Journal of Rehabilitation Medicine 51-10 | Page 7

Walking velocity and distance. Six studies considered the mean distance and velocity achieved during a 6MWT showing a range from 47 to 129 m and 0.22 to 0.36 m/s, respectively (6, 17–20, 22) (Appendix I). Six studies considered the velocity required to complete a 10MWT (Appendix II), ranging from 0.25 to 0.38 m/s across 4 studies (17, 18, 20, 21). The remaining 2 studies indicated that different injury levels can affect walking velocity (22), as can the level of assistance provided while walking (23). Cardiovascular demand. Four studies considered HR measures across the intervention (Table II), where no significant changes were found (2, 13, 14, 20). Three other studies, in addition to studies by Bach Bauns- gaard et al. (13) and Spungen et al. (20), considered HR changes within an exercise session. HR was reported to be highest during walking, compared with that of sitting or standing, and post-walking HR was higher than pre- or mid-walking HR (6, 7, 13, 24). Spungen et al. (20) determined HR to be highest during a 6MWT compared with other phases of the session. Four studies 727 considered BP changes with exoskeleton walking (Ta- ble II). Two of the studies found a significant increase in BP from pre to post session (7, 24). However, Bach Baunsgaard et al. (13) found no change in BP within the session or across the intervention. Spungen et al. (20) also found no changes in BP across the walking intervention. Six studies investigated changes in RPE (Table II). Two studies showed a significant decrease in walking RPE from baseline to post-intervention (13, 20). The other 2 studies showed no significant changes in RPE across walking sessions (15, 16). Two studies demon- strated that RPE within a session increased post- com- pared with pre-walk (6, 24). Spasticity and pain. Five studies considered spasticity measures (Table III), 2 studies used clinical measures only (7, 25), while the other 3 considered both clinical and subjective ratings (2, 18, 26). Of those presenting clinical measures, 2 found significant improvements in spasticity from pre to post walking (7, 26), one showed reduced spasticity across the intervention Robotic locomotor training in rehabilitation Fig. 2. Effect of robotic locomotor training on 6-min walk test (6MWT) distance (m) using a random effects model. Standardized mean difference –0.94 (95% confidence interval (95% CI) –1.53,–0.36; I 2 =27%; p  = 0.002). Fig. 3. Effect of robotic locomotor training on 10-metre walk test (10MWT) speed using a random effects model. Standardized mean difference –1.22 (95% confidence interval (95% CI) –1.87,–0.57; I 2  = 60%; p  = 0.0002). Fig. 4. Effect of robotic locomotor training on the Timed Up and Go test (TUG) time (in s) using a random effects model. Standardized mean difference 0.74 (95% CI 0.36, 1.11; I 2  = 0%, p  = 0.0001). J Rehabil Med 51, 2019