Body weight‑supported gait training for patients with spinal cord injury: a network meta‑analysis of randomised controlled trials

Scientific Reports, 2022 · DOI: 10.1038/s41598-022-23873-8 · Published: November 7, 2022

Spinal Cord Injury Rehabilitation Research Methodology & Design

Simple Explanation

This study compares different body weight-supported gait training strategies for individuals with spinal cord injury (SCI). These strategies include body weight-supported overground training (BWSOGT), body weight-supported treadmill training (BWSTT), and robot-assisted gait training (RAGT). The study uses a network meta-analysis of randomised controlled trials (RCTs) to assess the effect and priority of each training protocol. This approach allows for the comparison of multiple interventions simultaneously. The ranking probabilities indicated that the most effective approach was RAGT, followed by BWSOGT, BWSTT, and the control intervention. This suggests that robot-assisted gait training may be the most beneficial option for improving ambulation in SCI patients.

Study Duration

Not specified

Participants

497 participants

Evidence Level

Network meta-analysis of randomised controlled trials (RCTs)

Key Findings

1
Robot-assisted gait training (RAGT) was significantly more favourable than the control intervention in improving ambulatory function.
2
The ranking probabilities indicated that RAGT was the most effective approach, followed by BWSOGT, BWSTT, and the control intervention.
3
No significant inconsistency was noted between the results of the direct and indirect comparisons, suggesting the findings are robust.

Research Summary

This network meta-analysis aimed to compare the effectiveness of different body weight-supported gait training strategies (RAGT, BWSTT, and BWSOGT) for improving ambulation in patients with spinal cord injury (SCI). The analysis included 15 RCTs and found that RAGT was significantly more effective than the control intervention. The ranking probabilities indicated that RAGT was the most effective approach, followed by BWSOGT and BWSTT. The study concludes that RAGT should be the preferred training protocol for improving walking ability in individuals with SCI, while also calling for further research on BWSOGT and BWSTT.

Practical Implications

Clinical Practice

RAGT may be prioritized in rehabilitation programs for SCI patients to improve walking ability.

Research

Further research is needed to evaluate the effectiveness of BWSOGT and BWSTT compared to RAGT.

Technology Development

Continued development and refinement of RAGT devices and protocols are warranted to maximize their benefits for SCI patients.

Study Limitations

1
The number of included articles was relatively small, particularly those focused on BWSOGT and BWSTT, for conducting a network meta-analysis.
2
The transitivity of this study may have been influenced by the different treatment protocols and participant characteristics of the included studies.
3
Among the various robot-assisted devices available, we focused only on body weight-supported devices.

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