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Meta-Analysis
. 2019 Mar;42(2):142-154.
doi: 10.1080/10790268.2017.1390644. Epub 2017 Oct 25.

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

Ana Valeria Aguirre-Güemez  1 , Aberto Isaac Pérez-Sanpablo  2 , Jimena Quinzaños-Fresnedo  1 , Ramiro Pérez-Zavala  1 , Aída Barrera-Ortiz  1
Affiliations
Meta-Analysis

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

Ana Valeria Aguirre-Güemez et al. J Spinal Cord Med. 2019 Mar.

Abstract

Context: While there are previous systematic reviews on the effectiveness of the use of robotic-assisted gait training (RAGT) in people with spinal cord injuries (SCI), as this is a dynamic field, new studies have been produced that are now incorporated on this systematic review (SR) with meta-analysis, updating the available evidence on this area.

Objective: To synthesise the available evidence on the use of RAGT, to improve gait, strength and functioning.

Methods: SR and meta-analysis following the Cochrane Handbook for Systematic Reviews of Interventions were implemented. Cochrane Injuries Group Specialized Register, PubMed, MEDLINE, EMBASE, CINAHL, ISIWeb of Science (SCIEXPANDED) databases were reviewed for the period 1990 to December 2016. Three researchers independently identified and categorized trials; 293 studies were identified, 273 eliminated; remaining 15 randomized clinical trials (RCT) and five SR. Six studies had available data for meta-analysis (222 participants).

Results: The pooled mean demonstrated a beneficial effect of RAGT for WISCI, FIM-L and LEMS (3.01, 2.74 and 1.95 respectively), and no effect for speed.

Conclusions: The results show a positive effect in the use of RAGT. However, this should be taken carefully due to heterogeneity of the studies, small samples and identified limitations of some of the included trials. These results highlight the relevance of implementing a well-designed multicenter RCT powered enough to evaluate different RAGT approaches.

Keywords: Spinal cord injuries; locomotor training; robot-assisted gait training; robotics; walking.

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Figures

Figure 1.
Figure 1.
Flow Diagram
Figure 2.
Figure 2.
Risk of bias graph: review authors' judgments about each risk of bias item presented as percentages across all included studies
Figure 3.
Figure 3.
Risk of bias summary: review authors' judgments about each risk of bias for each included study
Figure 4.
Figure 4.
Effect on Speed
Figure 5.
Figure 5.
Effect on LEMS
Figure 6.
Figure 6.
Effect on WISCI
Figure 7.
Figure 7.
Effect on FIM-L
See this image and copyright information in PMC

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