Table 4.
Summary of efficacy of BWSTT exoskeleton-assisted gait training
| 4.1 BSWTT-RAGT vs BSWTT-TAGT | |||||
|---|---|---|---|---|---|
| Author | Hornby et al. [35] | Belas Dos Santos et al. [36] | Lewek et al. [38] | Westlake et al. [39] | |
| Additional treatment provided | N/A | Conventional PT | N/A | N/A | |
| Results in BSWTT-RAGT groups (pre, post change, p < 0.05) | Body function/structure level |
SSV + 0.07, d = 0.29 FV + 0.06, d = 0.19 |
SARA − 3.5, d = 0.49 BBS + 5.8, d = 0.31 TUG − 0:19 s, d = 0.64 |
No change |
FMLE + 2.6, d = 0.56, BBS + 1.4, d = 0.2 SS + 0.01 m/s, d = 0.29 FV + 0.09 m/s, d = 0.15 SLR (abs) − 0.16, d = 0.31 |
| Activity level | – | FIM + 4.6, d = 0.34 | – | – | |
| Results between groups (p < 0.05) | BWSTT-TAGT group showed greater improvements in SSV + 0.06 m/s, d = 0.65, FV + 0.07 m/s, d = 0.69, Single limb stance time at FV: + 2.4 ± 3.7%, d = 0.91 | No significant difference | No significant difference | No significant difference | |
| 4.2 BSWTT-RAGT vs BSWTT-RAGT with combination therapy | |||
|---|---|---|---|
| Author | Danzl et al. [40] | Bae et al. [41] | |
| Additional treatment provided | tDCS for experimental group |
FES for experimental group Conventional PT |
|
| Results in BSWTT-RAGT groups (pre, post change, p < 0.05) | Body function/structure level | 10MWT + improved |
MAS + 1.92, d = 0.27 TUG − 5.63 s, d = 0.38 BBS + 3.43, d = 0.41 Gait speed + 0.007 m/s, d = 0.47 Step length + 0.05, d = 0.43 Stride length + 0.33, d = 0.33 Maximal Knee flexion + 18.747 d = 1.07 Maximal Knee flexion + 6.904 d = 0.58 |
| Activity level |
FAC + improved SIS-16 + improved |
– | |
| Results between groups (p < 0.05) | BSWTT-RAGT with active tDCS group showed greater improvement than the sham group in 10MWT, FAC, and SIS-16 measures except BBS | BSWTT-RAGT with FES group showed a significantly greater in Maximal Knee flexion + 8.97, d = 0.56 | |
| 4.3 BSWTT-RAGT vs BWSTT | |||
|---|---|---|---|
| Author | Ogino et al. [42] | Ogino et al. [43] | |
| Additional treatment provided | N/A | N/A | |
| Results in BSWTT-RAGT groups (pre, post change, p < 0.05) | Body function/structure level |
GRC scale (change of gait) + improved |
10MWT + 0.09 m/s |
| Activity level | – | – | |
| Results between groups (p < 0.05) | No significant difference | BSWTT-RAGT group were significantly improved in TUG (r = 0.57), 6-min walk (r = 0.51) and score of general health in SF-8 (r = 0.49) | |
| 4.4 Other | ||||
|---|---|---|---|---|
| Author | Assist unaffected limb vs affected limb | HRR vs RPE guided BSWTT-RAGT | BSWTT-RAGT vs Conventional PT | |
| Seo et al. [37] | Bae et al. [44] | Erbil et al. [45] | ||
| Additional treatment provided | N/A | N/A |
Conventional PT BoNT-A |
|
| Results in BSWTT-RAGT groups (pre, post change, p < 0.05) | Body function/structure level |
Assist US: FMLE + 3.2, d = 1.18 MI + 11.7, d = 2.32 Step length asymmetry ratio -0.2, d = 2.0 Hip maximal extension moment (US) -0.5, d = 1.79 Assist AS: FMLE + 2.7, d = 1.29 Ankle maximal dorsiflexion angle (US) -8.9, d = 3.26 |
HRR guided: FMLE + 3.67, d = 0.23, 10MWT + 0.22 m/s, d = 0.80, WS + 0.20 m/s, d = 1.53 And Improved in Stride length, Cadence, Single and Double support rate, Swing time, Stance time, Step length, and Symmetrical index RPE guided: FMLE + 2.20, d = 0.63, 10MWT + 0.13 m/s, d = 0.41, WS + 0.14 m/s, d = 0.14 And Improved in Stride length, Cadence, Single support rate Single and Double support rate, Swing time, Stance time, Step length, Symmetrical index |
MAS − 1.5, d = 2.94 Tardieu Scale (spasticity grade) − 0.2, d = 0.44 BBS + 2.7, d = 0.29 TUG + 5.7, d = 0.66 |
| Activity level | Assist US: FAC + 0.7, d = 2.33 | – | RVGA + 5.3, d = 1.0 | |
| Results between groups (p < 0.05) | No significant difference | HRR-guided group showed significantly improved in compared to RPE-guided group in FMLE, 10MWT, WS, Stride length, Cadence, Single support rate, Single and Double support rate, Swing time, Symmetrical index | BSWTT-RAGT group is significantly higher in TUG, BBS, and RVGA | |
Each study was categorised according to the characteristics of the comparison group under investigation. The results of BWSTT-RAGT intervention groups in pre-post change (p < 0.05) and results compared to the control group are shown. Descriptive values are presented as the mean change and d describes effect size. Results were categorised as Body function/structure level and Activity level [55, 56]. RAGT Robot-assisted gait training, TAGT Therapist-assisted gait training, BWSTT Body-Weight Supported Treadmill Training, PT Physiotherapy, AS Affected side, US Unaffected side, BBS Berg balance scale, BWS body weight support, FAC Family Assistance Centre, FIM Functional Independence Measure, FMLE, Functional Mobilisation Lower Extremities; MMAS Modified Motor Assessment Scale, SARA Scale for Assessment and Rating of Ataxia, TUG Timed Up and Go, RVGA Rivermead Visual Gait Assessment, WS walking speed, FES functional electrical stimulation, GRC scale Global rating of change scale