Robot-Assisted Gait Training in Individuals With Spinal Cord Injury: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Open Access
- 30 June 2024
- journal article
- review article
- Published by Korean Academy of Rehabilitation Medicine in Annals of Rehabilitation Medicine
- Vol. 48 (3) , 171-191
Abstract
Spinal cord injury (SCI) rehabilitation emphasizes locomotion. Robotic-assisted gait training (RAGT) is widely used in clinical settings because of its benefits; however, its efficacy remains controversial. We conducted a systematic review and meta-analysis to investigate the efficacy of RAGT in patients with SCI. We searched international and domestic databases for articles published until April 18, 2024. The meta-analysis employed a random effects model to determine the effect size as either mean difference (MD) or standardized MD (SMD). Evidence quality was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Twenty-three studies with a total of 690 participants were included in the final analysis. The overall pooled effect size for improvement in activities of daily living was 0.24, with SMD (95% confidence interval [95% CI], 0.04–0.43; GRADE: high) favoring RAGT over conventional rehabilitation. Muscular strength (MD, 0.23; 95% CI, 0.02–0.44; GRADE: high), walking index for SCI (MD, 0.31; 95% CI, 0.07–0.55; GRADE: moderate) and 6 min walk test distance (MD, 0.38; 95% CI, 0.14–0.63; GRADE: moderate) showed significant improvement in the robot group. Subgroup analysis revealed that subacute patients and intervention periods >2 months were more effective. This meta-analysis revealed that RAGT significantly improved activities of daily living, muscular strength, and walking abilities. Additional studies are needed to identify the optimal treatment protocol and specific patient groups for which the protocol is most effective.Keywords
Funding Information
- Korean Academy of Rehabilitation Medicine
This publication has 52 references indexed in Scilit:
- Walking improvement in chronic incomplete spinal cord injury with exoskeleton robotic training (WISE): a randomized controlled trialSpinal Cord, 2022
- Robotic Locomotor Training Leads to Cardiovascular Changes in Individuals With Incomplete Spinal Cord Injury Over a 24-Week Rehabilitation Period: A Randomized Controlled Pilot StudyArchives of Physical Medicine and Rehabilitation, 2021
- Wearable robotic exoskeleton for gait reconstruction in patients with spinal cord injury: A literature reviewJournal of Orthopaedic Translation, 2021
- Energy cost and psychological impact of robotic-assisted gait training in people with spinal cord injury: effect of two different types of devicesNeurological Sciences, 2021
- A Comparison of Robotic Walking Therapy and Conventional Walking Therapy in Individuals With Upper Versus Lower Motor Neuron Lesions: A Randomized Controlled TrialArchives of Physical Medicine and Rehabilitation, 2014
- Conducting quantitative synthesis when comparing medical interventions: AHRQ and the Effective Health Care ProgramJournal of Clinical Epidemiology, 2011
- Locomotor training for walking after spinal cord injury2007
- Rehabilitative Therapies after Spinal Cord InjuryJournal of Neurotrauma, 2006
- Explaining heterogeneity in meta‐analysis: a comparison of methodsStatistics in Medicine, 1999
- Recovery of ambulation in motor-incomplete tetraplegiaArchives of Physical Medicine and Rehabilitation, 1997