Efficacy of Robot-Assisted Training Plus Acupuncture Therapy on Lower Limb Functional Recovery in Stroke Patients: A Systematic Review and Meta-Analysis

Abstract

Purpose

To assess the effectiveness of robot-assisted training (RAT) plus acupuncture therapy (AT) on lower limb functional recovery in stroke patients.

Methods

The study protocol was registered with INPLASY (INPLASY2024120107). We searched CNKI, Wanfang, VIP, CBM, PubMed, Embase, Web of Science, and Cochrane Library for RCTs comparing RAT plus AT versus conventional rehabilitation, RAT alone, or AT alone. The risk of bias was assessed using the Cochrane risk-of-bias tool 2.0.

Results

Twenty-one studies (n = 1821) were included. Meta-analyses showed RAT plus AT yielded superior improvements in FMA-LE (MD = 4.02, 95% CI [3.12, 4.93], I² = 89%), FAC (MD = 0.66, 95% CI [0.43, 0.89], I² = 86%), MBI (MD = 9.88, 95% CI [6.43, 13.33], I² = 83%), and BBS (MD = 6.79, 95% CI [5.43, 8.16], I² = 90%). Significant improvements were also observed in gait parameters: step length (MD = 7.42, 95% CI [6.48, 8.36], I² = 12%), step speed (MD = 0.16, 95% CI [0.12, 0.21], I² = 90%), and step width (MD = −2.22, 95% CI [3.96, −0.48], I² = 90%). Sensitivity analyses verified the robustness of these findings.

Conclusion

RAT plus AT effectively ameliorates post-stroke lower limb dysfunction, demonstrating superior improvements in motor function, gait parameters, and daily living activities compared to monotherapies.