Effects of using conventional assistive devices on gait of adults with neurological disorders: a systematic review with meta-analysis.

PURPOSE: Although assistive devices are prescribed for gait impairments in individuals with neurological disorders, evidence guiding their effects remains limited. This study aimed to investigate the effects of conventional assistive devices on gait in adults with neurological disorders. MATERIAL AND METHODS: This was a systematic review with meta-analysis of experimental studies. Study selection, data extraction, and risk of bias assessment (RoB2) were performed by two reviewers. Meta-analyses were conducted for homogeneous studies, and evidence was evaluated using GRADE. RESULTS: Twenty-three studies (n = 461) were included, most assessed immediate effects (92%) and compared gait with and without devices (83%). Immediate effects were uncertain, ranging from no difference to negative effects in gait speed (mean difference (MD) -0.131 to 0.030 m/s, 95%CI -0.191 to 0.055), stride length (MD -0.063 to -0.020 m, 95%CI -0.180 to -0.001), and cadence (MD -3.6 steps/min, 95%CI -6.247 to -0.954). Short-to-intermediate daily use of a single-point cane by individuals with stroke suggested improvements in gait speed with the device compared with controls who did not use it. (MD 0.14-0.18 m/s, 95%CI 0.05-0.30). Comparisons between single- and four-point canes favoured the single-point cane, with meta-analysis suggesting small improvements in gait speed (MD 0.058 m/s, 95%CI 0.025 to 0.090) and walking distance (MD 20.34 m, 95%CI 4.48 to 36.20) in individuals with stroke and a study suggesting similar benefits in individuals with multiple sclerosis. CONCLUSIONS: Training duration and device type should be considered in clinical prescription. Structured training programs and short- to long-term effects need to be investigated.