ABSTRACT

Background. Incomplete spinal cord injury is a common disorder leading to sensory or motor function loss. Objective. This study aimed to investigate the effect of repetitive transcranial magnetic stimulation therapy (rTMS) on functional outcome in patients with incomplete spinal cord injury. Design. A prospective randomized controlled trial. Setting. Agouza Rehabilitation Hospital Out clinic. Methods. Forty male patients with chronic traumatic incomplete spinal cord injury aging from 25 to 45years. Patients were randomly divided into two equal groups (group A and group B).Group A was the study group that received rTMS in addition to designed physical therapy program including BWST training and Group B was the control group that received the same designed physical therapy program including BWST training. The functional gait was assessed using walking index for spinal cord injury (WISCI II) and gait speed was assessed using 10 m walk test. Measurements were performed before and after treatment and three months after end of the treatment as follow up. Results. There was a statistically significant improvement in WISCI II and 10m walk test at post treatment and follow up compared with that pre-treatment in study group (P < 0.05). There was no statistically significant improvement in all outcome variables at post treatment and follow up compared with that pretreatment in control group (P > 0.05).There was a statistically significant improvement in patients who received rTMS with BWST compared with patients received BWST only in WISCI II and 10 m walk test at post treatment (p = 0.01 and p = 0.001 respectively) compared to pre treatment. The gained effect was lost at follow up measurement compared to post treatment in WISCI II and the gained effect was maintained at follow up measurement compared to post treatment in 10m walk test score. Conclusion. It was proven that rTMS add a valuable effect for restoring function in patients with incomplete spinal cord injury, particularly in cases when the effect of BWST has reached a plateau.

Background: People with incomplete spinal cord injury disabilities can be able to live a healthy, productive, and dignified life by using Assistive devices as their role in improving gait. Facilitate locomotion rehabilitation. And enable people with incomplete SCI to ambulate in an upright position. Objective: This systematic review aimed to examine the effectiveness of the role of using assistive devices in gait rehabilitation in patients with incomplete SCI. Material and Methods: Studies were identified from 2000 to 2020 by electronic search using PubMed, Cochrane Database of Systematic Reviews, Google Scholar, and Physiotherapy Evidence Database (Pedro). They were reviewed if they were randomized control trials focused on the effectiveness of Assistive Devices on Gait in Patients in age more than 18 years with incomplete Spinal Cord Injury being published in English. Eight studies were selected according to inclusive and exclusive criteria and descriptive analysis was conducted due to heterogeneity. Results: Eight trials were identified with good quality methodology. Descriptive analysis was applied for three studies that supported the use of assistive devices for those patients and meta-analysis was applied for five studies. The mean difference across all the five studies is -0.69 (95% CI -0.93, -0.45). According to AACPDM, there is level II evidence that supports the use of the assistive device as a method to be able to live a healthy, productive, and dignified life. Conclusion: The current level of evidence supports the effectiveness of assistive devices in improving gait in patients with incomplete spinal cord injury.