Impact of Robotic-Assisted Gait Therapy on Depression and Anxiety Symptoms in Patients with Subacute Spinal Cord Injuries (SCIs)—A Prospective Clinical Study

J. Clin. Med., 2023 · DOI: 10.3390/jcm12227153 · Published: November 17, 2023

Spinal Cord Injury Mental Health Rehabilitation

Simple Explanation

This study explores how robotic-assisted gait therapy (RAGT) affects depression and anxiety in patients with spinal cord injuries (SCIs). Patients were divided into two groups: one receiving RAGT and the other receiving conventional gait therapy. Both groups showed improvements in anxiety and depression symptoms after a 7-week rehabilitation program. This suggests that physical training and rehabilitation can positively impact the mental state of SCI patients. The type of rehabilitation (RAGT vs. conventional) did not significantly affect the magnitude of improvement in depression and anxiety. However, those with severe neurological conditions may benefit more from RAGT.

Study Duration

7 weeks

Participants

110 participants with subacute SCIs

Evidence Level

Prospective clinical study

Key Findings

1
SCI patients in both groups experienced significantly lower levels of anxiety- and depression-related symptoms after completing the seven-week rehabilitation program.
2
In the RAGT group, post-rehabilitation measurements also indicated an improvement in psychological functioning (i.e., decreases in depression and anxiety and an increase in self-regulation (SR)).
3
The rehabilitation modality did not appear to have a statistically significant relationship with the magnitude of improvement in the Depression Assessment Questionnaire (KPD) (including self-regulation) and State–Trait Anxiety Inventory (STAI) scores.

Research Summary

The study investigated the impact of robotic-assisted gait therapy (RAGT) on depression and anxiety symptoms in patients with subacute spinal cord injuries (SCIs), comparing it with conventional gait therapy with dynamic parapodium (DPT). Both RAGT and DPT groups experienced significant decreases in anxiety and depression after a 7-week rehabilitation program, suggesting that both types of rehabilitation are beneficial for improving mental health in SCI patients. The type of rehabilitation (DPT vs. RAGT) did not significantly differentiate between patients in terms of the magnitude of change in anxiety and depression symptoms, although individuals with severe neurological conditions and complete SCIs may experience greater benefits from RAGT.

Practical Implications

Rehabilitation Program Design

Both RAGT and DPT should be considered as effective components in rehabilitation programs for SCI patients, with a focus on integrating psychological support.

Personalized Therapy

Patients with severe neurological conditions and complete spinal cord injuries (AIS A) may benefit more from RAGT in terms of psychological parameters.

Mental Health Integration

Early coordinated rehabilitation programs should anticipate implications for psychological health, focusing on reducing anxiety and depression in SCI patients.

Study Limitations

1
Sample size was not estimated before the start of the study
2
Patients were self-recruited, which may have falsified the representativeness of this group among the general population of people with SCIs.
3
There were disproportionate numbers of patients between the experimental and control groups, and between those with complete and incomplete SCIs.

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