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Robot-assisted training for people with spinal cord injury: a meta-analysis
Cheung EYY, Ng TKW, Yu KKK, Kwan RLC, Cheing GLY
Archives of Physical Medicine and Rehabilitation 2017 Nov;98(11):2320-2331
systematic review

OBJECTIVE: To investigate the effects of robotic-assisted training on the recovery of people with spinal cord injury (SCI). DATA SOURCE: Randomized 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 SELECTION: We 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 EXTRACTION: All 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 SYNTHESIS: 11 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. CONCLUSION: Robotic-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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