Robotic locomotor training for spasticity, pain, and quality of life in individuals with chronic SCI: A pilot randomized controlled trial.
Claire Shackleton, Robert Evans, Sacha West and 2 others
PMID 36793803WHAT IT FOUND
Neither robotic walking nor conventional activity-based training reduced spasticity.
Both groups reported increased pain interference but improved quality of life. This pilot suggests exercise benefits well-being despite pain, but does not prove either method reduces spasticity.
Key findings
01There was no significant difference in total spasticity scores between the robotic locomotor training and activity-based training groups over time.
02Both groups experienced a significant increase in pain intensity from pre to post intervention, with no significant difference between the groups.
03The robotic locomotor training group showed significant improvements in general, physical, and psychological quality of life, whereas the activity-based training group showed non-significant increases.
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
Very small sample size (16 participants) limits statistical power and generalisability. No true control group (no exercise) was included, so it is unclear if changes are due to the specific interventions or just physical activity. Analgesic and anti-inflammatory medication use was not documented, which could confound pain and spasticity results. One participant was excluded due to a stress fracture, and baseline data for this participant may have been confounded. This was a secondary analysis of a pilot trial, not the primary outcome of the original study.
Declared interests
Funded by the National Research Foundation of South Africa Career Grant, University of Cape Town Development Grant, and the Oppenheimer Memorial Trust. No commercial conflicts of interest reported.
The easy way to misread this
Do not interpret the improved quality of life in the robotic training group as evidence that it is superior to activity-based training for pain or spasticity. The primary finding for spasticity was null, pain increased in both groups, and the quality of life difference between groups was not statistically significant.