Article

Quasi experiment ; single experimental group with matched historical
control.Objectives: To evaluate the effect of an additive robotic-assisted gait
training (RAGT) using the Lokomat system on the neurological and functional
outcomes of patients with subacute spinal cord injury (SCI).Setting:Department of
Physical Medicine and Rehabilitation.Methods: A total of 28 subacute SCI patients
were treated by RAGT, 2-3 times a week, 30-45 min every treatment, concomitantly
with regular physiotherapy.
As control, for each patient, we matched a comparable
patient treated in the same department in previous years, according to age,
severity of injury, level of injury and cause. The main outcomes were: the AIS
(American Spinal Injury Association impairment scale) the spinal cord
independence measurement (SCIM) score, the walking index for SCI II (WISCI II)
and functional ambulation category scale (FAC).
Results: At the end of
rehabilitation, both groups showed a significant improvement in both the FAC
score and the WISCI score
(P<0.01) without differences between the groups.
Functional abilities, according to the SCIM score, were also improved, with a
significant interaction effect; the RAGT patients improve by 30+/-20 points,
which was significantly greater gain as compared with the controls, 21+/-14
points (P=0.05). This improvement was mainly due to the change in the SCIM motor
subscales.Conclusion: RAGT is an important additional treatment to improve the
functional outcome of subacute SCI patients. Larger, controlled studies are still
required to determine the optimal timing and protocol design for the maximal
efficacy of RAGT in SCI patients.

Langue : ANGLAIS