Effects of walking training with and without a robot and standard care on clinical and mobility outcomes: A randomized clinical trial in acute ischemic stroke patients

Tollár, József and Kóra, Szilvia and Széphelyi, Klaudia and Drotár, István and Prukner, Péter and Törő, Blanka and Prontvai, Nándor and Csutorás, Bence and Haidegger, Tamás and Hortobágyi, Tibor (2025) Effects of walking training with and without a robot and standard care on clinical and mobility outcomes: A randomized clinical trial in acute ischemic stroke patients. EXPERIMENTAL GERONTOLOGY, 210. No. 112882. ISSN 10.1016/j.exger.2025.112882

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Abstract

Background: Stroke incidence rises with age. A stroke can severely affect walking ability, requiring therapy. Robot-assisted walking therapy (ROB) has been advocated as one form of walking rehabilitation in stroke patients. However, its comparative efficacy remains controversial and three-group comparisons are scant. We compared the effects of ROB, walking training therapy without a robot (WTT) and standard treatment therapy (STT) on clinical and mobility outcomes in acute ischemic stroke patients. Methods: Individuals (n = 45, 71 % males, age 64.4y ±6.34), who have recently experienced an ischemic stroke, were randomized to ROB, WTT or STT. Clinical and mobility outcomes were assessed before and after each intervention (3 weeks, 5 sessions/week) and after 5 weeks of no-intervention follow-up. Results: Outcomes did not differ between groups at baseline (p > 0.05). Modified Rankin Scale (primary outcome), improved (p < 0.05) after ROB and WTT vs. STT. These improvements were retained relative to baseline (p < 0.05) after follow-up. Barthel index, Berg Balance Scale, 10-m walking speed, the distance while walking with and without the robot for six minutes, and center pressure velocity in standing improved most after ROB (all p < 0.001), exceeding the changes after WTT which in turn were greater than the changes after STT (p ≤ 0.040). Conclusion: Older adults shortly after an ischemic stroke can quickly learn to walk with a soft robot and retain substantial clinical and mobility improvements at follow-up.

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