Abstract Details

Title Robot-assisted Gait Training in Cerebral Palsy: A Systematic Review, Meta-analysis, and Trial Sequential Analysis of Randomized Controlled Trials

Topic Child Neurology and Developmental Neurology

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 8-011

Objective To assess the efficacy of robot-assisted gait training (RAGT) versus conventional physiotherapy in cerebral palsy.

Background Cerebral palsy (CP) is the leading cause of chronic childhood disability, often marked by gait impairments that limit mobility and independence. RAGT offers intensive, repetitive practice with less therapist burden, but its effectiveness on gait, balance, and function in CP remains uncertain due to conflicting evidence.

Design/Methods

We performed a systematic review and meta-analysis of RCTs comparing RAGT with conventional therapy in patients with CP. Primary outcomes included gait, balance, and gross motor function. Study quality was assessed using the ROB 2 and GRADE frameworks. Meta-analysis was conducted using R, applying fixed- or random-effects models based on heterogeneity, with sensitivity, publication bias, and Trial Sequential Analysis to evaluate the robustness of findings.

Results A total of 15 studies involving 537 participants (239 girls and 298 boys; mean age 9.8 years) were included. Overall, robot-assisted gait training (RAGT) did not demonstrate superiority over conventional therapy. Meta-analyses showed significantly smaller improvements with RAGT in GMFM-88 Dimension D (MD –2.91, 95% CI –5.43 to –0.39) and Dimension E (MD –4.73, 95% CI –7.67 to –1.79), both favoring conventional physiotherapy. Similarly, 6MWT distance improvements were significantly greater in controls compared with RAGT (MD –17.52 m, 95% CI –27.34 to –7.70). Other gait parameters, including hip range of motion, stride length, walking speed, and balance scales, showed no significant between-group differences. Trial sequential analysis confirmed robust evidence in favor of conventional physiotherapy for GMFM-88 Dimension E and 6MWT, while evidence for other outcomes remained inconclusive.

Conclusions

RAGT provides comparable improvements to conventional therapy in most motor, gait, and balance outcomes for children with CP, with physiotherapy showing modest advantages in walking distance and GMFM-88 Dimension E. Further trials are needed to confirm benefits for other outcomes.

Authors/Disclosures
Hossam Younis, MD, MBBS PRESENTER	Dr. Younis has nothing to disclose.
Alzahra'a M. Al matairi II, Medical student	Miss Al matairi has nothing to disclose.
Omar Abuhashem, MD	Dr. Abuhashem has nothing to disclose.
Bara M. Hammadeh	Mr. Hammadeh has nothing to disclose.
Bana S. Al Najjar, MD	Miss Al Najjar has nothing to disclose.
Mohamad Ezzeldin, MD (Rush University Medical Center)	Dr. Ezzeldin has nothing to disclose.

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