Journal of Multiple Sclerosis

Comparison Between the Outcomes of Robot-Assisted Gait Training (RAGT) and Conventional Walking Training (CWT) in patients with Multiple Sclerosis (MS): A Systematic Review and Meta-Analysis

Javed Iqbal, Yumna Salman, Zaitoon Zafar, Saad Khalid, Muhammad Hassan Hafeez, Hafsa Shahid, Salman Sani, Abdullah Nadeem, Dalia Mehmood, Ahmer Ashraf, Dua Aijaz Siddiqui and Mohammad Ashraf*

Introduction: Robotic technology and physical therapy are of paramount significance for treating gait impairment in Multiple Sclerosis (MS) patients. However, there is still a lack of comparative studies between these two approaches. This systematic review and meta-analysis compares the effectiveness of Robot-assisted Gait Training (RAGT) with Conventional Walking Training (CWT) in MS patients.

Method: Following PRISMA guidelines, a comprehensive literature search was done through Pubmed/Medline, Google Scholar, Cochrane library, and ClinicalTrials.gov registry from 2001 to 2023. After careful screening, 14 articles of highly significant variables were involved in synthesising this meta-analysis. Data analysis was done through Review Manager (RevMan, Version 5.4.1; The Cochrane Collaboration, Copenhagen, Denmark).

Result: In our review, 14 studies comprising 457 subjects were shortlisted, of which 233 participants belonged to the Robot-Assisted Gait Training (RAGT) group, and 224 participants belonged to the Conventional Walking Training (CWT) group. The mean age of study participants in the RAGT and control groups is 51.67 ± 10.67 years and 52.36 ± 10.83 years, respectively. These studies' male and female populations were 35.66% and 57.33%, respectively. Our analysis showed that RAGT and CWT are equally effective in improving most outcomes. However, RAGT may be more effective than CWT in improving gait speed (MD, 23.65; 95% CI, 0.81, 46.50; P = 0.04; I2 = 74%), as measured by the six-minute walk test.

Conclusion: Our findings suggest that RAGT could be a viable alternative to CWT for MS patients with difficulty walking. Hence this study serves as a foundation for future investigations that minimize the study’s limitations to provide a more robust conclusion. Future research should aim to replicate our findings and investigate RAGT and CWT's long-term effects on MS patients.