[article] 
inAnnals of physical and rehabilitation medicine > Vol. 63, n°6 (November 20) . - p. 518-534

Titre :	Effects of robotic gait training after stroke : A meta-analysis
Type de document :	texte imprimé
Auteurs :	Geoffroy Moucheboeuf ; Romain Griffier ; David Gasq ; Bertrand Glize ; Laurent Bouyer ; Patrick Dehail ; Hélène Cassoudesalle
Année de publication :	2020
Article en page(s) :	p. 518-534
Note générale :	doi.org/10.1016/j.rehab.2020.02.008
Langues :	Anglais (eng)
Mots-clés :	Stroke  Robot-assisted gait training  Exoskeleton  End-effector  Gait  Walking  Rehabilitation
Résumé :	Background Robotic devices are often used in rehabilitation and might be efficient to improve walking capacity after stroke. Objective First to investigate the effects of robot-assisted gait training after stroke and second to explain the observed heterogeneity of results in previous meta-analyses. Methods All randomized controlled trials investigating exoskeletons or end-effector devices in adult patients with stroke were searched in databases (MEDLINE, EMBASE, CENTRAL, CINAHL, OPENGREY, OPENSIGLE, PEDRO, WEB OF SCIENCE, CLINICAL TRIALS, conference proceedings) from inception to November 2019, as were bibliographies of previous meta-analyses, independently by 2 reviewers. The following variables collected before and after the rehabilitation program were gait speed, gait endurance, Berg Balance Scale (BBS), Functional Ambulation Classification (FAC) and Timed Up and Go scores. We also extracted data on randomization method, blinding of outcome assessors, drop-outs, intention (or not) to treat, country, number of participants, disease duration, mean age, features of interventions, and date of outcomes assessment. Results We included 33 studies involving 1466 participants. On analysis by subgroups of intervention, as compared with physiotherapy alone, physiotherapy combined with body-weight support training and robot-assisted gait training conferred greater improvement in gait speed (+0.09 m/s, 95% confidence interval [CI] 0.03 to 0.15; p = 0.002), FAC scores (+0.51, 95% CI 0.07 to 0.95; p = 0.022) and BBS scores (+4.16, 95% CI 2.60 to 5.71; p = 0.000). A meta-regression analysis suggested that these results were underestimated by the attrition bias of studies. Conclusions Robot-assisted gait training combined with physiotherapy and body-weight support training seems an efficient intervention for gait recovery after stroke.
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[article] Effects of robotic gait training after stroke : A meta-analysis [texte imprimé] / Geoffroy Moucheboeuf ; Romain Griffier ; David Gasq ; Bertrand Glize ; Laurent Bouyer ; Patrick Dehail ; Hélène Cassoudesalle . - 2020 . - p. 518-534.
doi.org/10.1016/j.rehab.2020.02.008
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 63, n°6 (November 20) . - p. 518-534

Mots-clés :	Stroke  Robot-assisted gait training  Exoskeleton  End-effector  Gait  Walking  Rehabilitation
Résumé :	Background Robotic devices are often used in rehabilitation and might be efficient to improve walking capacity after stroke. Objective First to investigate the effects of robot-assisted gait training after stroke and second to explain the observed heterogeneity of results in previous meta-analyses. Methods All randomized controlled trials investigating exoskeletons or end-effector devices in adult patients with stroke were searched in databases (MEDLINE, EMBASE, CENTRAL, CINAHL, OPENGREY, OPENSIGLE, PEDRO, WEB OF SCIENCE, CLINICAL TRIALS, conference proceedings) from inception to November 2019, as were bibliographies of previous meta-analyses, independently by 2 reviewers. The following variables collected before and after the rehabilitation program were gait speed, gait endurance, Berg Balance Scale (BBS), Functional Ambulation Classification (FAC) and Timed Up and Go scores. We also extracted data on randomization method, blinding of outcome assessors, drop-outs, intention (or not) to treat, country, number of participants, disease duration, mean age, features of interventions, and date of outcomes assessment. Results We included 33 studies involving 1466 participants. On analysis by subgroups of intervention, as compared with physiotherapy alone, physiotherapy combined with body-weight support training and robot-assisted gait training conferred greater improvement in gait speed (+0.09 m/s, 95% confidence interval [CI] 0.03 to 0.15; p = 0.002), FAC scores (+0.51, 95% CI 0.07 to 0.95; p = 0.022) and BBS scores (+4.16, 95% CI 2.60 to 5.71; p = 0.000). A meta-regression analysis suggested that these results were underestimated by the attrition bias of studies. Conclusions Robot-assisted gait training combined with physiotherapy and body-weight support training seems an efficient intervention for gait recovery after stroke.
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