Can robot-assisted gait training improve walking and activity abilities in persons with spinal cord injury? A systematic review and meta-analysis of randomized controlled trials

By
Xiaojuan Li
Jiliang Kang
Xiaohan Li
Weiping Liu
Min Tang
Xiaobo Chen
May 29, 2026
0 min

Frontiers In Neurology

Overview

This systematic review and meta-analysis evaluated the efficacy of robot-assisted gait training (RAGT) in improving mobility and activity levels in individuals with spinal cord injury (SCI). The findings indicate significant improvements in walking ability and functional independence, although no notable difference was observed in lower limb muscle strength compared to conventional rehabilitation methods.

Background

Spinal cord injury (SCI) leads to severe mobility impairments, significantly affecting quality of life and increasing rehabilitation needs. Traditional rehabilitation methods often lack the intensity and precision required for effective recovery. Robot-assisted gait training has emerged as a potential alternative, yet its advantages over conventional therapies remain debated.

Data Highlights

Outcome Measure	Robot-Assisted Gait Training	Conventional Rehabilitation	SMD (95% CI)	p-value
6-min walk test distance	Improved	Not specified	0.57 (0.12–1.03)	0.01
Spinal Cord Injury Walking Index II score	Improved	Not specified	0.49 (0.13–0.84)	0.007
Functional independence scores	Improved	Not specified	0.39 (0.05–0.72)	0.02
Lower limb motor scores	No significant difference	Not specified	0.03 (−0.27–0.34)	0.84

Key Findings

Robot-assisted gait training significantly improved the 6-min walk test distance (SMD = 0.57, p = 0.01).
Improvements in the Spinal Cord Injury Walking Index II score were also significant (SMD = 0.49, p = 0.007).
Functional independence scores showed superior improvement with robot-assisted gait training (SMD = 0.39, p = 0.02).
No significant difference was found in lower limb muscle strength improvements between the two groups (SMD = 0.03, p = 0.84).
The core mechanism of RAGT is promoting task-specific motor learning and neuromuscular control.
Robot-assisted gait training is recommended as a primary strategy for functional improvement in clinical practice.

Clinical Implications

The findings support the integration of robot-assisted gait training in rehabilitation programs for individuals with spinal cord injury to enhance walking ability and functional independence. However, it is essential to combine this approach with targeted strength training to optimize overall rehabilitation outcomes.

Conclusion

Robot-assisted gait training demonstrates effectiveness in improving mobility and functional independence in individuals with spinal cord injury, emphasizing the need for its adoption in clinical rehabilitation settings.