The effect of robot-assisted gait training on physical activity outcomes in people with spinal cord injury: a systematic review
The effect of robot-assisted gait training on physical activity outcomes in people with spinal cord injury: a systematic review
Objective: to summarise the evidence for changes in physical activity outcomes during robot-assisted gait training in patients with spinal cord injury.
Data sources: the Web of Science, Physiotherapy Evidence Database, Central, Medline, Scopus and SportDiscus databases were searched in August 2025 for studies that recorded ≥1 physical activity outcome during robot-assisted gait training.
Review methods: data were synthesised according to the Synthesis Without Meta-analysis guidelines. Risk of bias was assessed using the Physiotherapy Evidence Database scale or the Revised Risk of Bias Assessment Tool for Non-Randomised Studies. Certainty of evidence was established following the Grading of Recommendations, Assessment, Development and Evaluations framework. The report followed the Preferring Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Results: thirty studies (638 participants) were eligible for inclusion. Quality of the randomised studies ranged from ‘Fair’ to ‘Good’, while there was high risk of bias for all non-randomised studies in ≥1 domain. Robot-assisted gait training significantly improved physical activity outcomes (up time, walk time, walk distance, walk speed and number of steps) over time, though these findings were constrained by very low certainty of evidence.
Conclusion: up time, walk time, walk distance, walk speed, and number of steps were significantly improved across the robot-assisted gait training period for patients with spinal cord injury. Robot-assisted gait training during rehabilitation for people following spinal cord injury is a useful adjunct to support independence and improved walking ability.
Spinal cord injury, exercise training, exertion, exoskeleton, functional outcome, gait, robot-assisted gait training, walk test
Belsey, James
e80f02d4-839c-4aef-ad92-f6ab1f861e76
Reid, Andrew
b4433255-8adc-4308-b5f9-50fa2b2c1d8a
Hannah, Scott
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Johnson, Louise
ee3acfbc-7a9b-4ff4-b748-29d75a1a61a1
Faulkner, James
b2bd38c9-667c-42e8-ad1e-6df58d1e3f7a
Belsey, James
e80f02d4-839c-4aef-ad92-f6ab1f861e76
Reid, Andrew
b4433255-8adc-4308-b5f9-50fa2b2c1d8a
Hannah, Scott
bfea6350-6f45-4317-b504-849b8c933101
Johnson, Louise
ee3acfbc-7a9b-4ff4-b748-29d75a1a61a1
Faulkner, James
b2bd38c9-667c-42e8-ad1e-6df58d1e3f7a
Belsey, James, Reid, Andrew, Hannah, Scott, Johnson, Louise and Faulkner, James
(2026)
The effect of robot-assisted gait training on physical activity outcomes in people with spinal cord injury: a systematic review.
Clinical Rehabilitation.
(doi:10.1177/02692155251411864).
Abstract
Objective: to summarise the evidence for changes in physical activity outcomes during robot-assisted gait training in patients with spinal cord injury.
Data sources: the Web of Science, Physiotherapy Evidence Database, Central, Medline, Scopus and SportDiscus databases were searched in August 2025 for studies that recorded ≥1 physical activity outcome during robot-assisted gait training.
Review methods: data were synthesised according to the Synthesis Without Meta-analysis guidelines. Risk of bias was assessed using the Physiotherapy Evidence Database scale or the Revised Risk of Bias Assessment Tool for Non-Randomised Studies. Certainty of evidence was established following the Grading of Recommendations, Assessment, Development and Evaluations framework. The report followed the Preferring Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Results: thirty studies (638 participants) were eligible for inclusion. Quality of the randomised studies ranged from ‘Fair’ to ‘Good’, while there was high risk of bias for all non-randomised studies in ≥1 domain. Robot-assisted gait training significantly improved physical activity outcomes (up time, walk time, walk distance, walk speed and number of steps) over time, though these findings were constrained by very low certainty of evidence.
Conclusion: up time, walk time, walk distance, walk speed, and number of steps were significantly improved across the robot-assisted gait training period for patients with spinal cord injury. Robot-assisted gait training during rehabilitation for people following spinal cord injury is a useful adjunct to support independence and improved walking ability.
Text
SCI review manuscript draft v3.2
- Accepted Manuscript
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belsey-et-al-2026-the-effect-of-robot-assisted-gait-training-on-physical-activity-outcomes-in-people-with-spinal-cord
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More information
Accepted/In Press date: 15 December 2025
e-pub ahead of print date: 18 February 2026
Keywords:
Spinal cord injury, exercise training, exertion, exoskeleton, functional outcome, gait, robot-assisted gait training, walk test
Identifiers
Local EPrints ID: 509475
URI: http://eprints.soton.ac.uk/id/eprint/509475
ISSN: 0269-2155
PURE UUID: 8ac8f96d-b273-4942-8dfa-a3da35439a26
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Date deposited: 24 Feb 2026 17:37
Last modified: 07 Mar 2026 04:24
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Contributors
Author:
James Belsey
Author:
Andrew Reid
Author:
Scott Hannah
Author:
Louise Johnson
Author:
James Faulkner
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