Accepted for/Published in: JMIR Research Protocols
Date Submitted: Jun 29, 2026
Date Accepted: Jul 22, 2026
Effectiveness of a Structured Robot-Assisted Ankle-Foot Sensorimotor Training Program Versus Manual Training in Chronic Stroke: Protocol for an Assessor-Blinded, Parallel-Group Randomized Controlled Trial
ABSTRACT
Background:
Stroke is a leading cause of long-term disability worldwide. Persistent lower-extremity motor and somatosensory impairments after stroke commonly limit walking and balance despite rehabilitation. Virtual reality (VR)-integrated robotic rehabilitation may support structured, goal-directed ankle-foot practice; however, evidence for ankle-foot-focused sensorimotor protocols remains limited. In particular, approaches that combine robot-assisted motor training with plantar tactile localization and VR-supported joint position sense (JPS) training to target plantar sensory and proprioceptive function are scarce.
Objective:
This study aims to evaluate the effectiveness of a structured, VR-integrated, robot-assisted ankle-foot sensorimotor rehabilitation protocol compared with a content-matched manual training protocol in individuals with chronic stroke and to examine its effects on clinical and sensorimotor outcomes.
Methods:
This is an assessor-blinded, two-arm, parallel-group randomized controlled trial. Thirty individuals with chronic stroke will be randomized 1:1 to the Robot-Assisted Training Group (RTG) or the Manual Training Group (MTG). All participants will receive conventional rehabilitation. In addition, the RTG will receive a structured robot-assisted ankle-foot training program integrated with VR and assist-as-needed control, whereas the MTG will receive the same structured ankle-foot training protocol delivered manually by a physiotherapist. Interventions will be delivered 3 times per week for 6 weeks, for a total of 18 sessions. Total session duration will be time-matched between groups at 50 to 60 minutes per session. The primary outcome will be the change in 10-Meter Walk Test-derived walking speed from baseline to 6 weeks. Secondary outcomes will include 2-Minute Walk Test distance, ankle range of motion, joint position sense, plantar tactile sensation, muscle tone, motor performance, static and dynamic balance, and stroke-specific quality of life.
Results:
This study is funded by the Scientific and Technological Research Council of Turkey (TÜBİTAK) under the 1002-A Rapid Support Program (Grant No. 225S390). Recruitment began in March 2026 and is planned to continue until May 2027. As of March 25, 2026, 4 participants have been enrolled and are currently receiving the assigned intervention. Data analysis will begin once all enrolled participants have completed postintervention assessments.
Conclusions:
This trial will provide evidence on whether a structured robot-assisted ankle-foot sensorimotor training program offers additional benefit compared with a content-matched manual training protocol in individuals with chronic stroke. The findings may contribute to the development of standardized, individualized, and sensorimotor-oriented rehabilitation protocols for improving walking and balance after stroke. Clinical Trial: ClinicalTrials.gov NCT07091045; https://clinicaltrials.gov/study/NCT07091045
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.