Cost-effectiveness analysis of overground robotic training versus conventional locomotor training in people with spinal cord injury.
Daniel Pinto, Allen W Heinemann, Shuo-Hsiu Chang and 7 others
PMID 36681852WHAT IT FOUND
Conventional training was more cost-effective for incomplete SCI, while robotic training showed better value for complete SCI.
Robotic training had higher costs and therapy minutes. The study did not measure walking ability, only quality-of-life gains and costs.
Key findings
01Conventional training was more cost-effective than overground robotic training for people with incomplete SCI.
02Overground robotic training was more cost-effective than conventional training for people with complete SCI.
03Functional outcomes such as change in walking ability were not investigated in this analysis.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample size was too small to control for confounding factors such as age, sex, or level of injury. The study did not measure walking ability or functional locomotor outcomes, which are the primary goals of locomotor training. Conventional training was not standardized, reflecting real-world practice rather than a controlled protocol. Robotic training sessions were longer and included non-therapeutic time for donning and doffing, which may have influenced quality-of-life scores independently of the robotic intervention. The study used a health-system perspective, ignoring out-of-pocket costs for patients and families.
Declared interests
The study was funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). No other conflicts of interest were declared in the provided text.
The easy way to misread this
Do not interpret the cost-effectiveness of robotic training for complete SCI as evidence that it improves walking. The study explicitly did not measure walking ability, and the QALY gains may reflect the higher intensity of care or the wellness model rather than the robotic device itself.