Mehrholz J, Harvey L A, Thomas S, Elsner B
Institute of Science, Private European Medical Academy of the Klinik Bavaria Kreischa, Kreischa, Germany.
Department of Public Health, Dresden Medical School, Technical University Dresden, Dresden, Germany.
Spinal Cord. 2017 Aug;55(8):722-729. doi: 10.1038/sc.2017.31. Epub 2017 Apr 11.
Systematic review about randomised trials comparing different training strategies to improve gait in people with spinal cord injuries (SCI).
The aim of this systematic review was to compare the effectiveness of body-weight-supported treadmill training (BWSTT) and robotic-assisted gait training with overground gait training and other forms of physiotherapy in people with traumatic SCI.
Systematic review conducted by researchers from Germany and Australia.
An extensive search was conducted for randomised controlled trials involving people with traumatic SCI that compared either BWSTT or robotic-assisted gait training with overground gait training and other forms of physiotherapy. The two outcomes of interest were walking speed (m s) and walking distance (m). BWSTT and robotic-assisted gait training were analysed separately, and data were pooled across trials to derive mean between-group differences using a random-effects model.
Thirteen randomised controlled trials involving 586 people were identified. Ten trials involving 462 participants compared BWSTT to overground gait training and other forms of physiotherapy, but only nine trials provided useable data. The pooled mean (95% confidence interval (CI)) between-group differences for walking speed and walking distance were -0.03 m s (-0.10 to 0.04) and -7 m (-45 to 31), respectively, favouring overground gait training. Five trials involving 344 participants compared robotic-assisted gait training to overground gait training and other forms of physiotherapy but only three provided useable data. The pooled mean (95% CI) between-group differences for walking speed and walking distance were -0.04 m s (95% CI -0.21 to 0.13) and -6 m (95% CI -86 to 74), respectively, favouring overground gait training.
BWSTT and robotic-assisted gait training do not increase walking speed more than overground gait training and other forms of physiotherapy do, but their effects on walking distance are not clear.
关于比较不同训练策略以改善脊髓损伤（SCI）患者步态的随机试验的系统评价。
本系统评价的目的是比较体重支持式跑步机训练（BWSTT）和机器人辅助步态训练与地面步态训练及其他形式物理治疗对创伤性SCI患者的有效性。
由德国和澳大利亚的研究人员进行的系统评价。
广泛检索涉及创伤性SCI患者的随机对照试验，这些试验比较了BWSTT或机器人辅助步态训练与地面步态训练及其他形式的物理治疗。两个感兴趣的结果是步行速度（米/秒）和步行距离（米）。分别对BWSTT和机器人辅助步态训练进行分析，并汇总各试验的数据，使用随机效应模型得出组间平均差异。
确定了13项涉及586人的随机对照试验。10项涉及462名参与者的试验将BWSTT与地面步态训练及其他形式的物理治疗进行了比较，但只有9项试验提供了可用数据。步行速度和步行距离的组间平均差异（95%置信区间（CI））分别为-0.03米/秒（-0.10至0.04）和-7米（-45至31），支持地面步态训练。5项涉及344名参与者的试验将机器人辅助步态训练与地面步态训练及其他形式的物理治疗进行了比较，但只有3项试验提供了可用数据。步行速度和步行距离的组间平均差异（95%CI）分别为-0.04米/秒（95%CI -0.21至0.13）和-6米（95%CI -86至74），支持地面步态训练。
BWSTT和机器人辅助步态训练在提高步行速度方面并不比地面步态训练和其他形式的物理治疗更有效，但其对步行距离的影响尚不清楚。
