A Cochrane review [Abstract] 1 included 5 studies with a total of 309 subjects. assessing the effects of locomotor training on improvement in walking for people with traumatic spinal cord injury (SCI). Different comparisons were made: bodyweight supported treadmill training (BWSTT) vs. all other training approaches; robotic-assisted locomotor training vs. all other training approaches; functional electrical stimulation and BWSTT vs. all other training approaches. Overall, the results were inconclusive. There was no statistically significant effect of any locomotor training on walking function after SCI compared with any other kind of physical rehabilitation. The use of bodyweight supported treadmill training as locomotor training for people after SCI did not significantly increase walking velocity (0.03 m/sec, 95% CI -0.05 to 0.11), nor did it increase walking capacity (-1.3 metres, 95% CI -41 to 40). However, in one study (n=74) the group receiving robotic-assisted locomotor training had reduced walking capacity compared with people receiving any other intervention, a finding which needs further investigation. In all studies there were no differences in adverse events or drop-outs between study groups.
Comment: The quality of evidence is downgraded by study quality (lack of blinding), by inconsistency (heterogeneity in interventions) and by imprecise results (limited study size for each comparison).
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