined intervention significantly improved gait function (SMD = 0.51, = 0.001), gait speed (SMD = 0.47, = 0.010), balance (MD = 4.58, < 0.001), and ADL performance (SMD = 0.35, = 0.001). Subgroup analyses revealed that end-effector robotic systems yielded superior outcomes compared to exoskeletons, particularly in subacute stroke patients. The most pronounced benefits were seen in gait velocity and dynamic balance, especially with ≤15 training sessions. Integrating RAGT with conventional rehabilitation enhances motor recovery and functional performance in stroke survivors. End-effector devices appear most effective in subacute phases, supporting individualized RAGT application based on patient and device characteristics.