Article Appraisal About the Lack of Support for the Patients With SCIS

The Case or Problem that Attracted Me to the Study

The problem that was attractive in the analyzed study is the lack of support for the patients with traumatic spinal cord injuries (SCIs) whose treatment remains incomplete despite the need for rehabilitation in working ability (Alcobendas-Maestro et al., 2012).

Study Description

The scholars compared the use of a walking re-education program using the Lokomat system with conventional training occurring overground. Lokomat-based training was seen to have potential in helping SCIs patients recover to normal functioning.

Statement of Research Hypothesis

The researchers put forth two hypotheses in the study. The first hypothesis is that in incomplete and recent SCIs, Lokomat-based rehabilitation will result in significant functional recovery both in terms of pattern and speed compared to conventional training. The second hypothesis is that walking re-education programs using robotic-assisted technologies will result in an improvement of physical condition in such areas as endurance, muscular strength, and functional independence for walking compared to traditional overground training.

Statement of Importance

The study is important for exploring the impact of the latest technologies on the rehabilitation of SCIs as compared to conventional methods that have shown to have limitations in helping individuals overcome the physical limitations in the relevant motor functions.

Methodology

The study was a randomized clinical trial involving a randomized, single-blind, parallel-group design. The population (P) involved study participants with recent SCI involved in the intervention (I) of 40 sessions of Lokomat training compared (C) to overground training over the course of 8 weeks (T). The baseline measurements of outcome variables were taken before the intervention involving Lokomat-therapy or overground training.

Quality Indicators

In the given study design, the researchers aimed to determine whether the implementation of intervention would lead to a change in specified outcomes within a target population. Important quality indicators that are addressed in the study include the conceptualization of the research, the description of participants, the description of the intervention and the nature of services provided to patients, outcome measures, and data analysis. All of the mentioned indicators are included in the study to provide reliable results.

Summary of Results

Even though rehabilitation with the Lokomat system helps improve walking mobility among patients with SCIs with less than six months’ longevity, the functional results attained in regard to speed and quality of walking may not be considered significantly better compared to the results produced by traditional overground training.

Application of Results

The results of the study are applicable to the rehabilitation practice for patients with SCIs that require the recovery of their mobility to reach satisfactory quality and speed of walking. While Lokomat-based training does not exceed conventional ground training methods, the use of the technologies in assisting rehabilitation has the potential for yielding greater endurance for walking among recovering patients as well as the increase of their lower-limb strength compared to traditional re-education. The results can be applied to future interventions targeting patients recovering from SCIs.

Clinical Utility

With the availability of new and advanced technologies to facilitate the recovery of patients with SCI, there is a possibility to try innovative methods and interventions and compare them with traditional models of recovery. The study adds to the body of literature on SCI rehabilitation that uses robotic-assisted body weight-supported treadmill training for optimizing sensory inputs that contribute to the improvement of neuroplasticity, step training, and other relevant functions.

Reference

Alcobendas-Maestro, M., Esclarín-Ruz, A., Casado-López, R., Muñoz-González, A., Pérez-Mateos, G., González-Valdizán, E., & Martín, J.L. (2012). Lokomat robotic-assisted versus overground training within 3 to 6 months of incomplete spinal cord lesion: Randomized controlled trial. Neurorehabilitation and Neural Repair, 26(9), 1058-1063.