title: Locomotor training using a robotic device in patients with subacute spinal cord injury.
abstract: METHODS
  Quasi experiment; single experimental group with matched historical control.
  
  
  OBJECTIVE
  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).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Hadassah University Hospital, Jerusalem, Israel.
authors.forename: I
authors.initials: I
authors.lastname: Schwartz
authors.forename: A
authors.initials: A
authors.lastname: Sajina
authors.forename: M
authors.initials: M
authors.lastname: Neeb
authors.forename: I
authors.initials: I
authors.lastname: Fisher
authors.forename: M
authors.initials: M
authors.lastname: Katz-Luerer
authors.forename: Z
authors.initials: Z
authors.lastname: Meiner
mesh_terms: D000208:Acute Disease; D000328:Adult; D016022:Case-Control Studies; D005081:Exercise Therapy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D010264:Paraplegia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D011782:Quadriplegia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D012371:Robotics / Q000379:methods*; D013119:Spinal Cord Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D055815:Young Adult