Background: Balance impairment is a common disability in post-stroke survivors, leading to reduced mobility and increased fall risk. Robotic gait training (RAGT) is largely used, along with traditional training. There is, however, no strong evidence about RAGT superiority, especially on balance. This study aims to determine RAGT efficacy on balance of post-stroke survivors. Methods: PubMed, Cochrane Library, and PeDRO databases were investigated. Randomized clinical trials evaluating RAGT efficacy on post-stroke survivor balance with Berg Balance Scale (BBS) or Timed Up and Go test (TUG) were searched. Meta-regression analyses were performed, considering weekly sessions, single-session duration, and robotic device used. Results: A total of 18 trials have been included. BBS pre-post treatment mean difference is higher in RAGT-treated patients, with a pMD of 2.17 (95% CI 0.79; 3.55). TUG pre-post mean difference is in favor of RAGT, but not statistically, with a pMD of −0.62 (95%CI − 3.66; 2.43). Meta-regression analyses showed no relevant association, except for TUG and treatment duration (β = −1.019, 95% CI − 1.827; −0.210, p-value = 0.0135). Conclusions: RAGT efficacy is equal to traditional therapy, while the combination of the two seems to lead to better outcomes than each individually performed. Robot-assisted balance training should be the focus of experimentation in the following years, given the great results in the first available trials. Given the massive heterogeneity of included patients, trials with more strict inclusion criteria (especially time from stroke) must be performed to finally define if and when RAGT is superior to traditional therapy.

Objectives: We assessed the difference between quiet stance and gait in the spatial distribution and intensity of foot plantar pressures and whether it is possible to estimate the distribution during gait from data obtained during stance. Methods: A total of 60 healthy subjects with a mean age of 31.0 ± 9.4 years performed two trials for quiet stance and four trials for gait on a baropodometric walkway with their eyes open. Foot plantar pressures were recorded from 10 areas of the foot sole. Results: During quiet stance, the highest plantar pressure occurred at metatarsal heads (M2 to M4) and the medial (MH) and lateral halves of the heel (LH). During gait, the profile of plantar pressure values was like that during stance, but significantly higher. The differences concentrated at the big toe (T1), M2 to M4, MH, and LH, whilst toes (T2,3,4,5) and midfoot (MF) showed the smallest difference. A significant positive correlation was found between the corresponding areas of foot pressure during gait and stance. Conclusions: During quiet stance and gait, the overall profile of plantar pressure distribution was similar. During quiet stance, the subjects loaded more on the heels, in keeping with the known position of the center of pressure just in front of the ankles. During gait, higher pressures on the metatarsal areas are related to the forward propulsion of the center of mass. The correlation between the corresponding areas of foot pressure during gait and stance suggests that the pressure distribution during gait can partly be estimated from that during stance. This finding might be useful in most clinical settings when a single sensorized platform rather than a complete walkway is available.

Background: Spinal cord injury (SCI) impairs sensorimotor function below the lesion and reshapes supralesional circuits, potentially influencing motor control above the injury. Although upper extremity strength and sensation are clinically normal in paraplegia, it is not known whether supralesional reorganization may produce subclinical alterations in the fine motor skills of the upper extremities. The aim of the study was to compare manual dexterity evaluated through the Purdue Pegboard Test between patients with SCI (PwSCI) and healthy subjects (HS). Methods: We recruited 18 PwSCI with complete paraplegia and 18 age- and sex-matched HS. Participants completed the four subtests of the Purdue Pegboard Test: dominant hand (1), non-dominant hand (2), bimanual (3), and assembly (4). For the first three subtests, a mixed 3 × 2 ANOVA (3 subtests × 2 groups) was performed, whereas for the fourth subtest, an independent samples t-test was performed. Spearman’s rho quantified correlations among subtests and with clinical findings. Results: PwSCI showed full upper extremity muscle strength and sensation. The mean scores of the four subtests were significantly lower in PwSCI than in HS. Unilateral and bimanual subtests correlated with each other in both groups; however, the bimanual subtest was not as well predicted by dominant hand alone, as PwSCI depended more on non-dominant ability. In PwSCI, the assembly subtest strongly depended on dominant, non-dominant, and bimanual scores, whereas this dependency was weaker in HS. The subtests were influenced by ageing in PwSCI. Conclusions: Despite upper extremity muscle strength and sensation being clinically normal, PwSCI showed impaired manual dexterity. This may reflect diminished ascending somatosensory input to supraspinal centres and plastic changes in supralesional motor pathways. These preliminary results open new rehabilitation perspectives for PwSCI.