Activity-based rehabilitation interventions are ‘effective in improving function’ in patients with spinal cord injury

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Activity-based rehabilitation interventions, including transcranial magnetic stimulation, functional electrical stimulation, and robotic-assisted treadmill training are effective in improving function in patients with spinal cord injury, according to a new systematic review and meta-analysis.

The study—the findings of which were published in the journal Spine by Xiaobing Yu (Affiliated Zhongshan Hospital of Dalian University, Dalian, China) et al—sought to evaluate the effects of various rehabilitation interventions in spinal cord injury. The effects of these rehabilitation exercises have been “controversial”, the authors note.

The researchers looked at publications from databases such as PubMed, Embase, Cochrane, the database of the US National Institutes of Health and World Health Organization International Clinical Trials Registry Platform, using search terms including spinal cord injury, transcranial magnetic stimulation, functional electrical stimulation, activity-based therapy, and robotic-assisted locomotor training.

Randomised controlled trials and controlled trials were both included. Primary outcomes included functional upper/lower extremity independence, walking capacity, spasticity, and life quality of individuals with spinal cord injury.

In total this amounted to 31 articles, with the subsequent meta-analysis showing that transcranial magnetic stimulation improved walking speed (95% confidence interval [CI] 0.01, 0.16) and lower extremity function (95% CI 1.55, 7.27).

Functional electrical stimulation was also shown to significantly increase upper extremity independence (95% CI 0.37, 5.48) and robotic-assisted treadmill training improved lower extremity function (95% CI 3.44, 6.56) compared with related controls.


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