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  4. Cost‑effectiveness analysis of overground robotic training versus conventional locomotor training in people with spinal cord injury

Cost‑effectiveness analysis of overground robotic training versus conventional locomotor training in people with spinal cord injury

Journal of NeuroEngineering and Rehabilitation, 2023 · DOI: https://doi.org/10.1186/s12984-023-01134-7 · Published: January 10, 2023

Spinal Cord InjuryHealthcareRehabilitation

Simple Explanation

This study looks at whether using overground robotic training is a cost-effective way to help people with spinal cord injuries walk again, compared to traditional methods. The study found that for people with complete spinal cord injuries, overground robotic training might be more cost-effective. But for those with incomplete injuries, conventional training seems to be better value for money. These findings can help doctors and hospitals make decisions about which type of training to offer based on the patient's specific injury and how much society is willing to pay for improvements in their quality of life.

Study Duration
Not specified
Participants
99 participants with spinal cord injury
Evidence Level
Practice-based evidence design

Key Findings

  • 1
    Conventional training was more cost-effective than overground robotic training for people with incomplete SCI.
  • 2
    Overground robotic training was more cost-effective than conventional training for people with complete SCI.
  • 3
    The incremental cost utility ratio for overground robotic training for people with complete spinal cord injury was $12,353/QALY.

Research Summary

This CEA represents a major contribution to the robotic neurorehabilitation literature and provides key benchmark data for future research. We found the most cost-effective locomotor strategy (conventional versus overground robotic) was different in people with incomplete versus complete injury. Conventional locomotor training was more cost-effective than overground robotic training for people with incomplete SCI.

Practical Implications

Treatment Decisions

The choice between conventional and overground robotic training should be tailored to the individual's injury completeness.

Resource Allocation

Healthcare resource allocation can be optimized by prioritizing conventional training for incomplete SCI and considering robotic training for complete SCI.

Future Research

Future research should focus on validating these findings with larger cohorts and exploring additional value elements beyond QALYs.

Study Limitations

  • 1
    Small sample sizes
  • 2
    Practice-based evidence methodology
  • 3
    Limited cost inputs to health system rehabilitation costs and the time horizon to one year.

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