Cheung Eddy Y Y, Ng Thomas K W, Yu Kevin K K, Kwan Rachel L C, Cheing Gladys L Y
Physiotherapy Department, Kowloon Hospital, Hospital Authority, Hong Kong, China.
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
Arch Phys Med Rehabil. 2017 Nov;98(11):2320-2331.e12. doi: 10.1016/j.apmr.2017.05.015. Epub 2017 Jun 20.
To investigate the effects of robot-assisted training on the recovery of people with spinal cord injury (SCI).
Randomized controlled trials (RCTs) or quasi-RCTs involving people with SCI that compared robot-assisted upper limbs or lower limbs training with a control of other treatment approach or no treatment. We included studies involving people with complete or incomplete SCIs.
We searched MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials (Cochrane Library), and Embase to August 2016. Bibliographies of relevant articles on the effect of body-weight-supported treadmill training on subjects with SCI were screened to avoid missing relevant articles from the search of databases.
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, FIM) or laboratory tests (ie, gait analysis). Subjective outcome measures were excluded from this review.
Eleven RCT studies involving 443 subjects were included in the study. Meta-analysis was performed on the included studies. Walking independence (3.73; 95% confidence interval [CI], -4.92 to -2.53; P<.00001; I=38%) and endurance (53.32m; 95% CI, -73.15 to -33.48; P<.00001; I=0%) were found to have better improvement in robot-assisted training groups. Lower limb robot-assisted training was also found to be as effective as other types of body-weight-supported training. There is a lack of upper limb robot-assisted training studies; therefore, performing a meta-analysis was not possible.
Robot-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 robot-assisted training on functional and cardiopulmonary recovery of patients with SCI.
探讨机器人辅助训练对脊髓损伤（SCI）患者康复的影响。
随机对照试验（RCT）或半随机对照试验，研究对象为SCI患者，比较机器人辅助上肢或下肢训练与其他治疗方法对照或不治疗。我们纳入了涉及完全性或不完全性SCI患者的研究。
检索MEDLINE、CINAHL、Cochrane对照试验中心注册库（Cochrane图书馆）和Embase至2016年8月。筛选了关于体重支持跑步机训练对SCI患者影响的相关文章的参考文献，以避免在数据库检索中遗漏相关文章。
纳入各种关于身体能力、移动性和/或功能能力的客观评估。评估可以是临床试验（如6分钟步行试验、FIM）或实验室检查（如步态分析）。本综述排除主观结果指标。
本研究纳入了11项涉及443名受试者的RCT研究。对纳入的研究进行荟萃分析。发现机器人辅助训练组在步行独立性（3.73；95%置信区间[CI]，-4.92至-2.53；P<0.00001；I=38%）和耐力（53.32m；95%CI，-73.15至-33.48；P<0.00001；I=0%）方面有更好的改善。还发现下肢机器人辅助训练与其他类型的体重支持训练效果相同。缺乏上肢机器人辅助训练研究；因此，无法进行荟萃分析。
机器人辅助训练是SCI患者身体和功能恢复的辅助治疗方法。未来需要高质量的研究来探讨机器人辅助训练对SCI患者功能和心肺恢复的影响。
