Robot-assisted gait training alleviates the symptoms of acute ischemic stroke via regulating gut microbiota composition and function

Background Robot-assisted gait training (RAGT) improves motor recovery after stroke, yet its biological mechanisms remain poorly understood. Increasing evidence suggests that gut microbiota dysbiosis contributes to stroke pathology and recovery. Objective . To investigate whether RAGT alleviates acute ischemic stroke (AIS) symptoms by modulating gut microbiota composition and function. Methods Forty-seven newly diagnosed AIS patients were enrolled and assigned to a RAGT group (IG, n = 24) or a conventional gait training group (CG, n = 23). Fecal samples were collected after the intervention, and functional outcomes were assessed at 90 days. Gut microbiota composition and predicted function were analyzed using 16S rRNA gene sequencing. Results Compared with CG patients, IG patients demonstrated significantly improved clinical outcomes. RAGT partially reversed stroke-associated gut dysbiosis, characterized by increased microbial richness and evenness. Beneficial taxa, including Lachnospiraceae , Ruminococcaceae , and Oscillospiraceae , were enriched, whereas Enterobacteriaceae and Bifidobacteriaceae were reduced. Functional prediction revealed decreased pathogenic potential of the gut microbiota in the IG, which correlated with improved AIS outcomes. Conclusion Poststroke RAGT was associated with alteration of gut microbiota composition and function, suggesting a novel microbiota-mediated mechanism underlying its neurorehabilitative benefits in AIS.