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Treadmill training in multiple sclerosis: can body weight support or robot assistance provide added value? A systematic review.

Swinnen E, Beckwée D, Pinte D, Meeusen R, Baeyens JP, Kerckhofs E - Mult Scler Int (2012)

Bottom Line: Conclusions.There is a limited number of published papers related to TT in persons with MS, concluding that TT, BWSTT, and RATT improve the walking speed and endurance.However, it is not clear what type of TT is most effective.

View Article: PubMed Central - PubMed

Affiliation: Vakgroep KINE, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium.

ABSTRACT
Purpose. This systematic review critically analyzes the literature on the effectiveness of treadmill training (TT), body-weight-supported TT (BWSTT), and robot-assisted TT (RATT) in persons with multiple sclerosis (MS), with focus on gait-related outcome measurements. Method. Electronic databases (Pubmed, Pedro, Web of Science, and Cochrane Library) and reference lists of articles and narrative reviews were searched. Pre-, quasi- and true-experimental studies were included if adult persons with MS were involved in TT, BWSTT, or RATT intervention studies published before 2012. Descriptive analysis was performed and two researchers scored the methodological quality of the studies. Results. 5 true- and 3 preexperimental studies (mean quality score: 66%) have been included. In total 161 persons with MS were involved (TT, BWSTT, or RATT, 6-42 sessions; 2-5x/week; 3-21 weeks). Significant improvements in walking speed and endurance were reported. Furthermore, improvements of step length, double-support time, and Expanded Disability Status Scale were found. Conclusions. There is a limited number of published papers related to TT in persons with MS, concluding that TT, BWSTT, and RATT improve the walking speed and endurance. However, it is not clear what type of TT is most effective. RCTs with larger but more homogeneous populations are needed.

No MeSH data available.


Related in: MedlinePlus

Flowchart of the search strategy.
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Related In: Results  -  Collection


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fig1: Flowchart of the search strategy.

Mentions: The flowchart (Figure 1) presents an overview of the search strategy. Ultimately, eight studies were included in this systematic review [29–36]. Five studies were true experimental trials (randomized controlled trials, RCTs [29–33]), no studies were quasi-experimental trials (clinical trials without random assignment) and three studies were preexperimental trials (one study was a randomized trial without comparison group and two studies were case reports with four and six subjects [34–36]) [37]. The methodology checklist: “Evaluation of quality of an intervention study” was used to assess the quality of the included studies [38]. Two researchers scored the studies independently and Cohen's kappa was used to test the interrater reliability. This check-list scores the internal validity of the studies, and consists of seven subscales: study question, study design, subjects, intervention, outcomes, analysis and recommendations. The Cohen's Kappa between the scores of the two researchers was 0.77 (SD 0.13), indicating a good agreement between the scores of the two researchers. The consensus method was used in case of disagreement. In Table 2 an overview of the scores of the Methodology checklist is presented. All studies scored between 48 and 79% on the methodological checklist, with the highest scores for the RCTs (between 62.5 to 79%) and the lowest scores for the case reports (48 and 54%). The mean score was 31.5/48 (SD 5.8) or 66%. We decided to includ all the eight studies. The lower scores were mainly caused by poor quality of the study design, the intervention, and the analysis of the results.


Treadmill training in multiple sclerosis: can body weight support or robot assistance provide added value? A systematic review.

Swinnen E, Beckwée D, Pinte D, Meeusen R, Baeyens JP, Kerckhofs E - Mult Scler Int (2012)

Flowchart of the search strategy.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3369491&req=5

fig1: Flowchart of the search strategy.
Mentions: The flowchart (Figure 1) presents an overview of the search strategy. Ultimately, eight studies were included in this systematic review [29–36]. Five studies were true experimental trials (randomized controlled trials, RCTs [29–33]), no studies were quasi-experimental trials (clinical trials without random assignment) and three studies were preexperimental trials (one study was a randomized trial without comparison group and two studies were case reports with four and six subjects [34–36]) [37]. The methodology checklist: “Evaluation of quality of an intervention study” was used to assess the quality of the included studies [38]. Two researchers scored the studies independently and Cohen's kappa was used to test the interrater reliability. This check-list scores the internal validity of the studies, and consists of seven subscales: study question, study design, subjects, intervention, outcomes, analysis and recommendations. The Cohen's Kappa between the scores of the two researchers was 0.77 (SD 0.13), indicating a good agreement between the scores of the two researchers. The consensus method was used in case of disagreement. In Table 2 an overview of the scores of the Methodology checklist is presented. All studies scored between 48 and 79% on the methodological checklist, with the highest scores for the RCTs (between 62.5 to 79%) and the lowest scores for the case reports (48 and 54%). The mean score was 31.5/48 (SD 5.8) or 66%. We decided to includ all the eight studies. The lower scores were mainly caused by poor quality of the study design, the intervention, and the analysis of the results.

Bottom Line: Conclusions.There is a limited number of published papers related to TT in persons with MS, concluding that TT, BWSTT, and RATT improve the walking speed and endurance.However, it is not clear what type of TT is most effective.

View Article: PubMed Central - PubMed

Affiliation: Vakgroep KINE, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium.

ABSTRACT
Purpose. This systematic review critically analyzes the literature on the effectiveness of treadmill training (TT), body-weight-supported TT (BWSTT), and robot-assisted TT (RATT) in persons with multiple sclerosis (MS), with focus on gait-related outcome measurements. Method. Electronic databases (Pubmed, Pedro, Web of Science, and Cochrane Library) and reference lists of articles and narrative reviews were searched. Pre-, quasi- and true-experimental studies were included if adult persons with MS were involved in TT, BWSTT, or RATT intervention studies published before 2012. Descriptive analysis was performed and two researchers scored the methodological quality of the studies. Results. 5 true- and 3 preexperimental studies (mean quality score: 66%) have been included. In total 161 persons with MS were involved (TT, BWSTT, or RATT, 6-42 sessions; 2-5x/week; 3-21 weeks). Significant improvements in walking speed and endurance were reported. Furthermore, improvements of step length, double-support time, and Expanded Disability Status Scale were found. Conclusions. There is a limited number of published papers related to TT in persons with MS, concluding that TT, BWSTT, and RATT improve the walking speed and endurance. However, it is not clear what type of TT is most effective. RCTs with larger but more homogeneous populations are needed.

No MeSH data available.


Related in: MedlinePlus