Meta-analysis of the efficacy of lower robot-assisted gait training on lower limb function in children with cerebral palsy
- HUANG Xinping, WU Juanmei, WU Yingying, XIE Hongxiang, CHEN Fangchuan
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Objective To study the efficacy of robot-assisted gait training (RAGT) on lower limb function in children with cerebral palsy through systematic review, in order to provide evidence-based reference for the application of lower robot-assisted gait training. Methods The randomized controlled trials on robotic gait training for lower limb rehabilitation in children with cerebral palsy were retrieved through CNKI, VIP, Wanfang, PubMed, Embase, and Cochrane Library, which were published from inception to September 2022. Two researchers independently screened the literature according to the inclusion and exclusion criteria, and completed the process of data extraction, checking the data and quality evaluation. RevMan5.3 was used to perform Meta-analysis and present the related results for gross motor functions, including standing, walking, running and jumping (GMFM-D, GMFM-E), muscle tone (MAS), balance function (BBS), step speed, and step length. Results A total of 16 randomized controlled trials with 759 children with cerebral palsy were included in this study. The control group received conventional rehabilitation therapy, while the experimental group was given RAGT/RAGT additionally. Compared with the control group, after RAGT, the GMFM-D raw score (MD=5.53, 95%CI:4.47 - 6.60, P<0.01), GMFM-D percentage (MD=11.46, 95%CI:6.75 - 16.17,P<0.01), and GMFM-E raw score (MD=8.41, 95%CI:5.31 - 11.51, P<0.01), GMFM-E percentage (MD=11.20, 95%CI:6.14 - 16.26, P<0.01), GMFM D+E total score (MD=9.93, 95%CI:5.78 - 14.08, P<0.01), MAS score (MD=-0.45, 95%CI:―0.51 - ―0.38, P<0.01), BBS score (MD=5.90, 95%CI:3.60 - 8.20, P<0.01), and stride speed (MD=4.03, 95%CI:0.94 - 7.11, P=0.01) of children in the experimental group all improved with significant differences (P>0.05), but there was no statistically significant difference in step length (MD=0.40, 95%CI:-0.02 - 0.82, P=0.06) between the two groups. Conclusions RAGT has a positive effect on lower limb function in children with cerebral palsy, but there is heterogeneity in the existing studies. Therefore, randomized controlled trials with large samples and rigorous intervention protocols are warranted in the future.