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Effect on functional outcome of robotic assisted rehabilitation versus conventional rehabilitation in patients with complete spinal cord injury: a prospective comparative study

Spinal Cord (2024)Cite this article

Subjects

Abstract

Study design

Prospective Comparative Study.

Objective

This study aims to compare the functional outcomes of Robotic-assisted rehabilitation by Lokomat system Vs. Conventional rehabilitation in participants with Dorsolumbar complete spinal cord injury (SCI).

Setting

University level teaching hospital in a hilly state of northern India.

Methods

15 participants with Dorsolumbar SCI with ASIA A neurology were allocated to robotic rehabilitation and 15 participants to conventional rehabilitation after an operative procedure. Pre-and Post-rehabilitation parameters were noted in terms of ASIA Neurology, Motor and sensory function scores, WISCI II score (Walking Index in SCI score), LEMS (Lower Extremity Motor Score), SCI M III score (Spinal Cord Independence Measure III score), AO Spine PROST (AO Patient Reported Outcome Spine Trauma), McGill QOL score (Mc Gill Quality of Life score), VAS score (Visual Analogue Scale) for pain and Modified Ashworth scale for spasticity in lower limbs.

Results

On comparing robotic group with conventional group there was a statistically significant improvement in Robotic-assisted rehabilitation group in terms of Motor score (p = 0.034), WISCI II score (p = 0.0001), SCIM III score (p = 0.0001), AO PROST score (p = 0.0001), Mc GILL QOL score (p = 0.0001), Max velocity (p = 0.0001) and Step length (p = 0.0001). Whereas LEMS score (p = 0.052), ASIA neurology (p = 0.264 (ASIA A); 1.000 (ASIA B); 0.053 (ASIA C)), VAS score (p = 0.099), Sensory score (p = 0.422) and Modified Ashworth scale for spasticity (p = 0.136) were not statically significant when comparing between two groups.

Conclusion

Robot-assisted rehabilitation is superior than conventional rehabilitation in people living with SCI with AIS A neurology. Differences in the patient group, type of a lesion its and severity, duration from onset to initiation of rehabilitation, devices employed, administration of the therapies and regulation of interventions are likely the cause of variations in the findings seen in the literature for robotic assisted training. Level of Evidence: III.

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Fig. 1: Flowchart of study participants with reasons for excluded patients.
Fig. 2: An illustrative case of robotic-assisted rehabilitation.
Fig. 3: An illustrative case showing conventional rehabilitation.

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Data availability

The datasets used and/or analysed during the current study are available from the corresponding author upon reasonable request. Data regarding this study is not available in any electronic databases.

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Author information

Authors and Affiliations

  1. Department of Orthopedics, AIIMS, Rishikesh, 249203, Uttarakhand, India

    Chandra Kumar Khande, Vishal Verma, Anil Regmi, Syed Ifthekar, P. Venkata Sudhakar, Siddharth Shekhar Sethy & Pankaj Kandwal

  2. Department of Trauma Surgery, AIIMS, Rishikesh, 249203, Uttarakhand, India

    Bhaskar Sarkar

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  1. Chandra Kumar Khande
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Contributions

C.K.K.—Planning of study, Data management, outcome assessment, manuscript preparation. V.V.—Data management, outcome assessment. A.R.—Literature search, writing the manuscript. S.I.—Data management, outcome assessment. P.V.S.—Data management, outcome assessment. S.S.S.—Data management, outcome assessment. P.K.—Data management, outcome assessment, revising manuscript. B.S.—Planning of study, manuscript preparation.

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Correspondence to Bhaskar Sarkar.

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The authors declare no competing interests.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee.

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Consent taken with parents of each individual for the enrolment of study and publication of data on research paper. Subjects of Figs. 2, 3 have provided INFORMED WRITTEN CONSENT for their photos to be used in this paper & understand that they will be published online.

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Khande, C.K., Verma, V., Regmi, A. et al. Effect on functional outcome of robotic assisted rehabilitation versus conventional rehabilitation in patients with complete spinal cord injury: a prospective comparative study. Spinal Cord (2024). https://doi.org/10.1038/s41393-024-00970-1

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