title: Is body-weight-supported treadmill training or robotic-assisted gait training superior to overground gait training and other forms of physiotherapy in people with spinal cord injury? A systematic review.
abstract: METHODS
  Systematic review about randomised trials comparing different training strategies to improve gait in people with spinal cord injuries (SCI).
  
  
  OBJECTIVE
  The aim of this systematic review was to compare the effectiveness of body-weight-supported treadmill training (BWSTT) and robotic-assisted gait training with overground gait training and other forms of physiotherapy in people with traumatic SCI.
  
  
  METHODS
  Systematic review conducted by researchers from Germany and Australia.
  
  
  METHODS
  An extensive search was conducted for randomised controlled trials involving people with traumatic SCI that compared either BWSTT or robotic-assisted gait training with overground gait training and other forms of physiotherapy. The two outcomes of interest were walking speed (m s-1) and walking distance (m). BWSTT and robotic-assisted gait training were analysed separately, and data were pooled across trials to derive mean between-group differences using a random-effects model.
  
  
  RESULTS
  Thirteen randomised controlled trials involving 586 people were identified. Ten trials involving 462 participants compared BWSTT to overground gait training and other forms of physiotherapy, but only nine trials provided useable data. The pooled mean (95% confidence interval (CI)) between-group differences for walking speed and walking distance were -0.03 m s-1(-0.10 to 0.04) and -7 m (-45 to 31), respectively, favouring overground gait training. Five trials involving 344 participants compared robotic-assisted gait training to overground gait training and other forms of physiotherapy but only three provided useable data. The pooled mean (95% CI) between-group differences for walking speed and walking distance were -0.04 m s-1(95% CI -0.21 to 0.13) and -6 m (95% CI -86 to 74), respectively, favouring overground gait training.
  
  
  CONCLUSIONS
  BWSTT and robotic-assisted gait training do not increase walking speed more than overground gait training and other forms of physiotherapy do, but their effects on walking distance are not clear.
authors.affiliation: Institute of Science, Private European Medical Academy of the Klinik Bavaria Kreischa, Kreischa, Germany.|Department of Public Health, Dresden Medical School, Technical University Dresden, Dresden, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Mehrholz
authors.affiliation: John Walsh Centre for Rehabilitation Research, Kolling Institute, Sydney Medical School/Northern, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: L A
authors.initials: LA
authors.lastname: Harvey
authors.affiliation: Institute of Science, Private European Medical Academy of the Klinik Bavaria Kreischa, Kreischa, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Thomas
authors.affiliation: Department of Public Health, Dresden Medical School, Technical University Dresden, Dresden, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Elsner
mesh_terms: D005684:Gait; D006801:Humans; D000066530:Neurological Rehabilitation; D026741:Physical Therapy Modalities; D016032:Randomized Controlled Trials as Topic; D012371:Robotics; D013119:Spinal Cord Injuries / Q000503:physiopathology / Q000534:rehabilitation*