Effectiveness of over-ground robotic locomotor training in improving walking performance, cardiovascular demands, secondary complications and user-satisfaction in individuals with spinal cord injuries: A systematic review.

A systematic review aiming to evaluate the effectiveness of over- ground robotic locomotor training in individuals with spinal cord injuries with regard to walking performance, cardiovascular demands, secondary health complications, and user-satisfaction. The review included 27 non-controlled studies representing 308 participants. Most studies showed decreases in exertion ratings, pain and spasticity, as well as reported positive well-being post-intervention. Seven studies were included in meta-analyses on walking performance, showing significant improvements post-intervention (p<0.05), with pooled effects for the 6-min walking test, 10-meter walking test, and The Timed Up and Go Test. The data suggests that exoskeleton ambulation allows patients with SCI to engage in physical activity at an intensity that provides health benefits, yet does not result in early fatigue. Authors concluded that robotic locomotor training shows promise as a tool for improving neurological rehabilitation however, there is limited evidence regarding its training benefits. Further high-powered, randomized controlled trials are suggested to enhance the evidence.

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