Key Takeaways & Executive Findings
- •• Robot-assisted walking training significantly improves balance, walking ability, and gait parameters in Parkinson's disease patients. • Interventions lasting 8 weeks or more yield greater improvements in walking endurance and dynamic balance. • The training increases gait speed by an average of 0.04 m/s and stride length by 9.11 cm. • Robot-assisted walking training is a promising rehabilitation approach for lower limb motor dysfunction in Parkinson's disease.
Abstract
OBJECTIVE: Studies have confirmed that robot-assisted walking training can effectively improve motor function in patients with neurological diseases such as stroke, spinal cord injury, and multiple sclerosis. Currently, different robot-assisted gait training devices differ in design and function, but their impact on Parkinson's disease patients remains unclear. Different robots can provide different motion parameters, motion frequencies, and training modes, but related research is scarce. Therefore, this article systematically evaluates the impact of robot-assisted walking training on lower limb motor function in Parkinson's disease patients. METHODS: Randomized controlled trials addressing the impact of robot-assisted walking training on lower limb motor function in Parkinson's disease patients were searched in English databases (PubMed, Web of Science, Embase, Cochrane Library) and Chinese databases (CNKI, VIP, Wanfang) from inception to April 20, 2025. Methodological quality was assessed using the Cochrane Risk of Bias tool, and meta-analysis was performed using RevMan 5.3 software. RESULTS: A total of 12 studies involving 526 patients were included. Meta-analysis showed that compared with the control group, robot-assisted walking training significantly improved Berg Balance Scale scores (MD=4.08, 95%CI 2.59 to 5.58, P<0.00001), Activities-specific Balance Confidence Scale scores (MD=4.31, 95%CI 2.97 to 5.83, P<0.00001), 6-minute walk test distance (MD=32.62, 95%CI 13.41 to 51.83, P=0.0009), Timed Up and Go test time (MD=-1.88, 95%CI -2.58 to -1.18, P<0.00001), cadence (MD=2.98, 95%CI 0.67 to 5.29, P=0.01), stride length (MD=9.11, 95%CI 7.06 to 11.15, P<0.00001), gait speed (MD=0.04, 95%CI 0.02 to 0.06, P=0.0001), Unified Parkinson's Disease Rating Scale part II score (MD=-2.05, 95%CI -2.55 to -1.55, P<0.00001), and part III score (MD=-3.73, 95%CI -4.17 to -3.29, P<0.00001). CONCLUSION: Robot-assisted walking training can effectively improve lower limb motor function in Parkinson's disease patients, specifically enhancing balance and walking ability, and improving gait parameters. Notably, intervention periods of 8 weeks or more showed greater improvements in walking endurance (6-minute walk test) and dynamic balance (Timed Up and Go test), with an average increase in gait speed of 0.04 m/s and stride length of 9.11 cm. However, large-sample, high-quality randomized controlled trials are still needed for further verification.
1. Introduction
Parkinson's disease is a common neurodegenerative disorder in the elderly, characterized by the loss of dopaminergic neurons in the substantia nigra pars compacta, manifesting as motor and non-motor symptoms. Motor dysfunction often presents as balance disorders, bradykinesia, postural instability, and gait abnormalities. The lower limb motor dysfunction is primarily related to abnormalities in the basal ganglia-cortical loop, where reduced regulation of motor cortex leads to difficulty in gait initiation, shortened stride length, and decreased balance stability. Approximately 85% of Parkinson's disease patients have gait abnormalities, and the risk of falls is three times higher than in healthy elderly individuals. This significantly increases fall risk, reduces activities of daily living and social participation, and severely impacts quality of life. Therefore, alleviating motor dysfunction in Parkinson's disease has become an urgent issue.
With the advancement of artificial intelligence, biomedical engineering, and robotics, rehabilitation robots have gradually become a common clinical rehabilitation technique. Robot-assisted walking training uses exoskeletons or end-effectors to support body weight and control the trunk, reproducing normal gait kinematics, gait cycles, and inter-limb and joint coordination through pre-programmed walking patterns. These preset gait patterns can increase the activity of dopaminergic neurons in the substantia nigra pars compacta, enhance the function of motor control loops, and stimulate the release of brain-derived neurotrophic factor and regulate neurotransmitter receptor activity, thereby aiding neuronal repair and neural network reconstruction to improve motor control loops and correct basal ganglia-cortical loop abnormalities. This increases motor cortex excitability, improving gait initiation delay and promoting recovery of normal motor function. Currently, robot-assisted walking has been used in rehabilitation training for neurological patients, with proven efficacy in improving motor function in spinal cord injury, stroke, and multiple sclerosis. However, the effects of robot-assisted walking training on balance, walking ability, and abnormal gait in Parkinson's disease patients remain controversial due to differences in device types, intervention durations, parameters, and disease severity. Previous systematic reviews have not reached consistent conclusions, and this meta-analysis aims to systematically evaluate the impact of robot-assisted walking training on lower limb motor function in Parkinson's disease patients.
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Ren Yi, Wang Qing, Yu Shaohong, Qiu Zhengang (2026). Meta-analysis of robot-assisted walking training on lower limb motor function improvement in Parkinson's disease patients. Chinese Journal of Tissue Engineering Research. https://doi.org/10.12307/2026.21374
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Frequently Asked Questions
What is robot-assisted walking training?
Robot-assisted walking training uses exoskeletons or end-effectors to support body weight and control the trunk, providing pre-programmed gait patterns to reproduce normal gait kinematics and improve motor function.
How does robot-assisted walking training benefit Parkinson's disease patients?
It improves balance, walking ability, and gait parameters such as speed and stride length, as shown in this meta-analysis.
What is the recommended duration for robot-assisted walking training?
Interventions of 8 weeks or more showed greater improvements in walking endurance and dynamic balance.
Are there any side effects of robot-assisted walking training?
The included studies did not report significant adverse effects, but individual responses may vary; it should be performed under professional supervision.
Is robot-assisted walking training suitable for all Parkinson's disease patients?
It may be suitable for many patients, but individual factors such as disease severity and comorbidities should be considered; consultation with a healthcare provider is recommended.
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