{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:59:10Z","timestamp":1790319550592,"version":"4.1.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Hum. Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effectiveness of non-pharmacological interventions in improving lower limb motor function in patients after stroke based on a systematic review and meta-analysis of randomized controlled trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature search was conducted in PubMed (MEDLINE), Scopus, and the Cochrane Library, supplemented by manual screening of reference lists. Randomized controlled trials involving adult patients after stroke comparing non-pharmacological interventions with conventional rehabilitation were included. The primary outcome was lower limb motor function assessed by the Fugl\u2013Meyer Assessment of the Lower Extremity (FMA-LE). The review was conducted in accordance with the PRISMA 2020 guidelines. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. A random-effects model was applied to calculate pooled mean differences (MDs) with 95% confidence intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifteen randomized controlled trials were included in the systematic review, of which 14 studies involving 623 participants were included in the quantitative synthesis. Non-pharmacological interventions demonstrated a statistically significant improvement in lower limb motor function compared with conventional rehabilitation (MD\u202f=\u202f3.06, 95% CI 1.97\u20134.16;\n                      <jats:italic>Z<\/jats:italic>\n                      \u202f=\u202f5.48,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.00001), with substantial heterogeneity (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f60%). In the subgroup analysis, robotic\/mechanized rehabilitation interventions showed a significant positive effect (MD\u202f=\u202f3.00, 95% CI 1.66\u20134.33;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f57%), as did other non-pharmacological interventions (MD\u202f=\u202f3.15, 95% CI 0.94\u20135.35;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f68%). There was no statistically significant difference between the subgroups (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.91;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f0%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Non-pharmacological rehabilitation interventions were associated with a statistically significant improvement in lower limb motor function after stroke compared with conventional rehabilitation. Substantial heterogeneity was observed across the included studies, highlighting the need for further high-quality randomized controlled trials with standardized intervention protocols and longer follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251154919<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnhum.2026.1864828","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:05:12Z","timestamp":1790316312000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Systematic review and meta-analysis of the effectiveness of non-pharmacological interventions in restoring lower limb motor function after stroke"],"prefix":"10.3389","volume":"20","author":[{"given":"Tokzhan","family":"Kispayeva","sequence":"first","affiliation":[{"name":"School of Nursing Education, Karaganda Medical University","place":["Karaganda, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inna","family":"Bolshakova","sequence":"additional","affiliation":[{"name":"Institute of Life Sciences, Karaganda Medical University","place":["Karaganda, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akmaral","family":"Izbasarova","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation and Sports Medicine, Asfendiyarov Kazakh National Medical University","place":["Almaty, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zilola","family":"Mavlyanova","sequence":"additional","affiliation":[{"name":"Department of Medical Rehabilitation, Sports Medicine and Traditional Medicine, Samarkand State Medical University","place":["Samarkand, Uzbekistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomiris","family":"Zhunussova","sequence":"additional","affiliation":[{"name":"Karaganda Medical University","place":["Karaganda, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1622661","DOI":"10.3389\/fnhum.2025.1622661","article-title":"Systematic review and meta-analysis of the effectiveness of robotic therapy in the recovery of motor functions after stroke","volume":"19","author":"Amirbekova","year":"2025","journal-title":"Front. 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