Effects of robot-assisted training on balance function in patients with stroke: A systematic review and meta-analysis.

OBJECTIVE To investigate the effectiveness of robot-assisted therapy on balance function in stroke survivors. DATA SOURCES PubMed, the Cochrane Library, Embase and China National Knowledge Infrastructure databases were searched systematically for relevant studies. STUDY SELECTION Randomized controlled trials reporting robot-assisted therapy on balance function in patients after stroke were included. DATA EXTRACTION Information on study characteristics, demographics, interventions strategies and outcome measures were extracted by 2 reviewers. DATA SYNTHESIS A total of 19 randomized trials fulfilled the inclusion criteria and 13 out of 19 were included in the meta-analysis. Analysis revealed that robot-assisted therapy significantly improved balance function assessed by berg balance scale (weighted mean difference (WMD) 3.58, 95% confidence interval (95% CI) 1.89-5.28, p < 0.001) compared with conventional therapy. Secondary analysis indicated that there was a significant difference in balance recovery between the conventional therapy and robot-assisted therapy groups in the acute/subacute stages of stroke (WMD 5.40, 95% CI 3.94-6.86, p < 0.001), while it was not significant in the chronic stages. With exoskeleton devices, the balance recovery in robot-assisted therapy groups was significantly better than in the conventional therapy groups (WMD 3.73, 95% CI 1.83-5.63, p < 0.001). Analysis further revealed that a total training time of more than 10 h can significantly improve balance function (WMD 4.53, 95% CI 2.31-6.75, p < 0.001). No publication bias or small study effects were observed according to the Cochrane Collaboration tool. CONCLUSION These results suggest that robot-assisted therapy is an effective intervention for improving balance function in stroke survivors.