Gait quality after robot therapy compared with physiotherapy in the patient with incomplete spinal cord injured: A systematic review

Abstract

Background: Spinal cord injury results in the interruption of neuronal conduction in the spinal cord, a condition that occurs in 0.1% of the world's population. This results in severe limitations in autonomy including locomotor function. Its recovery can be pursued through conventional isolated physiotherapeutic rehabilitation (overground walking training - OGT) or associated with Robot-assisted gait training - RAGT (e.g.: Lokomat ®). Aim: The aim of this review is to compare the effectiveness of RAGT combined with conventional physiotherapy. Methods: The databases consulted, from March 2022 to November 2022, were PubMed, PEDro, Cochrane Central Register of Controlled Trials (Cochrane Library) and CINAHL. RCT studies of people with incomplete spinal cord injuries treated with RAGT and/or OGT with the aim of improving walking were analysed. Results: Among the 84 RCTs identified, 4 were included in the synthesis, with a total of 258 participants. The outcomes analysed concerned both locomotor function through lower limb muscle strength and the need for assistance in walking, using the WISCI-II scale and the LEMS. Robotic treatment stimulated the greatest improvements in the four studies; however, they were not always statistically significant. Conclusion: A rehabilitation protocol combining RAGT with conventional physiotherapy is more effective than isolated OGT in improving ambulation in the subacute phase.

Keywords

• Overground walking training
• Robot-assisted gait training
• Spinal cord injury
• Locomotor function
• Physiotherapy