Unveiling the Clinical Impact of Lower Limb Robotic Devices in Neurorehabilitation: An Umbrella Review.
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PURPOSE: This umbrella review aimed to assess the effectiveness of lower extremity robotic devices in clinical settings by analyzing motor and non-motor rehabilitation outcomes across different neurological conditions, including stroke, spinal cord injury, multiple sclerosis, and Parkinson's disease. METHODS: A systematic search of literature published in English over the past twelve years was conducted using four major databases (PubMed, Scopus, Cochrane Library, and Web of Science). The search focused on reviews addressing the use of lower-limb robotic devices in patients with neurological diseases. Only reviews that followed standardized protocols and reported quantitative motor and/or non-motor rehabilitation outcomes were included. Extracted information included demographic characteristics, experimental procedures, and numerical outcomes related to motor and non-motor functions (e.g., walking test scores, clinical scale ratings). RESULTS: A total of 33 reviews met the inclusion criteria. Stroke was the most frequently studied condition, whereas Parkinson's disease and multiple sclerosis were rarely addressed. Findings related to stroke suggested that robotic rehabilitation may provide benefits over conventional therapy, with statistically significant improvements in some cases. In contrast, evidence for spinal cord injury, Parkinson's disease, and multiple sclerosis was limited and inconsistent. CONCLUSIONS: Overall, lower-limb robotic devices show promise in neurorehabilitation, particularly for post-stroke recovery. However, further research is required to standardize intervention protocols, assess cost-effectiveness, and better understand patient and therapist experiences to support broader clinical adoption.