Effect of Robotic-Assisted Gait Training in Patients With Incomplete Spinal Cord Injury

Ann Rehabil Med, 2014 · DOI: http://dx.doi.org/10.5535/arm.2014.38.6.719 · Published: December 1, 2014

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

This study investigates whether robotic-assisted gait training (RAGT) can help people with incomplete spinal cord injuries improve their walking ability, compared to traditional physical therapy. Patients in the RAGT group received robotic training combined with regular physiotherapy, while the control group received regular physiotherapy alone. The study found that both groups improved, but the RAGT group showed a statistically significant improvement in walking ability based on a specific walking assessment scale.

Study Duration

4 Weeks

Participants

60 patients with motor incomplete spinal cord injury (SCI)

Evidence Level

Level 1, Randomized Clinical Trial

Key Findings

1
Both RAGT and conventional therapy groups showed significant improvement in lower extremity motor score, ambulatory motor index, Spinal Cord Independence Measure III mobility section, and walking index for spinal cord injury version II.
2
The RAGT group showed a statistically significant improvement based on the Walking Index for Spinal Cord Injury Version II (WISCI-II) compared to the conventional therapy group.
3
There was no significant difference between the groups regarding the achievement of recovery based on LEMS and AMI scores.

Research Summary

This study aimed to determine the effect of robotic-assisted gait training (RAGT) compared to conventional overground training for patients with incomplete spinal cord injury (SCI). The results showed that both groups improved in various measures, but the RAGT group had a statistically significant improvement in walking ability based on the WISCI-II scale. The conclusion suggests that RAGT combined with conventional physiotherapy could yield more improvement in ambulatory function than conventional therapy alone.

Practical Implications

Enhanced Rehabilitation

RAGT can be considered as an additional tool to enhance neuromuscular reeducation in patients with incomplete SCI, potentially leading to better ambulatory function.

Personalized Training

The study highlights the importance of considering individual patient characteristics and needs when designing gait training programs, as RAGT may not be universally superior to conventional therapy.

Early Intervention

The findings suggest that earlier walking training could be more effective, and RAGT might be considered for implementation before overground walking training.

Study Limitations

1
The number of patients per group was relatively small with diverse etiologies.
2
Only short-term outcome was evaluated. Long-term follow-up was not assessed.
3
Walking ability should be measured based on both spatial and temporal parameters as well as kinematics (joint range changes) and kinetics (moments and forces acting across joints).

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