Strength training versus robot-assisted gait training after incomplete spinal cord injury: A randomized pilot study in patients depending on walking assistance

Background: task-specific locomotor training has been promoted to improve walking-related outcome after incomplete spinal cord injury (isci). however,there is also evidence that lower extremity strength training might lead to such improvements. the aim of this randomized cross-over pilot study was to compare changes in a broad spectrum of walking-related outcome measures and pain between robot-assisted gait training (ragt) and strength training in patients with chronic isci,who depended on walking assistance. we hypothesized that task-specific locomotor training would result in better improvements compared to strength training. methods. nine participants with a chronic isci were randomized to group 1 or 2. group 1 received 16 sessions of ragt (45 min each) within 4 weeks followed by 16 sessions of strength training (45 min each) within 4 weeks. group 2 received the same interventions in reversed order. main outcome measures were the 10 m walk test (10mwt) at preferred and maximal speed. furthermore,we assessed several measures such as walking speed under different conditions,balance,strength,and 2 questionnaires that evaluate risk of falling and pain. data were collected at baseline,between interventions after 4 weeks,directly after the interventions and at follow-up 6 months after the interventions. pain was assessed repeatedly throughout the study. results: there were no significant differences in changes in scores between the 2 interventions,except for maximal walking speed (10mwt),which improved significantly more after strength training than after ragt. pain reduced after both interventions. conclusion: in patients with chronic isci dependent on walking assistance,ragt was not more effective in improving walking-related outcome compared to lower extremity strength training. however,the low sample size limits generalizability and precision of data interpretation. trial registration. this study was registered at clinicaltrials.gov (nct01087918). © 2014 labruyère and van hedel; licensee biomed central ltd.