Body weight-supported gait training for restoration of walking in people with an incomplete spinal cord injury a systematic review

Objective: To evaluate the effect of body weight-supported gait training on restoration of walking, activities of daily living, and quality of life in persons with an incomplete spinal cord injury by a systematic review of the literature. Methods: Cochrane, MEDLINE, EMBASE, CINAHL, PEDro, DocOnline were searched and identified studies were assessed for eligibility and methodological quality and described regarding population, training protocol, and effects on walking ability, activities of daily living and quality of life. A descriptive and quantitative synthesis was conducted. Results: Eighteen articles (17 studies) were included. Two randomized controlled trials showed that subjects with injuries of less than one year duration reached higher scores on the locomotor item of the Functional Independence Measure (range 1-7) in the over-ground training group compared with the body weight-supported treadmill training group. Only for persons with an American Spinal Injury Association Impairment Scale C or D was the mean difference significant, with 0.80 (95% confidence interval 0.04-1.56). No differences were found regarding walking velocity, activities of daily living or quality of life. Conclusion: Subjects with subacute motor incomplete spinal cord injury reached a higher level of independent walking after over-ground training, compared with body weightsupported treadmill training. More randomized controlled trials are needed to clarify the effectiveness of body weightsupported gait training on walking, activities of daily living, and quality of life for subgroups of persons with an incomplete spinal cord injury.