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Jurnal Fisioterapi Terapan Indonesia

Abstract

Total Hip Arthroplasty (THA) remains a gold standard for restoring joint function in patients with severe hip osteoarthritis, yet achieving optimal functional recovery post-surgery remains a challenge. Robot-assisted rehabilitation (RAR) has emerged as a novel physiotherapy modality offering structured, repetitive, and sensor-driven training that may enhance recovery trajectories. Objective: This literature review aims to identify and synthesise current evidence on the effectiveness of RAR in improving functional outcomes after THA, focusing on gait performance, muscle strength, balance, and quality of life. Methods: A comprehensive search of PubMed, PEDro, ScienceDirect and Google Scholar was conducted for peer-reviewed articles published between 2015 and 2025. Studies included those evaluating robotic modalities in THA rehabilitation. Data extraction and narrative synthesis were guided by the PICO framework. Results: Eight studies met inclusion criteria. Robotic systems such as Hybrid Assistive Limb (HAL), Honda Walking Assist (HWA), Luna-EMG and Hunova demonstrated improvements in gait speed, stride length, lower limb strength, balance control and patient-reported functional scores compared with conventional therapy. Evidence supports enhanced neuromuscular coordination through individualized robot-based training. Conclusion: Robot-assisted rehabilitation appears to be a promising modality to support functional recovery after THA. Nevertheless, further large-scale studies with long-term follow-up are needed to confirm sustained benefits and cost-effectiveness for routine clinical practice.

References

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8. Beckman EM, Connick MJ, Tweedy SM. Assessing muscle strength for the purpose of classification in Paralympic sport: A review and recommendations. J Sci Med Sport. 2017 Apr;20(4):391–6.

9. Liu X, Huang C, Lin L, Zhang J, Zhu Z. Visualized load-bearing-based robot control system improves early function in femoral neck fracture patients: a randomized controlled trial focusing on outcomes after total hip arthroplasty. J Orthop Surg Res. 2025 Jul 18;20(1):673.

10. Guo D, Li X, Ma S, Zhao Y, Qi C, Xue Y. Total Hip Arthroplasty with Robotic Arm Assistance for Precise Cup Positioning: A Case‐Control Study. Orthop Surg. 2022 Jul 14;14(7):1498–505.

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12. Koseki K, Mutsuzaki H, Yoshikawa K, Endo Y, Maezawa T, Takano H, et al. Gait Training Using the Honda Walking Assistive Device® in a Patient Who Underwent Total Hip Arthroplasty: A Single-Subject Study. Medicina (B Aires). 2019 Mar 14;55(3):69.

13. Röhner E, Mayfarth A, Sternitzke C, Layher F, Scheidig A, Groß HM, et al. Mobile Robot-Based Gait Training after Total Hip Arthroplasty (THA) Improves Walking in Biomechanical Gait Analysis. J Clin Med. 2021 May 29;10(11):2416.

14. Castelli L, Iacovelli C, Ciccone S, Geracitano V, Loreti C, Fusco A, et al. RObotic-Assisted Rehabilitation of Lower Limbs for Orthopedic Patients (ROAR-O): A Randomized Controlled Trial. Appl Sci. 2023 Dec 12;13(24):13208.

15. Milewska A, Przedborska A, Irzmański R. Assessment of the Impact of Training Using the Luna-EMG Rehabilitation Robot on the Functional Status of Patients After Total Hip Replacement: A Randomized Trial. Appl Sci. 2025 Oct 15;15(20):11065.

16. Setoguchi D, Kinoshita K, Kamada S, Sakamoto T, Kise N, Kotani N, et al. Hybrid Assistive Limb improves restricted hip extension after total hip arthroplasty. Assist Technol. 2022 Jan 2;34(1):112–20.

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Bahasa Abstract

Latar Belakang: Total Hip Arthroplasty (THA) merupakan prosedur standar emas untuk memulihkan fungsi sendi pada pasien dengan osteoartritis panggul berat, namun pemulihan fungsional pascaoperasi masih menjadi tantangan. Rehabilitasi berbantuan robot (Robot-Assisted Rehabilitation/RAR) muncul sebagai modalitas fisioterapi baru yang menawarkan latihan terstruktur, berulang, serta berbasis sensor untuk mempercepat pemulihan fungsi. Tujuan: Tinjauan literatur ini bertujuan untuk mengidentifikasi dan mensintesis bukti terkini mengenai efektivitas RAR dalam meningkatkan hasil fungsional setelah THA, dengan fokus pada performa gaya berjalan, kekuatan otot, keseimbangan, dan kualitas hidup. Metode: Pencarian literatur dilakukan melalui basis data PubMed, PEDro, ScienceDirect, dan Google Scholar untuk artikel yang diterbitkan antara tahun 2015 hingga 2025. Studi yang disertakan adalah yang mengevaluasi penggunaan robot dalam rehabilitasi pasca-THA, dengan sintesis data dilakukan berdasarkan kerangka PICO. Hasil: Delapan studi memenuhi kriteria inklusi. Sistem robot seperti Hybrid Assistive Limb (HAL), Honda Walking Assist (HWA), Luna-EMG, dan Hunova menunjukkan peningkatan kecepatan berjalan, panjang langkah, kekuatan otot tungkai bawah, kontrol keseimbangan, serta skor fungsional pasien dibandingkan dengan terapi konvensional. Bukti menunjukkan adanya peningkatan koordinasi neuromuskular melalui latihan berbasis robot yang dipersonalisasi. Kesimpulan: Rehabilitasi berbantuan robot menunjukkan potensi yang menjanjikan untuk mendukung pemulihan fungsional setelah THA. Namun, diperlukan penelitian berskala besar dengan tindak lanjut jangka panjang untuk memastikan manfaat berkelanjutan dan efektivitas biaya dalam praktik klinis rutin.

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