Effectiveness of over-ground robotic locomotor training in improving walking performance, cardiovascular demands, secondary complications and user-satisfaction in individuals with spinal cord injuries: A systematic review

Objectives: To evaluate the effectiveness of over-ground robotic locomotor training in individuals with spinal cord injuries with regard to walking performance, cardiovascular demands, secondary health complications and user-satisfaction. Data sources: PubMed, Cochrane, Web of Science, Scopus, EBSCO...

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Main Authors: Claire Shackleton (Author), Robert Evans (Author), Delva Shamley (Author), Sacha West (Author), Yumna Albertus (Author)
Format: Book
Published: Medical Journals Sweden, 2019-10-01T00:00:00Z.
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Summary:Objectives: To evaluate the effectiveness of over-ground robotic locomotor training in individuals with spinal cord injuries with regard to walking performance, cardiovascular demands, secondary health complications and user-satisfaction. Data sources: PubMed, Cochrane, Web of Science, Scopus, EBSCOhost and Engineering Village. Study selection: Trials in which robotic locomotor training was used for a minimum of 3 participants with spinal cord injury. Data extraction: Independent extraction of data by 2 reviewers using a pre-established data abstraction table. Quality of evidence assessed using Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Data synthesis: Total of 27 non-controlled studies representing 308 participants. Most studies showed decreases in exertion ratings, pain and spasticity and reported positive well-being post-intervention. Seven studies were included in meta-analyses on walking performance, showing significant improvements post-intervention (p < 0.05), with pooled effects for the 6-min walking test and 10-metre walking test of-0.94 (95% confidence interval (95% CI) -1.53,-0.36) and -1.22 (95% CI -1.87,-0.57), respectively. The Timed Up and Go Test showed a positive pooled effect of 0.74 (95% CI 0.36, 1.11). Improvements in walking parameters were seen with an increase in session number; however, no significant cardiovascular changes were found over time. Conclusion: Robotic locomotor training shows promise as a tool for improving neurological rehabilitation; however, there is limited evidence regarding its training benefits. Further high-powered, randomized controlled trials, with homogenous samples, are required to investigate these effects.
Item Description:1650-1977
1651-2081
10.2340/16501977-2601