Effect of Progressive Speed Increase Versus Constant Speed in Robot-Assisted Gait Training on Balance and Gait Ability in Chronic Stroke: A Randomized Controlled Trial

Objective In this randomized controlled trial (RCT), we evaluated the efficacy of a progressive speed increase in robot-assisted gait training (RAGT) on balance and gait performance in chronic stroke patients. Methods In total, 20 patients with chronic stroke were randomly assigned to a progressive speed increase (n = 10) or a constant speed (n = 10) RAGT group. Both groups underwent 12 training sessions over 4 weeks (3 sessions per week). Outcome measures, including postural sway, limits of stability, the Berg Balance Scale score, and 6-min walk test (6MWT) performance, were assessed before and after the intervention. Within-group differences were analyzed using paired t-tests, whereas independent t-tests were employed to analyze between-group differences (α = 0.05). Results Both groups demonstrated significant improvements in all measured outcomes (p < 0.05). However, the experimental group showed significantly greater gains in 6MWT distance (mean between-group difference: 8.55 m; Cohen's d = 1.33) and walking speed (Cohen's d = 1.45) compared to the control group (p < 0.05). No significant between-group differences were observed in balance outcomes (p > 0.05). Conclusions Progressive speed increase in RAGT is an effective intervention for enhancing walking distance and speed in chronic stroke patients. However, the observed improvements did not exceed the minimal clinically important difference (MCID), and future studies should assess long-term clinical significance.