Table 1.
RAGT concise overview of the chosen papers’ key characteristics and bias risk.
| Author, Year | Country | Total Sample (TS) | Study Design | Intervention | Outcome | Level of Injury | NOS |
|---|---|---|---|---|---|---|---|
| Hornby 2005 [22] | USA | 30 | RCT | The utilization of robotic assistance in BWSTT and therapist-assisted BWSTT. The intervention involved engaging in overground ambulation via a mobile suspension device for three 30 min weekly sessions over 8 weeks. | LEMS, 6MWT | AIS B, C, and D. The level of damage is located above the tenth thoracic vertebra (T10). | - |
| Wirz 2005 [23] | USA | 20 | Single group | The Lokomat (DGO) intervention consisted of an 8 week duration, with participants attending three to five sessions per week, each lasting 45 min. | AS, LEMS, 6MWT, 10MWT, and TUG | AIS C and D. The level of injury is at L1 or above. | 7 |
| Field 2011 [24] | USA | 64 | RCT | The participants engaged in a training regimen for 12 weeks, with a frequency of 5 days per week. The training program encompassed four distinct modalities, namely treadmill-based training with manual help (TM), treadmill-based training with stimulation (TS), overground training with motivation (OG), and treadmill-based training with robotic assistance (LR). | LEMS | AIS C and D. The level of damage is located at or above the tenth thoracic vertebra (T10). | - |
| Alcobendas 2012 [25] | Spain | 75 | RCT | The study consisted of a total of 40 sessions conducted over 8 weeks. Each session lasted for approximately 1 h and involved a Lokomat group intervention. Specifically, participants spent 30 min utilizing the Lokomat device within each session, followed by an additional 30 min of normal physical treatment. The overground group implemented a standardized biological treatment protocol for one hour. | VAS, LEMS, 6MWT, and 10MWT | AIS C and D. The range of injuries observed in the individual spans from the second cervical vertebra (C2) to the twelfth thoracic vertebra (T12). | - |
| Aach 2014 [26] | Germany | 8 | Pre-post experimental design | HAL had been used for 90 days, with a frequency of five weekly sessions. | LEMS, 6MWT, 10MWT, and TUG | ASIA A. Degree of damage: T8 to L2 | 7 |
| del-Ama 2014 [27] | Switzerland | 3 | Pilot study | The Kinesis system was implemented during the first week, whereas no intervention was delivered the following week. | AS, VAS, 6MWT, and 10MWT | AIS A and D. Injuries impact the spinal levels encompassing L1 and L2. | 8 |
| Labruyère 2014 [28] | Switzerland | 9 | RCT | The first group underwent 16 sessions of RAGT using the Lokomat device, followed by an additional 16 strength training sessions. Group 2 received the intervention in reverse order. | VAS, LEMS, and 10MWT | AIS C and D. The extent of the injury ranges from the fourth cervical vertebra (C4) to the eleventh thoracic vertebra (T11). | - |
| Niu 2014 [29] | USA | 40 | RCT | The experimental group underwent twelve 1 h Lokomat training sessions over one month, whereas the control group did not receive any interventions. | TUG | AIS B, C, and D. The level of damage is located above the tenth thoracic vertebra (T10). | - |
| Shin 2014 [30] | South Korea | 53 | RCT | In four weeks, the RAGT group received three 40 min sessions per week of RAGT in addition to regular physiotherapy. The conventional group received physiotherapy twice daily, five days per week. | LEMS | AIS D. The level of injury is classified as upper motor neuron (UMN) involvement. | - |
| Varoqui 2014 [31] | USA | 30 | RCT | The Lokomat group participated in three weekly sessions for four weeks, each lasting one hour. The control group, on the other hand, did not receive any intervention. | 6MWT, 10MWT, TUG | AIS C and D. The level of damage is located above the tenth thoracic vertebra (T10). | - |
| Duffell 2015 [32] | USA | 56 | RCT | The study involved allocating participants with an incomplete SCI into three groups: a control group receiving no intervention, a group receiving Lokomat intervention, and a group receiving tizanidine intervention. | TUG | AIS C and D The level of damage is located above the tenth thoracic vertebra (T10). | - |
| Lam 2015 [33] | Canada | 15 | RCT | The Lokomat-assisted BWSTT intervention was conducted for 45 min, three times a week, for three months. | 6MWT, 10MWT | AIS C and D. Exclusion criteria encompassed individuals with lower motoneuron damage or lesion levels than T11. | - |
| Stampacchia 2016 [34] | Italy | 21 | Single group | The robotic exoskeleton (Ekso GT) exercise lasted approximately 40 min. | MAS, VAS | AIS A, B, and D. The observed lesions were located at the low cervical level (C7), dorsal level, and high lumbar level (L1–L2). | 7 |
| Mazzoleni 2017 [35] | Italy | 7 | Single group | The study consisted of 20 sessions, with a frequency of three sessions per week. The first set of sessions utilized a FES cycling system called Pegaso. It was followed by another group of 20 sessions, again with a frequency of three sessions per week, where participants used an overground robotic exoskeleton called the Ekso GT. | MAS, VAS, 6MWT, 10MWT, and TUG | AIS A. Injury severity: T4–T12 | 7 |
| Watanabe 2019 [36] | Japan | 2 | Case report | HAL has been used 3–4 times weekly for eight sessions. It is performed with regular physical therapy, each lasting approximately 20–30 min. | MAS, LEMS | AIS C and D Injury severity: T8–T10, L1 | 7 |
| Wirz 2017 [37] | USA | 21 | RCT | The intervention group received a training duration of 50 min per session, while the control group had a training duration of 25 min per session using the Lokomat device. Both groups underwent training sessions 3–5 days per week for a total period of 8 weeks. | 10MWT | AIS B and C. C4 to T12 are affected. | - |
AS: Ashworth Scale; MAS: Modified Ashworth Scale; VAS: Visual Analog Scale; 6MWT: 6 Minute Walk Test; 10MWT: 10 Meter Walking Test; LEMS: Lower Extremity Motor Score; TUG: Timed Up And Go Test; BWSTT: Body Weight-Supported Treadmill Training; HAL: Hybrid Assistive Limb; FES: Functional Electrical Stimulation; AIS: ASIA Impairment Scale; SCI: Spinal Cord Injury; NOS: Newcastle Ottawa Scale.