Arienti Chiara, Patrini Michele, Negrini Stefano, Kiekens Carlotte
IRCCS Fondazione Don Carlo Gnocchi, Milan.
Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan; IRCCS Istituto Ortopedico Galeazzi, Milan.
Arch Phys Med Rehabil. 2023 Jan;104(1):143-150. doi: 10.1016/j.apmr.2022.07.003. Epub 2022 Jul 26.
This article aims to describe the evidence on rehabilitation interventions for persons with spinal cord injury (SCI) identified in Cochrane Systematic Reviews (CSRs) selected for inclusion in the World Health Organization Rehabilitation Programme-Package of Interventions for Rehabilitation.
The CSRs search was led by the Cochrane Rehabilitation team, using the tagging process, using the terms "spinal cord injury" and "rehabilitation" in the Cochrane Library.
We performed an overview of all the CSRs according to the inclusion criteria defined with the World Health Organization: rehabilitation interventions in persons with SCI.
The CSRs identified after the screening process were summarized using an evidence map, grouping outcomes, and comparisons of included CSRs indicating the effect and the quality of evidence to provide a comprehensive view of what is known.
Out of 248 CSRs from the past 10 years tagged in the Cochrane Rehabilitation database, 3 were related to SCI. They provide data on 13 outcomes analyzed within 11 comparisons for a total of 64 primary studies, including 2024 participants with SCI. Of these, 7 outcomes and 1 comparison focused on people with cervical SCI. Rehabilitation interventions might improve respiratory outcomes and pain relief in people with SCI. There is uncertainty whether bodyweight-supported treadmill training, robotic-assisted training, and functional electrostimulation affect walking speed and capacity.
The current evidence needs to be confirmed by better quality research. Therefore, future priorities are the improvement of methodological quality of the studies in people with SCI, particularly considering the complexity of this health condition. Further, there is a need for more CSRs in the field.
本文旨在描述在被选入世界卫生组织康复计划——康复干预措施包的Cochrane系统评价（CSR）中确定的脊髓损伤（SCI）患者康复干预的证据。
CSR的检索由Cochrane康复团队牵头，采用标记程序，在Cochrane图书馆中使用“脊髓损伤”和“康复”等术语。
我们根据与世界卫生组织定义的纳入标准，对所有CSR进行了概述：SCI患者的康复干预。
筛选过程后确定的CSR使用证据图进行总结，对结果进行分组，并对纳入的CSR进行比较，以表明证据的效果和质量，从而全面了解已知情况。
在Cochrane康复数据库中标记的过去10年的248项CSR中，有3项与SCI相关。它们提供了11项比较中分析的13项结果的数据，共有64项主要研究，包括2024名SCI患者。其中，7项结果和1项比较聚焦于颈髓损伤患者。康复干预可能会改善SCI患者的呼吸结果和缓解疼痛。体重支持的跑步机训练、机器人辅助训练和功能性电刺激是否会影响步行速度和能力尚不确定。
目前的证据需要通过质量更高的研究来证实。因此，未来的重点是提高SCI患者研究的方法学质量，特别是考虑到这种健康状况的复杂性。此外，该领域需要更多的CSR。
