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Review
. 2024 Feb 15;13(4):1105.
doi: 10.3390/jcm13041105.

Effectiveness of Body Weight-Supported Gait Training on Gait and Balance for Motor-Incomplete Spinal Cord Injuries: A Systematic Review with Meta-Analysis

Rubén Arroyo-Fernández  1   2   3 , Raquel Menchero-Sánchez  1   2 , Diana P Pozuelo-Carrascosa  4 , Helena Romay-Barrero  1   2 , Araceli Fernández-Maestra  5 , Inés Martínez-Galán  1   2
Affiliations
Review

Effectiveness of Body Weight-Supported Gait Training on Gait and Balance for Motor-Incomplete Spinal Cord Injuries: A Systematic Review with Meta-Analysis

Rubén Arroyo-Fernández et al. J Clin Med. .

Abstract

Objective: This review aims to analyse the effectiveness of body weight-supported gait training for improving gait and balance in patients with motor-incomplete spinal cord injuries.

Method: Relevant articles were systematically searched in electronic databases to identify randomised controlled trials of body weight-supported gait training (either with methods of robotic, manual, and functional electrical stimulation assistance) versus conventional physical therapy or no intervention. Subjects were >16 years-old with motor-incomplete spinal cord injury (AIS C or D). Primary outcomes were gait-related parameters (functionality, endurance, and speed) and balance. Quality of life was included as a secondary outcome. Articles were selected up to 31 December 2023.

Results: Fifteen studies met the inclusion criteria (n = 673). Nine studies used robotic assistance, four trials performed manual assistance, one study functional electrical stimulation assistance, and one trial performed the intervention without guidance. Robot-assisted body weight-supported gait training improved walking functionality (SMD = 1.74, CI 95%: 1.09 to 2.39), walking endurance (MD = 26.59 m, CI 95% = 22.87 to 30.31), and balance (SMD = 0.63, CI 95% = 0.24 to 1.02).

Conclusions: Body weight-supported gait training is not superior to conventional physiotherapy in gait and balance training in patients with motor-incomplete spinal cord injury. However, body weight-supported gait training with robotic assistance does improve walking functionality, walking endurance, and balance, but not walking speed.

Keywords: balance; body weight-supported; gait; rehabilitation; spinal cord injury.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
PRISMA flow diagram of the literature search and study selection.
Figure 2
Figure 2
Risk of bias graph. The percentage (%) shows the risk of bias for each methodological domain of the tool.
Figure 3
Figure 3
Effectiveness of body weight-supported gait training on gait parameters in patients with motor-incomplete spinal cord injury: (A) walking functionality; (B) walking endurance; (C) walking speed. BWSGT = body weight-supported gait training; SD = standard deviation; IV = inverse variance; CI = confidence interval; Std = standardised. The green point and the horizontal black lines refer to the mean and standard deviation, respectively [23,24,25,27,28,29,30,31,32,33,34,35,36].
Figure 3
Figure 3
Effectiveness of body weight-supported gait training on gait parameters in patients with motor-incomplete spinal cord injury: (A) walking functionality; (B) walking endurance; (C) walking speed. BWSGT = body weight-supported gait training; SD = standard deviation; IV = inverse variance; CI = confidence interval; Std = standardised. The green point and the horizontal black lines refer to the mean and standard deviation, respectively [23,24,25,27,28,29,30,31,32,33,34,35,36].
Figure 4
Figure 4
Effectiveness of body weight-supported gait training on balance in patients with motor-incomplete spinal cord injury. BWSGT = body weight-supported gait training; SD = standard deviation; IV = inverse variance; CI = confidence interval; Std = standardised. The green point and the horizontal black lines refer to the mean and standard deviation, respectively. [24,26,28,30,33,34,35].
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