Clinical Benefit of Rehabilitation Training in Spinal Cord Injury

Abstract

Study Design. A systematic review and meta-analysis. Objective. This study was performed to evaluate the effects of different rehabilitation interventions in spinal cord injury. Summary of Background Data. Several activity-based interventions have been widely applied in spinal cord injury in the past, but the effects of these rehabilitation exercises are controversial. Methods. Publications were searched from databases (PubMed, Embase, Cochrane, the database of the U.S. National Institutes of Health and World Health Organization International Clinical Trials Registry Platform) using the searching terms like spinal cord injury, transcranial magnetic stimulation, functional electrical stimulation, activity-based therapy, and robotic-assisted locomotor training. Randomized controlled trials and controlled trials were included. The primary outcomes included functional upper/lower extremity independence, walking capacity, spasticity, and life quality of individuals with spinal cord injury. Meta-analysis was performed using Revman 5.0 software. Results. Thirty-one articles were included. Meta-analysis showed that transcranial magnetic stimulation improved walking speed (95% confidence interval [CI] 0.01, 0.16) and lower extremity function (95% CI 1.55, 7.27); functional electrical stimulation significantly increased upper extremity independence (95% CI 0.37, 5.48). Robotic-assisted treadmill training improved lower extremity function (95% CI 3.44, 6.56) compared with related controls. Conclusion. Activity-based intervention like transcranial magnetic stimulation, functional electrical stimulation, and robotic-assisted treadmill training are effective in improving function in individuals with spinal cord injury. Level of Evidence: 1

Factors for Predicting Instant Neurological Recovery of Patients with Motor Complete Traumatic Spinal Cord Injury

“…Inpatient rehabilitation plays an important role in neurological recovery in patients with TSCI. Research has shown that activity-based interventions, such as transcranial magnetic stimulation, functional electrical stimulation, and robotic-assisted treadmill training, are effective in improving function in individuals with spinal cord injury [ 24 , 25 ]. Nam et al [ 26 ] demonstrated that robot-assisted gait training can restore functional walking and improve locomotor ability, which might enable patients with SCI to increase their level of physical activity and maintain a healthy lifestyle.…”

Injectable hydrogel embedded with mesenchymal stem cells repairs severe spinal cord injury

“…However, we still need further monkey experiments to evaluate the therapeutic effect and optimize the dose before human clinical studies. Moreover, it has been proved that transcranial magnetic and functional electrical stimulation improve function in SCI patients 35 . So, we believe that combining proper training in the following clinical study with MSCs treatment could further improve the treatment effect.…”

Current Concepts of Neural Stem/Progenitor Cell Therapy for Chronic Spinal Cord Injury

“…A systematic review of the clinical benefits of rehabilitation training in SCI reported that robotic-assisted treadmill training improved lower extremity function (95% CI 3.44, 6.56) compared with related controls, and FES also significantly increased upper extremity independence (95% CI 0.37, 5.48) (Duan et al, 2021).…”