Journal of Rehabilitation Medicine 51-10 | Page 10

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C. Shackleton et al.
Table V. User-satisfaction of individuals with spinal cord injury (SCI) using robotic locomotor training (RLT)
Author (reference) Questionnaires
Satisfaction (VAS 1–5)
Acceptability (VAS 1–7)
Benson et al. (2016) ATD-PA scale:
(7)
T0 to T1 = increase in QoL subscale (+4 points; SD 4.2)*
T0 = 41; T1 = 34 (mean device form score)*
ADAPSS score:
Mean decrease in disability appraisal across all domains*
 = –3 points
Birch et al. (2017)
(11)
15 out of 16 statements
 = > 90% +ve response
1 statement
 = –ve response (transfer ability)
Esquenazi et al.
(2012) (18)
3/11 subjects = improved spasticity
1/11 subjects = use of device caused
fatigue
5/11 subjects = improved bowel
regulation
All subjects = no pain from the
device
Gagnon et al.
(2017) (27)
VAS (0–100):
95.7±0.7% = satisfied with the locomotor training programme
79.6±17% = positive ability to learn to perform sit–stand and walk
with the device
67.9±16.7% = perceived some health benefits
16.7±8.2% = reported no fear of developing secondary
complications or risks linked to the use of the device
Platz et al. (2016)
(25)
91.3±0.1% = felt motivated to engage in a regular physical activity
programme
SF–12v2 score:
T0 to T1 = increase in physical function (0.38 [0.01–0.76])*
Baseline scores:
Physical functioning = lower than norm
Mental component = higher psycho-emotional stability than norm
Sale et al. (2016)
(15)
All 10 statements = >3 score
Sale et al. (2018)
(16)
9 out of 10 statements = >3 score
1 statement = <3 (safety of device)
Stampacchia et al.
(2016) (26)
+ve sensations:
Comfort, 6.0 [ 6.0–6.0]
Enjoyment, 6.0 [6.0–7.0]
Advantages, 5.0 [5.0–6.0]
Motivation, 6.0 [6.0–7.0]
Suggest, 6.0 [6.0–7.0]
–ve experiences:
Pain, 2.0 [1.0–2.0]
Fatigue, 3.0 [2.0–5.0]
Zeilig et al. (2012)
(19)
8 out of 10 statements = > 3 score
2 statements = < 3 score (bowel and
wearing the device)
*Studies with missing original data or level of significance.
ATD-PA: Assistive Technology Device Predisposition Assessment; ADAPSS: Appraisals of DisAbility: Primary and Secondary Scale; SF-12v2: SF-12v2 Health
Survey; VAS: visual analogue scale.
Table VI. Quality of evidence using the GRADE system
Number of studies
(number of participants) Study design Quality Limitations
27 (308)
Observational
Low
Consistency
Directness
Serious limitations –2 Important inconsistency –1 Some indirectness –1
Precision
Publication/
reporting bias
Imprecise –1 Likely –1
GRADE: Grading of Recommendations, Assessment, Development and Evaluation system for rating quality of evidence of extracted data.
training periods ensure repetitive task practice, impro-
ving performance through increased motor learning
and neuroplasticity (3, 8, 16, 17, 28). Walking capacity
is also dependent on level, severity and time since
injury (15, 22). Participants with lesions at a lower
level walked longer distances and faster than those
with lesions at a higher level (19, 22). Individuals with
recent injuries were more likely to respond to training
stimuli and achieve greater velocities than those with
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chronic injuries (8, 15). Therefore, implementation of
more formalized SCI training programmes based on
level and time since injury may result in improved out-
comes for functional mobility after RLT interventions.
The mean velocity achieved across the studies for
the 6MWT ranged from 0.22 to 0.36 m/s and the mean
velocity in the 10MWT ranged from 0.25 to 0.38 m/s.
A previous meta-analysis investigating a similar group
of heterogeneous individuals, with various RLT proto-