Systematic review and meta-analysis of the effectiveness of non-pharmacological interventions in restoring lower limb motor function after stroke.

IF 3.6 3区医学 Q3 NEUROSCIENCES

Frontiers in Human Neuroscience Pub Date : 2026-09-25 eCollection Date: 2026-01-01 DOI:10.3389/fnhum.2026.1864828

Tokzhan Kispayeva, Inna Bolshakova, Akmaral Izbasarova, Zilola Mavlyanova, Tomiris Zhunussova

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引用次数: 0

Abstract

Objective: To evaluate the effectiveness of non-pharmacological interventions in improving lower limb motor function in patients after stroke based on a systematic review and meta-analysis of randomized controlled trials.

Methods: A systematic literature search was conducted in PubMed (MEDLINE), Scopus, and the Cochrane Library, supplemented by manual screening of reference lists. Randomized controlled trials involving adult patients after stroke comparing non-pharmacological interventions with conventional rehabilitation were included. The primary outcome was lower limb motor function assessed by the Fugl-Meyer Assessment of the Lower Extremity (FMA-LE). The review was conducted in accordance with the PRISMA 2020 guidelines. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. A random-effects model was applied to calculate pooled mean differences (MDs) with 95% confidence intervals.

Results: Fifteen randomized controlled trials were included in the systematic review, of which 14 studies involving 623 participants were included in the quantitative synthesis. Non-pharmacological interventions demonstrated a statistically significant improvement in lower limb motor function compared with conventional rehabilitation (MD = 3.06, 95% CI 1.97-4.16; Z = 5.48, p < 0.00001), with substantial heterogeneity (I ² = 60%). In the subgroup analysis, robotic/mechanized rehabilitation interventions showed a significant positive effect (MD = 3.00, 95% CI 1.66-4.33; I ² = 57%), as did other non-pharmacological interventions (MD = 3.15, 95% CI 0.94-5.35; I ² = 68%). There was no statistically significant difference between the subgroups (p = 0.91; I ² = 0%).

Conclusion: Non-pharmacological rehabilitation interventions were associated with a statistically significant improvement in lower limb motor function after stroke compared with conventional rehabilitation. Substantial heterogeneity was observed across the included studies, highlighting the need for further high-quality randomized controlled trials with standardized intervention protocols and longer follow-up.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251154919.

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来源期刊

Frontiers in Human Neuroscience 医学-神经科学

CiteScore

4.70

自引率

6.90%

发文量

830

审稿时长

2-4 weeks

期刊介绍： Frontiers in Human Neuroscience is a first-tier electronic journal devoted to understanding the brain mechanisms supporting cognitive and social behavior in humans, and how these mechanisms might be altered in disease states. The last 25 years have seen an explosive growth in both the methods and the theoretical constructs available to study the human brain. Advances in electrophysiological, neuroimaging, neuropsychological, psychophysical, neuropharmacological and computational approaches have provided key insights into the mechanisms of a broad range of human behaviors in both health and disease. Work in human neuroscience ranges from the cognitive domain, including areas such as memory, attention, language and perception to the social domain, with this last subject addressing topics, such as interpersonal interactions, social discourse and emotional regulation. How these processes unfold during development, mature in adulthood and often decline in aging, and how they are altered in a host of developmental, neurological and psychiatric disorders, has become increasingly amenable to human neuroscience research approaches. Work in human neuroscience has influenced many areas of inquiry ranging from social and cognitive psychology to economics, law and public policy. Accordingly, our journal will provide a forum for human research spanning all areas of human cognitive, social, developmental and translational neuroscience using any research approach.