Mapping the Role of Robot-Assisted Gait Training in Post-Stroke Recovery Among Elderly Patients: A Scoping Review.

Background/

Objective: Stroke is one of the leading causes of death and disability worldwide, with older survivors (aged > 65 years) bearing significant health and economic impacts, particularly in industrialized countries. While gait rehabilitation is a cornerstone in post-stroke recovery and robotic technologies offer promising tools to enhance its effectiveness, the existing literature has largely overlooked elderly populations. Most studies on robot-assisted gait training (RAGT)-which uses exoskeleton or end-effector devices to support and guide movement-either exclude older adults or do not analyze their outcomes separately. This review aims to critically evaluate the current evidence on RAGT in elderly post-stroke patients, addressing a significant gap in the literature and providing novel insights into the effectiveness and adaptability of RAGT for this specific population.

Methods: The search included databases such as PubMed, Scopus, Embase, Web of Science, and ClinicalTrials. The inclusion criteria covered studies published up to March 2025, focusing on post-stroke individuals aged >65 years, who underwent RAGT.

Results: 25 studies were included in the review, 21 involving exoskeleton and 4 end-effector devices. The primary focus was on motor outcomes, such as gait independence, gait parameters, and balance control. Only a few studies examined non-motor aspects, including cognitive and emotional functions, fatigue, pain, and neuroplasticity. Moreover, data on the long-term effects on the elderly population remain scarce.

Conclusions: RAGT is an effective strategy for promoting motor recovery and improving functional outcomes, from independence in daily activities to quality of life, in the post-stroke elderly population. Early and high-intensity interventions are particularly useful with positive effects on neuronal plasticity, cognitive function, and well-being.