Supervisors info:
Πνευματικός Σπυρίδων,Καθηγητής ,Ιατρική Σχολή,ΕΚΠΑ
Βασιλειάδης Ηλίας, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ευαγγελόπουλος Δημήτριος-Στέργιος, Ακαδημαικός Υπότροφος,Ιατρική Σχολή, ΕΚΠΑ
Summary:
Objective: Incomplete cervical spinal cord injuries can lead to severe functional loss, with
mobility deficits of the lower limbs and motor control. Contemporary gait rehabilitation
techniques focus on the motor reprogramming of neuronic circuits. This systematic review
aims to compare the results of different rehabilitation techniques, ranging from robotic
exoskeleton systems, to new and improves weight- bearing systems, and other methods
including virtual reality, on their ability to achieve measurable therapeutic goals.
Methods: Three electronic databases (MEDLINE, PEDro και GoogleScholar) were
systematically searched for clinical trials, up until May 2022. The following search terms
were used: “Incomplete Cervical Spinal Cord Injury” AND “Gait Training” OR “Rehabilitation”
OR “Exoskeletal assisted walking” OR “Lokomat” OR “Robot- assisted gait training”.
Results: Of the initial 2.411 papers, 54 were selected to be review for eligibility to this
systematic review, leading to the final 20 that were included. The most common evaluation
tools were 6MWT, 10MWT, TUG, LEMS και WISCI-II. In all 20 papers significant or very
significant changes were noted between the time of the first assessment and the last. 13 of
them noted statistically significant differences between the control groups and the
intervention groups at the end of the trial period, regardless of the method used. In this
systematic review, 409 patients were recruited for trials on robotic exoskeletons, 70
participated in Weight- Bearing trials, and another 55 completed trials on interventions
including WBV, OLT and GRAIL. In regards to the use of a robotic exoskeleton system, 10 out
of 13 tirals noted statistical significant differences between groups, a result shared by 2 out
of 3 trials on weight-bearing systems.
Conclusion: Contemporary interventions using the latest technological advances, whether
they be robotic exoskeletons, advanced weight-bearing systems or enhanced virtual reality,
may contribute to a faster and more efficient gait rehabilitation of patients suffering from
incomplete cervical spinal cord injuries.
Keywords:
Incomplete spinal cord injury, Gait training, Rehabilitation, Exoskeleton
