Over-ground walking or robot-assisted gait training in people with .multiple sclerosis: does the effect depend on baseline walking speed and disease related disabilities? A systematic review and meta-regression.
Meta-regression, systematic review
Multiple sclerosis
Over-ground walking
Robot-assisted gait training
Journal
BMC neurology
ISSN: 1471-2377
Titre abrégé: BMC Neurol
Pays: England
ID NLM: 100968555
Informations de publication
Date de publication:
08 May 2019
08 May 2019
Historique:
received:
19
07
2017
accepted:
29
04
2019
entrez:
10
5
2019
pubmed:
10
5
2019
medline:
14
6
2019
Statut:
epublish
Résumé
It was suggested that robot-assisted gait training (RAGT) should not be routinely provided to disabled patients in place of conventional over-ground walking training (CGT). There exist several randomised controlled trials reporting on RAGT for people with multiple sclerosis. However, the effectiveness of RAGT varies between studies with the effectiveness pointing in different directions. It might be possible that the effectiveness of RAGT and CGT depends on the disease related disabilities of the people included in the clinical studies. We aimed to systematically search RCTs and to perform a meta-regression to compare the effects of robot-assisted gait training in people with less and higher disease related disabilities. The Expanded Disability Status Scale (EDSS) scores were used to classify level of disability. A systematic search was developed to search four electronic databases (MEDLINE, CENTRAL, EMBASE and CINAHL) for eligible articles. A random effects model was applied to meta-analyse the effects of the interventions. Meta-regression was performed with an uni-variable random effects model using baseline walking speed and EDSS to predict the between group effect. The search on databases resulted in 596 records and finally nine studies were included into the review. The pooled estimates of the effects for performance over short and long distance tests were small and non-significant: -0.08 SMD (95% CI: -0.51 to 0.35) and - 0.24 SMD (95% CI: -0.67 to 0.19). Neither baseline walking speed or disease related disability were related to the mean effect size. Future studies are needed to help clinicians to decide, which intervention should be allocated to the individual patient.
Sections du résumé
BACKGROUND
BACKGROUND
It was suggested that robot-assisted gait training (RAGT) should not be routinely provided to disabled patients in place of conventional over-ground walking training (CGT). There exist several randomised controlled trials reporting on RAGT for people with multiple sclerosis. However, the effectiveness of RAGT varies between studies with the effectiveness pointing in different directions. It might be possible that the effectiveness of RAGT and CGT depends on the disease related disabilities of the people included in the clinical studies. We aimed to systematically search RCTs and to perform a meta-regression to compare the effects of robot-assisted gait training in people with less and higher disease related disabilities. The Expanded Disability Status Scale (EDSS) scores were used to classify level of disability.
METHODS
METHODS
A systematic search was developed to search four electronic databases (MEDLINE, CENTRAL, EMBASE and CINAHL) for eligible articles. A random effects model was applied to meta-analyse the effects of the interventions. Meta-regression was performed with an uni-variable random effects model using baseline walking speed and EDSS to predict the between group effect.
RESULTS
RESULTS
The search on databases resulted in 596 records and finally nine studies were included into the review. The pooled estimates of the effects for performance over short and long distance tests were small and non-significant: -0.08 SMD (95% CI: -0.51 to 0.35) and - 0.24 SMD (95% CI: -0.67 to 0.19). Neither baseline walking speed or disease related disability were related to the mean effect size.
DISCUSSION
CONCLUSIONS
Future studies are needed to help clinicians to decide, which intervention should be allocated to the individual patient.
Identifiants
pubmed: 31068151
doi: 10.1186/s12883-019-1321-7
pii: 10.1186/s12883-019-1321-7
pmc: PMC6506946
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
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