Flexible exoskeleton-assisted training enhances lower limb motor function after stroke: a systematic review and meta-analysis.

IF 4.6 2区 医学 Q1 CLINICAL NEUROLOGY Journal of Neurology Pub Date : 2025-03-19 DOI:10.1007/s00415-025-12998-1
Jiawei Liu, Kai Liu, Xuanxuan Ge, Ping Zhou, Tianzhe Bao, Weijun Gong
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Abstract

Background: Recent advances in flexible exoskeleton technology have broadened its application in stroke rehabilitation, particularly for improving motor functions in the affected lower limb. This review examines the impact of flexible exoskeleton-assisted training (FEAT) compared to conventional therapy on balance, motor functions, and gait parameters in post-stroke patients.

Methods: We conducted a meta-analysis using data from randomized controlled trials (RCTs) identified through database searches and manual screening, focusing on outcomes such as balance (Berg Balance Scale, BBS), lower limb motor functions (Ten-Meter Walk Test, 10MWT; Six-Minute Walk Test, 6MWT; Functional Ambulation Category, FAC), and gait parameters (walking speed, step length, cadence, and symmetry).

Results: This meta-analysis included 6 studies with 213 patients. FEAT significantly enhanced BBS scores, and performances on the 10MWT and 6MWT, along with other gait parameters; however, FAC scores did not improve significantly. Subgroup analyses revealed that FEAT with hip assistance significantly improved step length, cadence, and gait symmetry ratio, while ankle assistance improved performance on the 10MWT and 6MWT. FEAT was especially effective in improving step length, cadence, and gait symmetry ratio in patients with a post-stroke duration exceeding three months.

Conclusion: Compared to the conventional therapy, FEAT markedly improves the balance, walking ability, and gait parameters in stroke rehabilitation. These findings support the value of FEAT in lower extremity rehabilitation post-stroke, suggesting its integration into clinical programs could enhance the therapy effectiveness or efficiency. In addition, the appropriate type of FEAT needs to be selected in the rehabilitation program based on the patient's specific impairment. For example, FEAT with hip assistance may be recommended for stroke patients with severe gait asymmetry, aiding the development of personalized interventions.

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柔性外骨骼辅助训练增强中风后下肢运动功能:系统回顾和荟萃分析。
背景:近年来柔性外骨骼技术的进展扩大了其在中风康复中的应用,特别是在改善患下肢运动功能方面。本综述探讨了与传统疗法相比,柔性外骨骼辅助训练(FEAT)对卒中后患者平衡、运动功能和步态参数的影响。方法:我们使用随机对照试验(rct)的数据进行meta分析,这些数据是通过数据库检索和人工筛选获得的,重点关注平衡(Berg balance Scale, BBS)、下肢运动功能(10m Walk Test, 10MWT;6分钟步行测试,6MWT;功能步行类别(FAC)和步态参数(步行速度、步长、节奏和对称性)。结果:本荟萃分析纳入6项研究,213例患者。FEAT显著提高了BBS评分、10MWT和6MWT以及其他步态参数的表现;然而,FAC评分没有明显提高。亚组分析显示,髋关节辅助的FEAT显著改善了步长、节奏和步态对称比,而脚踝辅助则改善了10MWT和6MWT的表现。对于中风后持续时间超过3个月的患者,FEAT在改善步长、节奏和步态对称比方面特别有效。结论:与常规治疗相比,FEAT可显著改善脑卒中康复患者的平衡、行走能力和步态参数。这些发现支持FEAT在中风后下肢康复中的价值,表明将其整合到临床项目中可以提高治疗效果或效率。此外,在康复方案中需要根据患者的具体损伤选择合适的FEAT类型。例如,对于步态严重不对称的脑卒中患者,可以推荐采用髋关节辅助的FEAT,以帮助制定个性化的干预措施。
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来源期刊
Journal of Neurology
Journal of Neurology 医学-临床神经学
CiteScore
10.00
自引率
5.00%
发文量
558
审稿时长
1 months
期刊介绍: The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.
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