Innovative technologies for gait rehabilitation in incomplete spinal cord injury: A systematic review and meta-analysis.

OBJECTIVE

This systematic review and meta-analysis aimed to synthesize the current evidence on the efficacy of various technological interventions for gait rehabilitation in adults with incomplete spinal cord injury (iSCI).

LITERATURE SURVEY: MEDLINE (accessed by PubMed), Embase, Cochrane Central Register of Controlled Trials (Cochrane CENTRAL), and the Physiotherapy Evidence Database (PEDro) from inception to March 2025.

METHODOLOGY: Eligible studies evaluated the effects of innovative rehabilitation technologies on gait-related outcomes in individuals with iSCI. The primary outcome was gait speed. Secondary outcomes were functional mobility and functional capacity assessed before and after intervention. Two reviewers independently performed study selection and data extraction.

SYNTHESIS: Twenty-one studies involving 601 participants were included. The interventions assessed encompassed robot-assisted gait training (RAGT), body-weight-supported treadmill training (BWSTT), exoskeletons (EXO), repetitive transcranial magnetic stimulation, functional electrical stimulation, electromyography (EMG)-triggered stimulation, virtual walking, and weight support feedback. Outcomes focused on gait speed, functional mobility, and functional capacity. RAGT was the only intervention associated with improvements in all three outcomes. BWSTT and EMG improved gait speed, while EXO enhanced functional mobility.

CONCLUSIONS

RAGT appears to be the most consistently effective intervention for improving gait-related outcomes in individuals with iSCI. However, additional high-quality randomized controlled trials are needed to confirm these findings and to support clinical decision-making.