Brain Sciences (Jan 2023)
Balance Rehabilitation through Robot-Assisted Gait Training in Post-Stroke Patients: A Systematic Review and Meta-Analysis
- Alberto Loro,
- Margherita Beatrice Borg,
- Marco Battaglia,
- Angelo Paolo Amico,
- Roberto Antenucci,
- Paolo Benanti,
- Michele Bertoni,
- Luciano Bissolotti,
- Paolo Boldrini,
- Donatella Bonaiuti,
- Thomas Bowman,
- Marianna Capecci,
- Enrico Castelli,
- Loredana Cavalli,
- Nicoletta Cinone,
- Lucia Cosenza,
- Rita Di Censo,
- Giuseppina Di Stefano,
- Francesco Draicchio,
- Vincenzo Falabella,
- Mirko Filippetti,
- Silvia Galeri,
- Francesca Gimigliano,
- Mauro Grigioni,
- Marco Invernizzi,
- Johanna Jonsdottir,
- Carmelo Lentino,
- Perla Massai,
- Stefano Mazzoleni,
- Stefano Mazzon,
- Franco Molteni,
- Sandra Morelli,
- Giovanni Morone,
- Antonio Nardone,
- Daniele Panzeri,
- Maurizio Petrarca,
- Federico Posteraro,
- Andrea Santamato,
- Lorenza Scotti,
- Michele Senatore,
- Stefania Spina,
- Elisa Taglione,
- Giuseppe Turchetti,
- Valentina Varalta,
- Alessandro Picelli,
- Alessio Baricich
Affiliations
- Alberto Loro
- Department of Health Sciences, Università del Piemonte Orientale “Amedeo Avogadro”, 28100 Novara, Italy
- Margherita Beatrice Borg
- Department of Health Sciences, Università del Piemonte Orientale “Amedeo Avogadro”, 28100 Novara, Italy
- Marco Battaglia
- Department of Health Sciences, Università del Piemonte Orientale “Amedeo Avogadro”, 28100 Novara, Italy
- Angelo Paolo Amico
- Physical Medicine and Rehabilitation Unit, Polyclinic of Bari, 70124 Bari, Italy
- Roberto Antenucci
- Rehabilitation Unit, Castel San Giovanni Hospital, 29015 Piacenza, Italy
- Paolo Benanti
- Theology Department, Pontifical Gregorian University, 00187 Rome, Italy
- Michele Bertoni
- Physical Medicine and Rehabilitation, ASST Sette Laghi, 21100 Varese, Italy
- Luciano Bissolotti
- Casa di Cura Domus Salutis, Fondazione Teresa Camplani, 25100 Brescia, Italy
- Paolo Boldrini
- Robotic Rehabilitation Section, Italian Society of Physical and Rehabilitative Medicine (SIMFER), 00187 Rome, Italy
- Donatella Bonaiuti
- Robotic Rehabilitation Section, Italian Society of Physical and Rehabilitative Medicine (SIMFER), 00187 Rome, Italy
- Thomas Bowman
- Neurorehabilitation Department, IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy
- Marianna Capecci
- Experimental and Clinic Medicine Department, Università Politecnica delle Marche (UNIVPM), 60126 Ancona, Italy
- Enrico Castelli
- Neurorehabilitation Unit, Bambino Gesù Children’s Hospital, 00165 Rome, Italy
- Loredana Cavalli
- Physical Medicine and Rehabilitation Unit, Centro Giusti, 50125 Florence, Italy
- Nicoletta Cinone
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, 71100 Foggia, Italy
- Lucia Cosenza
- Rehabilitation Unit, Department of Rehabilitation, “Santi Antonio e Biagio e Cesare Arrigo” National Hospital, 15122 Alessandria, Italy
- Rita Di Censo
- Unit of Neurorehabilitation, Department of Neuroscience, Biomedicine, and Movement Sciences, University Hospital of Verona, University of Verona, 37126 Verona, Italy
- Giuseppina Di Stefano
- Robotic Rehabilitation Section, Italian Society of Physical and Rehabilitative Medicine (SIMFER), 00187 Rome, Italy
- Francesco Draicchio
- Dipartimento Medicina, Epidemiologia, Igiene del Lavoro e Ambientale, Istituto Nazionale Assicurazione Infortuni sul Lavoro (INAIL), 00192 Rome, Italy
- Vincenzo Falabella
- Italian Federation of Persons with Spinal Cord Injuries (FISH), 00197 Rome, Italy
- Mirko Filippetti
- Unit of Neurorehabilitation, Department of Neuroscience, Biomedicine, and Movement Sciences, University Hospital of Verona, University of Verona, 37126 Verona, Italy
- Silvia Galeri
- Neurorehabilitation Department, IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy
- Francesca Gimigliano
- Department of Physical and Mental Health and Prevention Medicine, Luigi Vanvitelli University of Campania, 81100 Naples, Italy
- Mauro Grigioni
- Department of New Technologies in Public Healthcare, Italian National Institute of Health (ISS), 00161 Rome, Italy
- Marco Invernizzi
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera Santi Antonio e Biagio e Cesare Arrigo, 15122 Alessandria, Italy
- Johanna Jonsdottir
- Neurorehabilitation Department, IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy
- Carmelo Lentino
- Rehabilitation Unit, Santa Corona Hospital, 17027 Pietra Ligure, Italy
- Perla Massai
- Tuscany Rehabilitation Clinic, 52025 Montevarchi, Italy
- Stefano Mazzoleni
- Department of Electrical Engineering and Information Technology, Polytechnic University of Bari, 70126 Bari, Italy
- Stefano Mazzon
- Azienda Unità Locale Socio Sanitaria Euganea (AULSS 6), 35100 Padua, Italy
- Franco Molteni
- Rehabilitation Department, Valduce Villa Beretta Hospital, 23845 Costa Masnaga, Italy
- Sandra Morelli
- Department of New Technologies in Public Healthcare, Italian National Institute of Health (ISS), 00161 Rome, Italy
- Giovanni Morone
- Neurorehabilitation Unit, Santa Lucia Foundation IRCCS, 00179 Rome, Italy
- Antonio Nardone
- Pediatric, Diagnostical and Clinical-Surgical Sciences Department, University of Pavia, 27100 Pavia, Italy
- Daniele Panzeri
- Pediatric Rehabilitation Unit, IRCCS Eugenio Medea, 23842 Bosisio Parini, Italy
- Maurizio Petrarca
- Neurorehabilitation Unit, Bambino Gesù Children’s Hospital, 00165 Rome, Italy
- Federico Posteraro
- Rehabilitation Unit, Versilia Hospital, 55041 Camaiore, Italy
- Andrea Santamato
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, 71100 Foggia, Italy
- Lorenza Scotti
- Department of Translational Medicine, Università del Piemonte Orientale “Amedeo Avogadro”, 28100 Novara, Italy
- Michele Senatore
- Italian Association of Occupational Therapists (AITO), 00136 Rome, Italy
- Stefania Spina
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, 71100 Foggia, Italy
- Elisa Taglione
- Rehabilitation Unit, Istituto Nazionale Assicurazione Infortuni sul Lavoro (INAIL), 56048 Volterra, Italy
- Giuseppe Turchetti
- Institute of Management, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
- Valentina Varalta
- Unit of Neurorehabilitation, Department of Neuroscience, Biomedicine, and Movement Sciences, University Hospital of Verona, University of Verona, 37126 Verona, Italy
- Alessandro Picelli
- Unit of Neurorehabilitation, Department of Neuroscience, Biomedicine, and Movement Sciences, University Hospital of Verona, University of Verona, 37126 Verona, Italy
- Alessio Baricich
- Department of Health Sciences, Università del Piemonte Orientale “Amedeo Avogadro”, 28100 Novara, Italy
- DOI
- https://doi.org/10.3390/brainsci13010092
- Journal volume & issue
-
Vol. 13,
no. 1
p. 92
Abstract
Background: Balance impairment is a common disability in post-stroke survivors, leading to reduced mobility and increased fall risk. Robotic gait training (RAGT) is largely used, along with traditional training. There is, however, no strong evidence about RAGT superiority, especially on balance. This study aims to determine RAGT efficacy on balance of post-stroke survivors. Methods: PubMed, Cochrane Library, and PeDRO databases were investigated. Randomized clinical trials evaluating RAGT efficacy on post-stroke survivor balance with Berg Balance Scale (BBS) or Timed Up and Go test (TUG) were searched. Meta-regression analyses were performed, considering weekly sessions, single-session duration, and robotic device used. Results: A total of 18 trials have been included. BBS pre-post treatment mean difference is higher in RAGT-treated patients, with a pMD of 2.17 (95% CI 0.79; 3.55). TUG pre-post mean difference is in favor of RAGT, but not statistically, with a pMD of −0.62 (95%CI − 3.66; 2.43). Meta-regression analyses showed no relevant association, except for TUG and treatment duration (β = −1.019, 95% CI − 1.827; −0.210, p-value = 0.0135). Conclusions: RAGT efficacy is equal to traditional therapy, while the combination of the two seems to lead to better outcomes than each individually performed. Robot-assisted balance training should be the focus of experimentation in the following years, given the great results in the first available trials. Given the massive heterogeneity of included patients, trials with more strict inclusion criteria (especially time from stroke) must be performed to finally define if and when RAGT is superior to traditional therapy.
Keywords
