Effect of body weight support training on lower extremity motor function in patients with spinal cord injury: a systematic review and meta-analysis

Abstract

Objective To systematically evaluate the effect of body weight support training (BWST) on lower extremity motor functions in patients with spinal cord injury (SCI) and to compare the effect differences among three BWST methods. Design PubMed, Web of Science, Cochrane Library, EMBASE, CNKI, CBM, VIP, and Wan Fang databases were searched until December 31, 2022. Meta-analysis and network meta-analysis were conducted using RevMan 5.4 and ADDIS 1.16.8. Results Nineteen RCTs involving 864 patients were included. The meta-analysis showed that BWST could improve lower extremity motor scores (LEMSs) according to the ISCNCSCI standard (mean difference [MD] = 6.38, 95% confidence interval [CI] = 3.96, 8.80; P < 0.05), walking speed (SMD = 0.77, 95% CI = 0.52, 1.02; P < 0.05), and modified Barthel index (MBI) scores (MD = 9.85, 95% CI = 8.39, 11.30; P < 0.05). The network meta-analysis showed no significant difference among the three BWST methods for improving LEMSs in patients with SCI. The best probability ranking of the BWST methods for improving LEMSs in patients with SCI was robot-assisted gait training (RAGT) (P = 0.60), followed by aquatic exercise (P = 0.21) and BWST (P = 0.19). Conclusions BWST can improve lower extremity motor function in patients with SCI. No significant difference was observed among the three BWST methods, but RAGT may produce the best effect.

Effectiveness of Body Weight-Supported Gait Training on Gait and Balance for Motor-Incomplete Spinal Cord Injuries: A Systematic Review with Meta-Analysis

“…Previous meta-analyses evaluated the effect of BWSGT in both complete and incomplete spinal-cord-injured patients and found further positive effects compared to conventional physical therapy only when robotic-assisted interventions were included [12,[16][17][18][19]. However, systematic reviews without meta-analysis [39,40] that only included patients with motor-iSCI also failed to show that BWSGT was more effective than conventional physical therapy.…”

“…Former meta-analyses [12,16,17] assessing the effectiveness of these forms of gait training either jointly included patients with complete and incomplete SCI or did not consider all forms of assistance previously described in BWSGT. However, recent studies suggest that, in the case of complete spinal cord injuries, robotic assistance could be more beneficial [18,19]. This review with meta-analysis focuses on motor-iSCI and widens the scope of assessed outcome variables by incorporating balance and quality of life.…”