Psychosocial Outcomes in Robotic Gait Training in Stroke Survivors: A Narrative Review
Abstract
Stroke survivors frequently identify walking independence, safety, and confidence as top rehabilitation priorities; however, most research on robot-assisted gait training (RAGT) emphasizes physical outcomes like gait speed and balance over psychosocial dimensions. This narrative review aimed to synthesize the evidence on patient priorities, fear of falling (FoF), balance confidence, health-related quality of life (HRQoL), participation, and caregiver outcomes within the context of RAGT after stroke. A literature search of PubMed, Scopus, Web of Science, and CINAHL up to June 2025 identified 20 relevant studies. The results indicate that while stroke survivors consistently prioritize walking independence, FoF remains highly prevalent and strongly correlates with activity restriction. Emerging data suggest that combining RAGT with balance training yields significantly greater improvements in balance confidence and falls efficacy compared to balance training alone. Furthermore, improved walking independence through robotic interventions shows potential in reducing physical and emotional caregiver burden. In conclusion, RAGT has the potential to influence psychosocial outcomes when embedded within person-centered, participation-oriented rehabilitation. Future trials should routinely incorporate measurements of confidence and HRQoL to align robotic training with the outcomes that matter most to survivors and their families.
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Dromerick AW, Lang CE, Birkenmeier R. Stroke survivors’ priorities for recovery: a qualitative study. Arch Phys Med Rehabil 2023;104:1012-20.
Reddy KSS, Varadaraj P, Senthilnathan S, Vivekanandan T, Gunasekaran N. Evaluating the coagulation parameters in acute ischemic versus hemorrhagic stroke patients upon hospital admission. Rom J Med Pract 2024;19:257-62.
Kakumani J, Geetha NK, Kumar A. Prognostic significance of microalbuminuria in non-diabetic patients with acute ischemic stroke. Rom J Neurol 2024;23:256-60.
Gunduz MS, Mustafaoglu R, Ural IH. Effects of robot-assisted gait training on balance and fear of falling in patients with stroke: a randomized controlled clinical trial. Am J Phys Med Rehabil 2025;104:558-66. PubMed
Ha Y, Park M. Effects of stroke rehabilitation using gait robot-assisted training and person-centered goal setting: a single blinded pilot study. Healthcare (Basel) 2023;11:588. PubMed
van Nimwegen D, Hjelle EG, Bragstad LK, Kirkevold M, Sveen U, Hafsteinsdottir T, et al. Interventions for improving psychosocial well-being after stroke: a systematic review. Int J Nurs Stud 2023;142:104492. PubMed
Venugopal A, Subramanian SS, Sahal M, Bai P, GN J. Mirror therapy versus dual-task training on motor functions in MCA. Phys Rehabil Recreat Health Technol 2025;10:300-7. phrir.com
Maruvada SS, Sornavalli V, Poonambalaganapathi, Sankar AG. Mini mental state examination (MMSE) as a predictor of cognitive recovery in acute stroke. Rom J Neurol 2025;24:20-6.
Moore SA, Boyne P, Fulk G, Verheyden G, Fini NA. Walk the talk: current evidence for walking recovery after stroke, future pathways and a mission for research and clinical practice. Stroke 2022;53:3494-505. PubMed
Lee JH, Kim G. Effectiveness of robot-assisted gait training in stroke rehabilitation: a systematic review and meta-analysis. J Clin Med 2025;14:4809. PubMed
Hu MM, Wang S, Wu CQ, Li KP, Geng ZH, Xu GH, et al. Efficacy of robot-assisted gait training on lower extremity function in subacute stroke patients: a systematic review and meta-analysis. J Neuroeng Rehabil 2024;21:165. PubMed
Manickavasagam I, Srinivasan V, Umasankar Y, Alagesan J. Preliminary effects of robotic-assisted gait training in post-stroke patients: a pilot study. Bangabandhu Sheikh Mujib Med Univ J 2025;18:e84607.
Baronchelli F, Zucchella C, Serrao M, Intiso D, Bartolo M. The effect of robotic assisted gait training with Lokomat on balance control after stroke: systematic review and meta-analysis. Front Neurol 2021;12:661815. PubMed
Muto K, Shiratsuchi D, Nanbu K, Sakamoto H, Furuya N, Nakamura K, et al. Ability to walk 10 m within the first week of stroke predicts independent outdoor walking and destination. J Stroke Cerebrovasc Dis 2023;32:107145. PubMed
Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39:142-8.
Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Todd C. Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age Ageing 2005;34:614-9. PubMed
Powell LE, Myers AM. The Activities-specific Balance Confidence (ABC) scale. J Gerontol A Biol Sci Med Sci 1995;50:M28-34. PubMed
Xie Q, Pei J, Gou L, Zhang Y, Zhong J, Su Y, et al. Risk factors for fear of falling in stroke patients: a systematic review and meta-analysis. BMJ Open 2022;12:e056340. PubMed
Yaqoob E, Khan S, Sahitia N, Barkatullah Z, Zaidi DA, Khan SA, et al. Caregiver burden in stroke care: identifying predictors and effective interventions - a narrative review. Ann Med Surg (Lond) 2025;87:3458-63. PubMed
da Silva EP, Mallagoli ISS, Piccinelli ECS, Oliveira MAN, Passos KG, Belasco AGS. Burden and quality of life of caregivers of individuals with stroke in the Western Amazon. Rev Bras Med Trab 2025;23:e20251379.
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