Robot-assisted gait training for individuals with severe acquired brain injury: a scoping review.

Robot-assisted gait training (RAGT) may help improve physical recovery and arousal in people with severe acquired brain injury who have impaired consciousness or cognitive functioning, but the evidence is limited. A scoping review of seven studies involving 162 participants found that RAGT was used mainly to support physical recovery, stimulate arousal, and ensure safety during early mobilization. Twenty-six different outcome measures were reported, indicating a lack of standardization. The review identifies a research gap: the rationales for using RAGT in this population need further investigation, and standardized outcome measures must be established. While RAGT shows potential for improving functional recovery and consciousness, future studies must address safety and feasibility while navigating ethical challenges.

Study at a glance

Abstract

Early out-of-bed mobilization is recommended for individuals with severe acquired brain injury and impaired consciousness to promote recovery. Robot-assisted gait training (RAGT) utilizes robotic assistance to facilitate neuroplastic changes through repetitive training and feedback. We aimed to map the evidence of RAGT in non-ambulatory individuals with impaired consciousness or cognitive functioning, focusing on the rationales underpinning its use and the assessment methods employed. Following the Joanna Briggs Institute and PRISMA scoping review guidelines, we systematically searched for studies involving adults with severe acquired brain injury. Source selection, data extraction, and charting were performed in duplicate. Out of 10 444 records screened, seven were included, involving 162 participants. The studies included one randomized and two non-randomized clinical trials, two retrospective studies, and two case reports. RAGT aimed to improve physical recovery (n = 6), arousal stimulation (n = 4), and safety (n = 4). Twenty-six outcome measures were reported. Our review highlights a research gap in RAGT for individuals with severe brain injury and cognitive impairments. Specifically, the underlying rationales need investigation, and standardized outcome measures must be established. RAGT shows potential in improving functional recovery and consciousness, but future studies must address safety, and feasibility while navigating ethical challenges.