Robot-Assisted Training for People With Spinal Cord Injury: A Meta-Analysis

Arch Phys Med Rehabil. 2017 Nov;98(11):2320-2331.e12. doi: 10.1016/j.apmr.2017.05.015. Epub 2017 Jun 20.


Objective: To investigate the effects of robot-assisted training on the recovery of people with spinal cord injury (SCI).

Data sources: 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.

Study selection: 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.

Data extraction: 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.

Data synthesis: 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; I2=38%) and endurance (53.32m; 95% CI, -73.15 to -33.48; P<.00001; I2=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.

Conclusions: 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.

Keywords: Exoskeleton device; Rehabilitation; Spinal cord injuries.

Publication types

  • Review

MeSH terms

  • Activities of Daily Living
  • Humans
  • Lower Extremity / physiopathology
  • Physical Therapy Modalities*
  • Randomized Controlled Trials as Topic
  • Recovery of Function
  • Robotics*
  • Spinal Cord Injuries / rehabilitation*
  • Upper Extremity / physiopathology