Balance Rehabilitation through Robot-Assisted Gait Training in Post-Stroke Patients: A Systematic Review and Meta-Analysis

被引：29

作者：

Loro, Alberto ^{[1
,2
]}

Borg, Margherita Beatrice ^{[1
,2
]}

Battaglia, Marco ^{[1
,2
]}

Amico, Angelo Paolo ^{[3
]}

Antenucci, Roberto ^{[4
]}

Benanti, Paolo ^{[5
]}

Bertoni, Michele ^{[6
]}

Bissolotti, Luciano ^{[7
]}

Boldrini, Paolo ^{[8
]}

Bonaiuti, Donatella ^{[8
]}

Bowman, Thomas ^{[9
]}

Capecci, Marianna ^{[10
]}

Castelli, Enrico ^{[11
]}

Cavalli, Loredana ^{[12
]}

Cinone, Nicoletta ^{[13
]}

Cosenza, Lucia ^{[14
]}

Di Censo, Rita ^{[15
]}

Di Stefano, Giuseppina ^{[8
]}

Draicchio, Francesco ^{[16
]}

Falabella, Vincenzo ^{[17
]}

Filippetti, Mirko ^{[15
]}

Galeri, Silvia ^{[9
]}

Gimigliano, Francesca ^{[18
]}

Grigioni, Mauro ^{[19
]}

Invernizzi, Marco ^{[20
]}

Jonsdottir, Johanna ^{[9
]}

Lentino, Carmelo ^{[21
]}

Massai, Perla ^{[22
]}

Mazzoleni, Stefano ^{[23
,24
]}

Mazzon, Stefano ^{[25
]}

Molteni, Franco ^{[26
]}

Morelli, Sandra ^{[19
]}

Morone, Giovanni ^{[27
]}

Nardone, Antonio ^{[28
,29
]}

Panzeri, Daniele ^{[30
]}

Petrarca, Maurizio ^{[11
]}

Posteraro, Federico ^{[31
]}

Santamato, Andrea ^{[13
]}

Scotti, Lorenza ^{[32
]}

Senatore, Michele ^{[33
]}

Spina, Stefania ^{[13
]}

Taglione, Elisa ^{[34
]}

Turchetti, Giuseppe ^{[35
]}

Varalta, Valentina ^{[15
]}

Picelli, Alessandro ^{[15
]}

Baricich, Alessio ^{[1
,2
]}

机构：

[1] Univ Piemonte Orientale Amedeo Avogadro, Dept Hlth Sci, I-28100 Novara, Italy

[2] AOU Maggiore Carita Univ Hosp, Phys Med & Rehabil Unit, I-28100 Novara, Italy

[3] Polyclin Bari, Phys Med & Rehabil Unit, I-70124 Bari, Italy

[4] Castel San Giovanni Hosp, Rehabil Unit, I-29015 Piacenza, Italy

[5] Pontifical Gregorian Univ, Theol Dept, I-00187 Rome, Italy

[6] ASST Sette Laghi, Phys Med & Rehabil, I-21100 Varese, Italy

[7] Fdn Teresa Camplani, Casa Cura Domus Salutis, I-25100 Brescia, Italy

[8] Italian Soc Phys & Rehabil Med SIMFER, Robot Rehabil Sect, I-00187 Rome, Italy

[9] IRCCS Fdn Don Carlo Gnocchi, Neurorehabil Dept, I-20148 Milan, Italy

[10] Univ Politecn Marche UNIVPM, Expt & Clin Med Dept, I-60126 Ancona, Italy

[11] Bambino Gesu Pediat Hosp, Neurorehabil Unit, I-00165 Rome, Italy

[12] Ctr Giusti, Phys Med & Rehabil Unit, I-50125 Florence, Italy

[13] Univ Hosp Foggia, Div Phys Med & Rehabil, Unit Spast & Movement Disorders, I-71100 Foggia, Italy

[14] Santi Antonio & Biagio & Cesare Arrigo Natl Hosp, Dept Rehabil, Rehabil Unit, I-15122 Alessandria, Italy

[15] Univ Verona, Univ Hosp Verona, Dept Neurosci Biomed & Movement Sci, Unit Neurorehabil, I-37126 Verona, Italy

[16] Ist Nazl Assicuraz Infortuni Lavoro INAIL, Dipartimento Med Epidemiol Igiene Lavoro & Ambient, I-00192 Rome, Italy

[17] Italian Federat Persons Spinal Cord Injuries FISH, I-00197 Rome, Italy

[18] Luigi Vanvitelli Univ Campania, Dept Phys & Mental Hlth & Prevent Med, I-81100 Naples, Italy

[19] Italian Natl Inst Hlth ISS, Dept New Technol Publ Healthcare, I-00161 Rome, Italy

[20] Azienda Osped Santi Antonio & Biagio & Cesare Arri, Dipartimento Atti Integrate Ric & Innovaz DAIRI, Translat Med, I-15122 Alessandria, Italy

[21] Santa Corona Hosp, Rehabil Unit, I-17027 Pietra Ligure, Italy

[22] Tuscany Rehabil Clin, I-52025 Montevarchi, Italy

[23] Polytech Univ Bari, Dept Elect Engn & Informat Technol, I-70126 Bari, Italy

[24] Scuola Super Sant Anna, BioRobot Inst, I-56025 Pontedera, Italy

[25] Azienda Unita Locale Socio Sanit Euganea AULSS 6, I-35100 Padua, Italy

[26] Valduce Villa Beretta Hosp, Rehabil Dept, I-23845 Costa Masnaga, Italy

[27] Santa Lucia Fdn IRCCS, Neurorehabil Unit, I-00179 Rome, Italy

[28] Univ Pavia, Pediat Diagnost & Clin Surg Sci Dept, I-27100 Pavia, Italy

[29] Ist Clin Sci Maugeri SPA IRCCS, Neurorehabil Unit, I-27100 Pavia, Italy

[30] IRCCS Eugenio Medea, Pediat Rehabil Unit, I-23842 Bosisio Parini, Italy

[31] Versilia Hosp, Rehabil Unit, I-55041 Camaiore, Italy

[32] Univ Piemonte Orientale Amedeo Avogadro, Dept Translat Med, I-28100 Novara, Italy

[33] Italian Assoc Occupat Therapists AITO, I-00136 Rome, Italy

[34] Ist Nazl Assicuraz Infortuni Lavoro INAIL, Rehabil Unit, I-56048 Volterra, Italy

[35] Scuola Super Sant Anna, Inst Management, I-56127 Pisa, Italy

来源：

BRAIN SCIENCES | 2023年 / 13卷 / 01期

基金：

英国科研创新办公室;

关键词：

rehabilitation; robotics; balance; stroke; gait; SUBACUTE STROKE PATIENTS; LIMB MOTOR FUNCTION; HEMIPARETIC STROKE; MIRROR THERAPY; PILOT; FEASIBILITY; RECOVERY; BLIND;

D O I：

10.3390/brainsci13010092

中图分类号：

Q189 [神经科学];

学科分类号：

071006 ;

摘要：

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 (beta = -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.

引用

页数：14

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