Robot-assisted training for people with spinal cord injury: A meta-analysis

Publication date: Available online 20 June 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Eddy YY. Cheung, Thomas KW. Ng, Kevin KK. Yu, Rachel LC. Kwan, Gladys LY. Cheing
ObjectiveTo investigate the effects of robotic-assisted training on the recovery of people with spinal cord injury (SCI).Data SourceRandomized controlled trials (RCTs) or quasi-RCTs involving people with SCI that compared robotic-assisted upper limbs or lower limbs training to a control of other treatment approach or no treatment. We included studies involving people with complete or incomplete spinal cord injuries.Study SelectionWe searched in Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (Cochrane Library) and Excerpta Medica dataBASE (EMBASE) to August, 2016. Bibliography of relevant articles on the effect of body weight supported treadmill training (BWSTT) on SCI subjects were screened to avoid missing relevant articles from the search of databases.Data ExtractionAll kinds of objective assessments concerning physical ability, mobility and/or functional ability were included. Assessments could be clinical tests (ie: 6-minute walk test and Functional Independence Measure) or laboratory test (ie: gait analysis). Subjective outcome measures were excluded from the present review.Data Synthesis11 RCT studies involving 443 subjects were included in the study. Meta-analysis was performed on the included studies. Walking independence (3.73 with 95% CI -4.92 to -2.53; P<0.00001; I²=38%) and endurance (53.32 m with 95% CI – 73.15 to -33.48; P<0.00001; I²=0%) were found to have better improvement in robotic-assisted training groups. Lower limb robotic-assisted training was also found to be as effective as other types of body weight supported training. There is a lack of upper limb robotic-assisted training studies, so a meta-analysis was not possible to be performed.ConclusionRobotic-assisted training is an adjunct therapy for physical and functional recovery for patients with SCI. Future high-quality studies are warranted to investigate the effects of robotic-assisted training on functional and cardiopulmonary recovery of SCI patients.



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