Objective To determine the effects of robotic-assisted gait training on cardiopulmonary fitness and exercise capacity for people with incomplete spinal cord injury. Methods PubMed, Embase, Web of Science, PEDro, CENTRAL and CINAHL were searched from inception until September 4, 2022. Randomized controlled trials that evaluated the effects of robotic-assisted gait training on cardiopulmonary fitness and exercise capacity for individuals with incomplete spinal cord injury were selected. Mean differences (MD) with 95% confidence interval (CI) were calculated. The methodological quality was evaluated by the Cochrane Risk of Bias 2.0 tool. Subgroup analyses were conducted according to the time since injury. Results In total 19 studies involving 770 patients were eligible for analysis. Individuals with acute incomplete spinal cord injury in robotic-assisted gait training groups showed significantly greater improvements in 6-minute walking test (MD 53.32; 95% CI 33.49 to 73.15; P < 0.001), lower extremity motor scale (MD 5.22; 95% CI 3.63 to 6.80; P < 0.001) and walking index for spinal cord injury II (MD 3.18; 95% CI 1.34 to 5.02; P < 0.001). Robotic-assisted gait training improved peak oxygen consumption to a greater degree for chronic incomplete spinal cord injury patients (MD 4.90; 95% CI 0.96 to 8.84; P = 0.01). Conclusion Robot-assisted gait training may be a feasible and effective intervention in terms of cardiopulmonary fitness and exercise capacity for individuals with incomplete spinal cord injury.
IntroductionLung cancer remains a highly fatal disease. Surgical resection has been proven to be the most effective treatment for early-stage lung cancer. The conventional hospital-based pulmonary rehabilitation (PR) is shown to reduce symptoms, improve exercise capacity and impact the quality of life (QoL) for lung cancer patients. To date, scientific evidence on the effectiveness of home-based PR for patients with lung cancer following surgery is scarce. We aim to explore if home-based PR is non-inferior to outpatient PR for patients with lung cancer following surgical resection.Methods and analysisThis study is a two-arm, parallel-group, assessor-blind, single-centre, randomised controlled trial. Participants will be recruited from West China Hospital, Sichuan University and randomly allocated to either an outpatient group or a home-based group at a ratio of 1:1. The PR programme involves self-management and exercises. The exercise includes warm-up (10 min), aerobic training (20 min), resistance training (15 min) and cool-down (10 min), lasting 4 weeks, with two sessions per week either at home or in the outpatient setting. The intensity will be adjusted according to the modified Borg rating of perceived exertion and heart rate before and after each exercise session. The primary outcome is QoL measured by EORTC QLQ-C30 & LC 13 after an intervention. Secondary outcomes include physical fitness measured by a 6 min walk test and stair-climbing test and symptom severity measured by patient-reported questionnaires and pulmonary function. The main hypothesis is that home-based PR is non-inferior to outpatient PR for patients with lung cancer following surgical resection.Ethics and disseminationThe trial has been approved by the Ethical Committee of West China Hospital and is also registered with the Chinese Clinical Trial Registry. The results of this study will be disseminated through peer-reviewed publications and presentations at national and international conferences.Trial registration numberChiCTR2100053714.
Background: Spinal cord injury (SCI) is one of the most disabling and devastating neurological conditions, afflicting individuals and societies widely. Edaravone, a well-known synthetic ROS scavenger, is approved in the treatment of amyotrophic lateral sclerosis. In recent years, the role of edaravone in the treatment of SCI has been investigated in a growing number of studies. Methods: The systematic review will include the controlled studies evaluating the neurological roles of edaravone on experiment rat models following SCI. The primary outcome is the 21-point Basso, Beattie, and Bresnahan locomotor rating scale, and preservation of white matter areas and malondialdehyde will be employed as the secondary outcomes. Two researchers will search PubMed, Embase, Web of Science, Scopus and Cochrane Library from their inception date independently. Following study selection, data extraction, and assessment of methodological quality in the included studies using the SYRCLE’s RoB tool, data from eligible studies will be pooled and analyzed using random‑effects models with RevMan 5.3 software. In case of sufficient data, subgroup analyses with respect to species, age, sex, duration of intervention, dose or route of administration will be carried out to explore the factors modifying on BBB scores. For exploring the appropriate dose of edaravone, a network meta-analysis approach will be conducted based on the Bayesian method. Importantly, the proposed mechanisms and changes of related molecules will be also extracted from included studies for comprehensively investigating the neuroprotective mechanism behind edaravone. Discussion: In this study, we will quantitatively analyze the role of edaravone in locomotor recovery and tissue damage in SCI rat model. Besides, the efficacy of edaravone in distinct scenarios will be investigated by subgroups, and we plan to predict the candidate dose that exerts the greater neuroprotective effect with network meta-analyses. Moreover, we will provide comprehensive overview on the mechanisms underlying the emerging neuroprotective effects of edaravone in SCI. This study will provide implications for future preclinical studies and clinical applications of SCI.
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