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Robot-assisted gait training in individuals with spinal cord injury: A systematic review for the clinical effectiveness of Lokomat

      Highlights

      • Combined Lokomat and conventional physiotherapy has superior effects than Lokomat alone.
      • The Lokomat may improve the functional gait ability after incomplete SCI.
      • The effect of the Lokomat on balance and cardiorespiratory fitness remains unclear.
      • The effects of Lokomat on the lower extremity spasticity was limited.
      • Lokomat is not superior in improving the gait speed.

      Abstract

      Background

      Spinal cord injury (SCI) is a critical medical condition that causes numerous impairments leading to accompanying disability. Robotic-assisted gait training (RAGT) offers many advantages, including the capability to increase the intensity and total duration of training while maintaining a physiological gait pattern. The effects of the RAGT ‘Lokomat’ on various impairments following SCI remain unclear.

      Objectives

      This review was conducted to examine the impacts of the RAGT ‘Lokomat’ on the impairments following SCI.

      Methods

      We searched PubMed, SCOPUS, PEDro, REHABDATA, MEDLINE, EMBASE, and web of science from inception to January 2021. Experimental studies examining the effects of the Lokomat on the impairments following incomplete SCI were selected. The methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale.

      Results

      Sixteen studies were met the inclusion criteria. Thirteen were randomized controlled trials, two were clinical trials, and one was a pilot study. The scores on the PEDro scale ranged from two to eight, with a median score of six. The results showed evidence for the beneficial effects of the Lokomat on many motor impairments following incomplete SCI.

      Conclusions

      The Lokomat may improve gait speed, walking distance, strength, range of motion, and mobility after incomplete SCI. There is insufficient evidence for the effect of the Lokomat on balance, depression, cardiorespiratory fitness, and quality of life. The effects of the Lokomat on the lower extremity spasticity were limited.

      Keywords

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