La Rosa Giuseppe, Avola Marianna, Di Gregorio Tiziana, Calabrò Rocco Salvatore, Onesta Maria Pia
Consorzio Siciliano di Riabilitazione, 95100 Catania, Italy.
Unità Spinale Unipolare, AO Cannizzaro, 98102 Catania, Italy.
Brain Sci. 2023 Apr 22;13(5):703. doi: 10.3390/brainsci13050703.
Gait recovery is a fundamental goal in patients with spinal cord injury to attain greater autonomy and quality of life. Robotics is becoming a valid tool in improving motor, balance, and gait function in this patient population. Moreover, other innovative approaches are leading to promising results. The aim of this study was to investigate new rehabilitative methods for gait recovery in people who have suffered spinal cord injuries. A systematic review of the last 10 years of the literature was performed in three databases (PubMed, PEDro, andCochrane). We followed this PICO of the review: P: adults with non-progressive spinal cord injury; I: new rehabilitative methods; C: new methods vs. conventional methods; and O: improvement of gait parameters. When feasible, a comparison through ES forest plots was performed. A total of 18 RCTs of the 599 results obtained were included. The studies investigated robotic rehabilitation ( = 10), intermittent hypoxia (N = 3) and external stimulation (N = 5). Six studies of the first group (robotic rehabilitation) were compared using a forest plot for 10MWT, LEMS, WISCI-II, and SCIM-3. The other clinical trials were analyzed through a narrative review of the results. We found weak evidence for the claim that robotic devices lead to better outcomes in gait independence compared to conventional rehabilitation methods. External stimulation and intermittent hypoxia seem to improve gait parameters associated with other rehabilitation methods. Research investigating the role of innovative technologies in improving gait and balance is needed since walking ability is a fundamental issue in patients with SCI.
步态恢复是脊髓损伤患者实现更大自主性和更高生活质量的基本目标。机器人技术正成为改善这类患者运动、平衡和步态功能的有效工具。此外，其他创新方法也取得了喜人的成果。本研究的目的是调查脊髓损伤患者步态恢复的新康复方法。我们在三个数据库（PubMed、PEDro和Cochrane）中对过去10年的文献进行了系统综述。我们遵循了本综述的PICO原则：P：非进行性脊髓损伤的成年人；I：新的康复方法；C：新方法与传统方法对比；O：步态参数的改善。在可行的情况下，通过效应量森林图进行比较。在获得的599项结果中，共纳入了18项随机对照试验。这些研究调查了机器人康复（n = 10）、间歇性低氧（n = 3）和外部刺激（n = 5）。使用森林图对第一组（机器人康复）的六项研究在10米步行试验（10MWT）、下肢运动评分（LEMS）、脊髓损伤步行指数第二版（WISCI-II）和脊髓损伤功能独立性测量量表第三版（SCIM-3）方面进行了比较。其他临床试验通过对结果的叙述性综述进行分析。我们发现，与传统康复方法相比，机器人设备在步态独立性方面能带来更好结果这一说法的证据不足。外部刺激和间歇性低氧似乎能改善与其他康复方法相关的步态参数。由于步行能力是脊髓损伤患者的一个基本问题，因此需要开展研究来调查创新技术在改善步态和平衡方面的作用。
