Electromechanical-assisted gait training after stroke: a systematic review comparing end-effector and exoskeleton devices.

OBJECTIVES Although electromechanical-assisted gait training after stroke seems to be effective, in the absence of a direct comparison between electromechanical devices it is not clear which device may be the most effective for recovery of walking. The aim of this study was therefore to compare the effects of different devices used in gait training after stroke. DATA SOURCES We searched the Cochrane Stroke Group Trials Register, CENTRAL, MEDLINE, EMBASE, CINAHL, AMED, SPORTDiscus, PEDro, COMPENDEX and INSPEC. In addition, we hand-searched relevant conference proceedings, trials and research registers, checked reference lists and contacted authors to identify further trials. STUDY SELECTION Randomized studies were included. Authors independently selected trials for inclusion, assessed trial quality and extracted the data. DATA EXTRACTION Data were extracted with the help of a standardized data extraction form. DATA SYNTHESIS Data were pooled for meta-analysis. The primary outcome was the proportion of patients walking independently. RESULTS We included 18 trials involving 885 patients. We found significantly higher rates of independent walking in end-effector compared with exoskeleton-based training (p = 0.03). Complication rates in both groups were comparable. CONCLUSION The results suggest that the type of electromechanical-assisted device might influence the outcome of gait rehabilitation after stroke.