Effects of robotic therapy associated with noninvasive brain stimulation on motor function in individuals with incomplete spinal cord injury: A systematic review of randomized controlled trials

This review examines if combining robotic therapy with non-invasive brain stimulation (NIBS) can improve motor function after incomplete spinal cord injury (SCI). Motor impairments following SCI can significantly reduce a person's quality of life. The study analyzed five randomized controlled trials, revealing that the combination of robotic therapy and NIBS may be safe for individuals with incomplete SCI, but the existing evidence on its effects is limited. More research is needed to fully understand these effects. NIBS techniques like tDCS and rTMS can modulate brain activity and potentially enhance the benefits of robotic training, which offers repetitive, targeted movements. The review aimed to assess the current evidence for using robotics and NIBS together for motor rehabilitation in SCI patients.

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  The review of five randomized trials (n = 122) showed varied results due to differences in treatment protocols and outcome measures. However, the included studies demonstrated high methodological quality.
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  Some studies showed improvements in upper extremity motor scores and lower extremity motor scores (LEMS) with combined rTMS and Lokomat therapy compared to sham interventions.
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  Other studies found significant improvements in walking ability (WISCI II) and balance (BBS) after the interventions. However, not all studies showed significant differences between the experimental and control groups.