The effect of tilt-table robot-assisted training on functional outcomes in people with stroke and sarcopenia: a retrospective cohort study

Background This study aimed to compare rehabilitation outcomes between people with stroke who have sarcopenia and those without, stroke following tilt-table robot-assisted training. By analyzing differences in physical function between these groups, this study sought to identify the impact of sarcopenia on the effectiveness of rehabilitation. These findings are expected to offer clinical insights into the need for personalized rehabilitation strategies to optimize functional recovery in people with stroke and sarcopenia. Methods A total of 74 people with stroke who received tilt-table robot-assisted training at Gwangju G Rehabilitation Hospital between July 2022 and June 2024 were included. The participants were classified into two groups on the basis of the 2019 criteria established by the Asian Working Group for Sarcopenia (AWGS): those with sarcopenia (SRG) and those without sarcopenia (NSRG). All participants underwent a 4-week recovery-phase rehabilitation program that included tilt-table robot-assisted training (R-BOT+, CoTras, Republic of Korea), conducted five times a week for 30 minutes per session. Functional outcomes—including muscle strength (Manual Muscle Testing, MMT), balance (Berg Balance Scale, BBS), gait function (Functional Ambulation Categories, FAC), and activities of daily living (Korean version of the Modified Barthel Index, K-MBI)—were assessed before and after the intervention. The Wilcoxon signed-rank test was used for within-group comparisons, and the Mann–Whitney U test was used for between-group comparisons. Statistical significance was set at p < .05. Results Both groups showed significant improvements in muscle strength, balance, gait, and activities of daily living after the intervention (p < .05). However, between-group comparisons revealed significantly greater improvements in balance and activities of daily living in the group without sarcopenia (p < .05). No significant differences in muscle strength or gait function were detected between the groups (p > .05). Conclusion Tilt-table robot-assisted training effectively improved muscle strength, balance, gait, and activities of daily living in people with stroke, regardless of sarcopenia status. However, individuals with both stroke and sarcopenia showed less improvement in balance and activities of daily living, underscoring the need for tailored rehabilitation strategies for this population. Trial registration: This trial was approved by the Public Institutional Review Board of the Ministry of Health and Welfare (P01–202411–01–011) and registered in the Clinical Research Information Service of Korea (KCT0010038).