Effectiveness of Robotic Systems with Dynamic Body Weight Support in Post-Traumatic Lower Limb Rehabilitation: A Systematic Review

Background and Objectives: Post-traumatic lower limb injuries are frequently associated with gait impairment, reduced functional independence, and delayed recovery due to weight-bearing restrictions. Dynamic body weight support (DBWS) refers to rehabilitation technologies that provide real-time, adaptive unloading of body weight during functional tasks such as walking, enabling safer and more effective gait training. Although these robotic systems have been extensively investigated in neurological pathologies, there is a lack of evidence regarding their use in post-traumatic lower limb injuries. Therefore, this systematic review aimed to evaluate the clinical effectiveness of robotic systems incorporating DBWS in the rehabilitation of post-traumatic lower limb pathologies. Materials and Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the protocol was registered in PROSPERO (CRD420261294273). Seven major databases (PubMed, Scopus, ScienceDirect, Cochrane, Web of Science, Springer, and Wiley) were searched from inception to October 2025. Studies that were considered included patients with recent post-traumatic pathologies in the lower limbs. The methodological quality and risk of bias of the included studies were evaluated using the PEDro scale and the RoB 2 tool. Results: Seven studies involving 265 participants with recent post-traumatic lower limb injuries were included. The rehabilitation systems reviewed enabled early, intensive gait and balance training by reducing lower limb loading and facilitating safe performance of functional walking tasks. However, substantial heterogeneity in intervention protocols and outcome measures limited direct comparisons across studies. Conclusions: The findings of this systematic review suggest that DBWS interventions may enhance gait and balance recovery in individuals with post-traumatic lower limb injuries. Despite the small number of participants included, the available evidence indicates that these technologies can facilitate functional improvements during the early stages of rehabilitation and may represent a valuable adjunct to conventional therapeutic approaches. Nevertheless, further well-designed studies with larger sample sizes, standardized intervention protocols, and long-term follow-up are required to establish optimal clinical implementation strategies and to confirm the durability of treatment effects.