Psychosocial Outcomes in Robotic Gait Training in Stroke Survivors: A Narrative Review

Stroke survivors frequently identify walking independence, safety, and confidence as top rehabilitation priorities; however, most research on robot-assisted gait training (RAGT) emphasizes physical outcomes like gait speed and balance over psychosocial dimensions. This narrative review aimed to synthesize the evidence on patient priorities, fear of falling (FoF), balance confidence, health-related quality of life (HRQoL), participation, and caregiver outcomes within the context of RAGT after stroke. A literature search of PubMed, Scopus, Web of Science, and CINAHL up to June 2025 identified 20 relevant studies. The results indicate that while stroke survivors consistently prioritize walking independence, FoF remains highly prevalent and strongly correlates with activity restriction. Emerging data suggest that combining RAGT with balance training yields significantly greater improvements in balance confidence and falls efficacy compared to balance training alone. Furthermore, improved walking independence through robotic interventions shows potential in reducing physical and emotional caregiver burden. In conclusion, RAGT has the potential to influence psychosocial outcomes when embedded within person-centered, participation-oriented rehabilitation. Future trials should routinely incorporate measurements of confidence and HRQoL to align robotic training with the outcomes that matter most to survivors and their families.