Effectiveness and design specifications of home-based lower extremity rehabilitation systems for patients with stroke: a systematic review and meta-analysis protocol

Introduction Stroke, one of the leading causes of death worldwide, leads to disability in most patients, posing a burden on society and families. Intensive rehabilitation in the early stages is the most effective method of minimising these disabilities. Home-based rehabilitation strategies have emerged as a promising alternative to conventional approaches, as highlighted during the coronavirus disease pandemic. Currently, no systematic reviews are available on the effects of home-based lower extremity rehabilitation systems in patients with stroke, or on the design specifications for their further development. Therefore, we present a protocol for a systematic review and meta-analysis to provide up-to-date evidence on this topic. Methods and analysis The study search for this review will be conducted in October 2026 across five electronic databases—MEDLINE, CENTRAL, EMBASE, Web of Science and CHINAL—and will be supplemented by Google searches and manual screening of the reference lists of the finally included studies. The search strategy has been developed using relevant keywords such as stroke, lower extremity rehabilitation, robotics and virtual reality, and study selection, data collection and risk of bias assessment will be performed independently by two authors; if these yield different results, final decisions will be made after discussion with the third author. The risk of bias in the existing literature will be evaluated using appropriate tools and methods in accordance with the Cochrane group guidelines (eg, RoB 2, Risk of Bias in Nonrandomised Studies of Interventions). Moreover, the level of evidence presented by this study will be evaluated using the Grading of Recommendations Assessment, Development, and Evaluation approach. If feasible, we will conduct a meta-analysis using the RevMan Web version; otherwise, a narrative review will be presented. Ethics and dissemination Since this study will be conducted without recruiting participants or using personal information, ethical approval and informed consent are not required (PROSPERO registration number: CRD 42024551398). Our proposed study will provide important evidence for policymakers, rehabilitation providers and system developers, and the results will be published in a journal and presented at conferences.