Simulating space walking: a systematic review on anti-gravity technology in neurorehabilitation

Abstract

Neurological disorders, such as Parkinson's disease (PD), multiple sclerosis (MS), cerebral palsy (CP) and stroke are well-known causes of gait and balance alterations. Innovative devices (i.e., robotics) are often used to promote motor recovery. As an alternative, anti-gravity treadmills, which were developed by NASA, allow early mobilization, walking with less effort to reduce gait energy costs and fatigue. A systematic search, according to PRISMA guidelines, was conducted for all peer-reviewed articles published from January 2010 through September 2023, using the following databases: PubMed, Scopus, PEDro and IEEE Xplore. After an accurate screening, we selected only 16 articles (e.g., 5 RCTs, 2 clinical trials, 7 pilot studies, 1 prospective study and 1 exploratory study). The evidence collected in this systematic review reported promising results in the field of anti-gravity technology for neurological patients, in terms of improvement in gait and balance outcomes. However, we are not able to provide any clinical recommendation about the dose and parameters of anti-gravity treadmill training, because of the lack of robust high-quality RCT studies and large samples. Registration number CRD42023459665.

Keywords: Anti-gravity technology; Anti-gravity treadmill; Neurological disorders; Neurorehabilitation.

Fig. 1

PRISMA flow diagram

Fig. 2

RoB 2 assessment of the 5 RCT studies

Fig. 3

ROBINS-I assessment of the eleven non-RCTs studies

Fig. 4

Key gait, balance, metabolic, and muscle responses provided by anti-gravity treadmill training. Legend: Supporting evidence: ‘Gait and balance functions’ [17-20, 23-26, 28, 30, 32]; ‘Metabolic responses’ [21, 24, 29]; ‘Muscle activation responses’ [17, 22, 32]