Walking speed is not the best outcome to evaluate the effect of robotic assisted gait training in people with motor incomplete Spinal Cord Injury: A Systematic Review with meta-analysis

Aguirre-Güemez, Ana Valeria; Pérez-Sanpablo, A I; Quinzaños-Fresnedo, Jimena; Pérez-Zavala, Ramiro; Barrera-Ortíz, Aida

doi:10.1080/10790268.2017.1390644

Cited by 19 publications

(19 citation statements)

References 58 publications

(165 reference statements)

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“…The use of robot-assisted gait training (RAGT) in the field of rehabilitation has become more widespread since this training is not limited by the individuals' muscle paralysis level. Current systems of RAGT include Lokomat (Hocoma AG, Switzerland), G-EO systemTM (Reha Technology AG, Switzerland), Walkbot (P&S Mechanics Co., Ltd, Korea), and ReoAmbula-torTM (Motorika, USA Inc.) [22]. RAGT provides repetitive and functional task training which induces greater activation of the sensorimotor cortex (S1, S2) and cerebellar regions [23].…”

Section: Introductionmentioning

confidence: 99%

Effects of Robot-Assisted Gait Training in Individuals with Spinal Cord Injury: A Meta-analysis

Fang

Tsai

et al. 2020

BioMed Research International

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Background. To investigate the effects of robot-assisted gait training (RAGT) on spasticity and pain in people with spinal cord injury (SCI). Material and methods. Four electronic databases (PubMed, Scopus, Medline, and Cochrane Central Register of Controlled Trials) were searched for studies published up to November 2019. Only human trials and of English language were included. The searched studies were reviewed and extracted independently by two authors. Randomized controlled trials (RCTs) and non-RCTs were pooled separately for analyses. Primary outcome measures included spasticity assessed by Ashworth scale (AS) or modified Ashworth scale (MAS) and pain assessed by VAS. Secondary outcome measures included lower extremity motor score (LEMS) and walking ability (i.e., 6-minute walk test, 10-meter walk test). Results. A total of 225 studies were identified. Eighteen studies (7 RCTs and 11 non-RCTs) including 301 subjects met inclusion criteria. The outcome measure of spasticity significantly improved in favor of RAGT group in non-RCTs (AS: 95%CI=−0.202 to -0.068, p≤0.001; MAS: 95%CI=−2.886 to -1.412, p≤0.001). The results on pain did not show significant change after RAGT in either RCTs or non-RCTs. LEMS and walking ability significantly increased in favor of RAGT. Conclusions. RAGT can improve spasticity and walking ability in people with SCI. The probable reason for no significant change in pain after RAGT is floor effect. RAGT is beneficial for normalizing muscle tone and for improving lower extremity function in people with SCI without causing extra pain.

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Section: Introductionmentioning

confidence: 99%

Effects of Robot-Assisted Gait Training in Individuals with Spinal Cord Injury: A Meta-analysis

Fang

Tsai

et al. 2020

BioMed Research International

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“…In previous studies on RAGT in SCI patients, the 6mWT, WISCI-II, and LEMS revealed improvements compared to the control group; however, the 10 MWT and BBS showed no significant improvement after the RAGT. [7,9,15,[20][21][22] Most studies on RAGT in SCI patients used the 10MWT, 6mWT, LEMS, and WISCI-II as clinical outcomes. Only one study has used BBS as a clinical outcome [21], and no study has assessed proprioception in RAGT studies in SCI patients.…”

Section: Discussionmentioning

confidence: 99%

“…RAGT in patients with incomplete SCI revealed improvements in mobility-related outcomes (gait endurance and Walking Index for Spinal Cord Injury [WISCI]-II) and lower extremity motor strength compared to conventional physiotherapy [7,9,12]. However, recent RAGT studies for incomplete SCI patients have used Lokomat ® , except for three articles [15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Effects on the Motor Function, Proprioception, Balance, and Gait Ability of the End-Effector Robot-Assisted Gait Training for Spinal Cord Injury Patients

et al. 2021

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The primary aim of this study was to reveal the effects of end-effector robot-assisted gait training (RAGT) on motor function, proprioception, balance, and gait ability in patients with incomplete spinal cord injury (SCI). The secondary aim was to determine the correlation between clinical outcomes. This study was a prospective and multi-center study. A total of 13 incomplete SCI patients who met inclusion criteria received 30 min of RAGT with Morning Walk® (Curexo, Seoul, South Korea), and 1 h of conventional physiotherapy 5 times per week for 4 weeks. Clinical outcome measures were 10 m walk test (10MWT), 6 min walk test (6mWT), lower extremity motor score (LEMS), proprioception, Berg Balance Scale (BBS), and Walking Index for Spinal Cord Injury (WISCI)-II. All participants were assessed within 48 h before and after the intervention. All clinical outcomes were statistically improved after RAGT. Subgroup analysis according to the initial proprioception, WISCI-II in the normal group showed a statistically significant improvement compared to the abnormal group. Initial BBS and WISCI-II had a positive correlation with most of the final clinical outcomes. The final BBS had a strong positive correlation with the final 10MWT, 6mWT, and WISCI-II. Initial proprioception had a positive correlation with the final WISCI-II. The final proprioception also had a moderate positive correlation with 6mWT and BBS. This study’s results suggest that the end-effector RAGT could promote proprioception, balance ability and walking ability. Postural control ability and proprioception also had a positive relationship with gait ability.

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“…Previous studies reported that high walking speed is important for daily living and social participation ability, 32 and that walking quality includes the ability to walk quickly. 33 Some walking training methods aim to improve walking speed. 34 Taken together, these findings suggest that walking under ETAAC conditions could improve walking quality and facilitate walking in daily living.…”

Section: Discussionmentioning

confidence: 99%

Enhanced Active Contraction of the Transversus Abdominis During Walking

Deng

Zhong

et al. 2021

Rev Bras Med Esporte

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Introduction: We applied three-dimensional gait analysis to assess the effects of enhanced active contraction of the transversus abdominis (EACTA) during walking. We sought to evaluate the effect of EACTA during walking in order to improve walking quality. Methods: Thirty college students were recruited and trained to perform EACTA during walking. We examined gait parameters under different conditions, including EACTA and habitual ACTA (natural walking with mild contraction of the feedforward mechanism of ACTA, HACTA) during walking using three-dimensional gait analysis. We compared differences in gait parameters under the two walking conditions using SPSS 16.0 statistical software. Results: The following gait parameters were significantly lower under EACTA conditions than under HACTA conditions (P < 0.05): stance phase, 59.151% ± 1.903% vs. 59.825% ± 1.495%; stride time, 1.104 s ± 0.080 s vs. 1.134 s ± 0.073 s:; stance time, 0.656 s ± 0.057 s vs. 0.678 s ± 0.053 s; and swing time, 0.447 s ± 0.028 s vs. 0.454 s ± 0.031 s, respectively. Gait parameters single support phase and mean velocity were significantly higher for EACTA than for HACTA conditions (both P < 0.05). Conclusions: Overall, the results revealed that EACTA during walking can improve gait. This method is simple, and EACTA training during walking to improve gait quality in daily life could provide a positive basis for people to strengthen the transverse abdominal muscle. Level of evidence III; Retrospective comparative study .

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Walking speed is not the best outcome to evaluate the effect of robotic assisted gait training in people with motor incomplete Spinal Cord Injury: A Systematic Review with meta-analysis

Cited by 19 publications

References 58 publications

Effects of Robot-Assisted Gait Training in Individuals with Spinal Cord Injury: A Meta-analysis

Effects of Robot-Assisted Gait Training in Individuals with Spinal Cord Injury: A Meta-analysis

Effects on the Motor Function, Proprioception, Balance, and Gait Ability of the End-Effector Robot-Assisted Gait Training for Spinal Cord Injury Patients

Enhanced Active Contraction of the Transversus Abdominis During Walking

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