Abstract
Objective
The objective of the article is to analyze the effects of the end-effector technology
for gait rehabilitation on acute, subacute, and chronic stroke in order to verify
the efficacy of the treatment in older people, based on evidence from randomized controlled
trials, and thus increase the clinical knowledge for future applications in the hospital
setting.
Design
A systematic review of the literature was conducted in October 2018. The data were
collected from Cochrane, Embase, Scopus, and PubMed databases, analyzing manuscripts
and articles of the last 10 years.
Setting
We included only randomized controlled trials written in English and aimed to study
the effects of end-effector devices in improving walking in stroke patients. We selected
20 studies, and the results were divided into subacute stroke patients and chronic
stroke patients.
Measures
Quality evaluation was performed using the PEDro scale. Of the 10 studies considered,
9 were randomized controlled trials. The PEDro scale score ranged from 7 to 10.
Results
Robotic-assisted gait trainer is more effective for subacute stroke patients with
a lower function ambulation assessment, showing significant changes in independent
walking ability. One possible explanation of the improvement of the gait speed and
functional ambulation is the opportunity of receiving a more intensive and repetitive
task-oriented training through end-effector robotic-based intervention.
Conclusions and Implications
The use of robotic-assisted gait trainer, together with a conventional treatment,
seems to improve the walking capability of patients. Future research trials should
take into account the impact of the robotic end-effector gait training on the oldest
population, as this target was only partially included in the studies examined. Availability
of new evidence will support the design of innovative assistive models for the clinical
rehabilitation setting, which will take into account the need of personalizing the
intervention to support the growing oldest old population.
Keywords
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Article info
Publication history
Published online: November 28, 2019
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
