Effects of robot-assisted gait training on lower extremity strength, functional independence, and walking function in men with incomplete traumatic spinal cord injury

Background. To investigate the effects of robot-assisted gait training (RAGT) on spasticity and pain in people with spinal cord injury (SCI). Material and methods. Four electronic databases (PubMed, Scopus, Medline, and Cochrane Central Register of Controlled Trials) were searched for studies published up to November 2019. Only human trials and of English language were included. The searched studies were reviewed and extracted independently by two authors. Randomized controlled trials (RCTs) and non-RCTs were pooled separately for analyses. Primary outcome measures included spasticity assessed by Ashworth scale (AS) or modified Ashworth scale (MAS) and pain assessed by VAS. Secondary outcome measures included lower extremity motor score (LEMS) and walking ability (i.e., 6-minute walk test, 10-meter walk test). Results. A total of 225 studies were identified. Eighteen studies (7 RCTs and 11 non-RCTs) including 301 subjects met inclusion criteria. The outcome measure of spasticity significantly improved in favor of RAGT group in non-RCTs (AS: 95%CI=−0.202 to -0.068, p≤0.001; MAS: 95%CI=−2.886 to -1.412, p≤0.001). The results on pain did not show significant change after RAGT in either RCTs or non-RCTs. LEMS and walking ability significantly increased in favor of RAGT. Conclusions. RAGT can improve spasticity and walking ability in people with SCI. The probable reason for no significant change in pain after RAGT is floor effect. RAGT is beneficial for normalizing muscle tone and for improving lower extremity function in people with SCI without causing extra pain.

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Retrospective Analysis of Clinical Practice Data of Robot-Assisted Gait Training in Patients with Spinal Cord Injury

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2016.08.423 ◽

2016 ◽

Vol 97 (10) ◽

pp. e136

Author(s):

Gloria Vergara-Diaz ◽

Jairo Alberto Dussan-Sarria ◽

Massiel Dominguez-Iglesia ◽

Anne O’Brien ◽

Catherine Adans-Dester ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Clinical Practice ◽

Retrospective Analysis ◽

Gait Training ◽

Robot Assisted ◽

Cord Injury

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Effect of Treadmill Training on Gait and Functional Independence in Patients with Incomplete Spinal Cord Injury: A Case Series

Internet Journal of Allied Health Sciences and Practice ◽

10.46743/1540-580x/2012.1409 ◽

2012 ◽

Author(s):

Shahnawaz Anwer ◽

Ameed Equebal ◽

Ratnesh Kumar

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Walking Speed ◽

Case Series ◽

Gait Training ◽

Functional Independence ◽

Treadmill Training ◽

Incomplete Spinal Cord Injury ◽

Post Injury ◽

Cord Injury

Background and purpose: Many individuals with an incomplete spinal cord injury (SCI) have the potential to walk. The effectiveness of using a treadmill for gait training for these patients has been substantiated in the literature. This case series describes the effectiveness of incorporating gait training on a treadmill for two individuals with an incomplete SCI. Case Description: The treatments of two males each with an incomplete paraplegia were described. Subject 1 was 40 years old and was 14 months post injury at the time of the study. He had a T6 incomplete spinal cord injury classified as a D on the American Spinal Injury Association (ASIA) Impairment Scale and neurological classification standards. Subject 2 was 48 years old and was 10 months post injury. He had a T8 incomplete spinal cord injury classified as ASIA C. Intervention: Both subjects participated in gait training for a maximum of 10 minutes on a motorized treadmill without elevation at a comfortable walking speed three days a week for four weeks as an adjunct to a conventional physiotherapy programme.Results: An increase in step length, stride length, cadence, and comfortable walking speed were noted in both subjects. Both subjects improved their walking level as measured by the Walking Index for Spinal Cord Injury (WISCI II) and functional independence as measured by Spinal Cord Independent Measure (SCIM II). Conclusion: Gait training on a treadmill can improve gait parameters and functional independence in patients with incomplete paraplegia. Further research is needed to improve the generalizability of these findings and to identify which patients might benefit most from treadmill training.

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Non-invasive brain stimulation and robot-assisted gait training after incomplete spinal cord injury: A randomized pilot study

Neurorehabilitation ◽

10.3233/nre-151291 ◽

2016 ◽

Vol 38 (1) ◽

pp. 15-25 ◽

Cited By ~ 19

Author(s):

Ravi Raithatha ◽

Cheryl Carrico ◽

Elizabeth Salmon Powell ◽

Philip M. Westgate ◽

Kenneth C. Chelette II ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Pilot Study ◽

Brain Stimulation ◽

Gait Training ◽

Incomplete Spinal Cord Injury ◽

Robot Assisted ◽

Non Invasive ◽

Cord Injury

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P.076 Epidemiology of traumatic spinal cord injury patients in New Brunswick

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2016.180 ◽

2016 ◽

Vol 43 (S2) ◽

pp. S38-S39

Author(s):

YZ Chishti ◽

D Gaudet ◽

C O’Connell ◽

N Attabib

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

New Brunswick ◽

Motor Vehicle ◽

Functional Independence ◽

Outcome Data ◽

Traumatic Spinal Cord Injury ◽

Surgical Interventions ◽

Cervical Spine Injuries ◽

Cord Injury

Background: Characteristics of traumatic spinal cord injury (tSCI) patients admitted to the Saint John Regional Hospital and the Stan Cassidy Center for Rehabilitation from 2011 to 2014 were examined. Methods: Demographic, neurological and functional outcome data for 18 patients, who had consented to participate in a database for tSCI in Canada, was obtained. Results: The majority of patients were male (88.9%), with a mean age of 41. 33 (SD=17.17). The most common causes of tSCI were motor vehicle accidents (41.2%) and falls (29.4%). Cervical spine injuries (70.6%) and an ASIA impairment scale classification of D (38.9%) predominated. The median latency from injury to surgery was 22.67 hours. Functional independence Measure scores (M=64.17, SD=25.84) indicated that motor/functional independence was impaired (M=32.44, SD=19.15) relative to cognitive independence (M=31.83, SD=4.07). Conclusions: The results suggest that characteristics of tSCI patients in New Brunswick are similar to the Canadian tSCI patient population. Emergency care appears to be delivered in a timely fashion. Both centers participate in research registries focused on collecting data related to tSCI, surgical interventions, and patient outcomes. Registries are valuable research tools that allow for an alternative way to examine the quality of care their patients receive.

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Trajectory and Determinant of Functional Independence among Patient with Traumatic and Non-Traumatic Spinal Cord Injury

International Journal of Public Health Science (IJPHS) ◽

10.11591/ijphs.v7i2.13249 ◽

2018 ◽

Vol 7 (2) ◽

pp. 145

Author(s):

Yudha Mathan Sakti ◽

Astri Ferdiana ◽

Dananjaya Putramega ◽

Zikrina A. Lanodiyu ◽

Galih Prasetya Sakadewa ◽

...

Keyword(s):

Quality Of Life ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Life Satisfaction ◽

Cohort Study ◽

Lumbar Vertebra ◽

Functional Independence ◽

Traumatic Spinal Cord Injury ◽

Cord Injury

<p>The level of functional independence was directly proportional to life satisfaction and quality of life in patients with spinal cord injury. By knowing the determinants that predict changes in functional independence, medical treatment and rehabilitation can be better planned to improve the patient’s quality of life. We conducted a prospective cohort study on 49 patients with spinal cord injury at Dr. Sardjito general hospital Yogyakarta from April to June 2016. The data were taken before patient underwent surgery, before discharged from the hospital, and 3 months after underwent surgery. We found that most common spinal cord injury was at the level of lumbar vertebra with 28 patients (58%). There was a positive trajectory of the patients with spinal cord injury with ASIA grade B-E classification. However, patients with spinal cord injury with ASIA classification grade A have a neutral trajectory.We conclude there was a positive trajectory between functional independence and traumatic or non-traumatic spinal cord injury except in patients with ASIA grade A classification spinal cord injury. The determinants that affected the trajectory of patients with spinal cord injury were the level of the injured vertebra and severity of the neurological deficit. </p>

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