Robotic assisted versus conventional training for physical rehabilitation care after burns: a systematic review and meta-analysis based on high-quality randomized controlled trials.

BACKGROUND: Conventional burn rehabilitation faces challenges in restoring physical function due to pain-related kinesiophobia and therapist-dependent variability. Objective: To evaluate the efficacy and mechanisms of robot-assisted training (RAT) versus conventional rehabilitation in burn patients. Methods: Meta-analysis of 10 randomized controlled trials (RCTs, n = 593) via Cochrane methodology. Inverse-variance models assessed outcomes (α = 0.05); heterogeneity quantified by I². Primary outcomes included gait independence (Functional Ambulation Categories), hand dexterity, scar biomechanics (R0), and pain (VAS). Results: RAT significantly improved FAC scores (OR:0.89, 95%CI:0.08–1.70; p = 0.03), scar pliability (R0: OR:0.28, 95%CI:0.08–0.47; p = 0.006; I²=31%), and fine motor dexterity (JTT-small objects: p = 0.04). Walking endurance increased substantially (6MWT: MD:0.89 m, p < 0.001; 10MWT: MD: -4.30s, p < 0.001), with lower limb active ROM enhancement exceeding controls by 45.8% (p < 0.001). RAT induced no pain exacerbation (ΔVAS: p = 0.15), potentially attributed to biomechanical collagen remodeling and neurocognitive pain modulation. Evidence limitations included geographical concentration (80% East Asian cohorts) and absence of long-term (> 12-week) data. Conclusions: RAT surpasses conventional therapy in functional recovery by leveraging neuromechanical adaptations without increasing pain. Multicenter trials standardizing protocols and integrating psychosocial metrics are warranted.