Article

OBJECTIVE: To assess the quality of current evidence as to the effectiveness of
robot-assisted gait training in spinal cord injured patients, focusing on walking
ability and performance. METHODS: A search was conducted in MEDLINE, Web of
Knowledge, Cochrane Library, Physiotherapy Evidence Database (PEDro) and Digital
Academic Repositories (DAREnet) (1990-2009). Key words included "spinal cord
injury", "(robot-assisted) gait rehabilitation" and "driven gait orthosis".
Articles were included when complete and incomplete adult spinal cord injured
patients participated in robot-assisted gait training intervention studies. The
methodological quality was rated independently by 2 researchers using "van Tulder
criteria list" and "evaluation of quality of an intervention study". Descriptive
analyses were performed using the Population Intervention Comparison Outcome
(PICO) method. RESULTS: Two randomized controlled trials (mean quality score:
11.5/19) and 4 pre-experimental trials (mean quality score: 24.25 (standard
deviation; SD 0.28)/48) involving 43 patients with incomplete, acute or chronic
lesions between C3 and L1 were analysed. Five studies used the Lokomat and one
used the LokoHelp. Although some improvements were reported related to body
functions and activities, there is insufficient evidence to draw firm
conclusions, due to small samples sizes, methodological flaws and heterogeneity
of training procedures. CONCLUSION: There is currently no evidence that
robot-assisted gait training improves walking function more than other locomotor
training strategies. Well-designed randomized controlled trials are needed.

Langue : ANGLAIS