Effectiveness of robotic-assisted gait training on cardiopulmonary fitness and exercise capacity for incomplete spinal cord injury: A systematic review and meta-analysis of randomized controlled trials

Abstract

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.

Impact of Robotic-Assisted Gait Training in Subacute Spinal Cord Injury Patients on Outcome Measure

“…We observed clinical improvement in both the control and experimental study groups; however, there were greater effects (in functional gait parameters) in the RAGT group. These results are consistent with reports from the literature [14][15][16]34,36]. In a study by Labruyère et al, no such relationship was observed [37]; however, the study included a small group of only nine patients with incomplete SCI (AIS-C and D).…”

“…Regular locomotor training can also prevent secondary problems associated with physical inactivity in SCI patients. RAGT has been shown to have beneficial effects in reducing pain, spasticity, or improving cardiopulmonary, urinary, and bowel functions [4,11,[14][15][16]. The greatest effects of RAGT are observed in Diagnostics 2023, 13,1966 2 of 15 individuals with incomplete SCI and in the early stages of this therapy [12].…”

Effect of robotic-assisted gait training on gait and motor function in spinal cord injury: a protocol of a systematic review with meta-analysis

“…It ultimately shortens patients’ life expectancy 5. In addition, the mortality rate of patients with SCI is higher than that of the general population 6–8. National statistical data show an increasing incidence rate of SCI annually, and that the incidence rate of SCI per million residents is 9.3 persons/year 9.…”

“… 13 RAGT can also improve balance function and has been gradually applied in patients with SCI. 14 In patients with SCI, robots for lower limb rehabilitation can effectively and safely improve walking ability; reduce pressure ulcers, 15 lung infections, 8 urinary tract infections and other complications 16 ; improve dignity; and reduce costs. However, high-quality evidence-based medical studies that systematically evaluated the efficacy of RAGT in the treatment of SCI remain scarce.…”

“…5 In addition, the mortality rate of patients with SCI is higher than that of the general population. [6][7][8] National statistical data show an increasing incidence rate of SCI annually, and that the incidence rate of SCI per million residents is 9.3 persons/year. 9 During the rehabilitation treatment of SCI, improving the walking ability, self-care ability and self-esteem of patients is an important aspect that helps them return to society and reduces their costs.…”