The effect of robot-assisted gait training for patients with spinal cord injury: a systematic review and meta-analysis

Abstract

BackgroundWith the aging of the global population, Spinal injuries are often prone to occur and affect human health. The development of technology has put robots on the stage to assist in the treatment of spinal injuries.MethodsA comprehensive literature search were carried out in multiple databases, including PubMed, Medline (Ovid), Web of Science, Cochrane, Embase, Scopus, CKNI, Wang fang, VIP database, Sino Med, Clinical Trails until 20th, June, 2023 to collect effect of robot-assisted gait training for patients with spinal cord injury patients. Primary outcome includes any changes of gait distance and gait speed. Secondary outcomes include any changes in functions (Such as TUG, Leg strength, 10 MWT) and any advent events. Data were extracted from two independent individuals and Cochrane Risk of Bias tool version 2.0 was assessed for the included studies. Systematic review and meta-analysis were performed by RevMan 5.3 software.Results11 studies were included in meta-analysis. The result showed that gait distance [WMD = 16.05, 95% CI (−15.73, 47.83), I2 = 69%], gait speed (RAGT vs. regular treatment) [WMD = 0.01, 95% CI (−0.04, 0.05), I2 = 43%], gait speed (RAGT vs. no intervention) [WMD = 0.07, 95% CI (0.01, 0.12), I2 = 0%], leg strength [WMD = 0.59, 95% CI (−1.22, 2.40), I2 = 29%], TUG [WMD = 9.25, 95% CI (2.76, 15.73), I2 = 74%], 10 MWT [WMD = 0.01, 95% CI (−0.15, 0.16), I2 = 0%], and 6 MWT [WMD = 1.79, 95% CI (−21.32, 24.90), I2 = 0%].ConclusionRobot-assisted gait training seems to be helpful for patients with spinal cord to improve TUG. It may not affect gait distance, gait speed, leg strength, 10 MWT, and 6 MWT.

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.…”

Effects of a Gait Training Program on Spinal Cord Injury Patients: A Single-Group Prospective Cohort Study

“…Taking into account the number of scientific articles that relate gait training to the use of new rehabilitation methods, it can be inferred that the attention given to conventional gait training methods is scarce, but not the same for those articles that focus on the use of new technologies [23][24][25][26][27].…”

“…In fact, as detailed in a recent systematic review, robot-assisted gait training alone fails to improve such important parameters in gait rehabilitation as walking distance, walking speed, and leg strength [27]. To achieve an improvement in these indicators, it is necessary to improve the gait patterns so that as the gait becomes more efficient in terms of its performance, the patient will have less energy expenditure, which will allow him to increase the distance and speed to be covered.…”