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Arch Phys Med Rehabil. 2014 Jun;95(6):1023-31. doi: 10.1016/j.apmr.2013.12.017. Epub 2014 Jan 3.

A comparison of robotic walking therapy and conventional walking therapy in individuals with upper versus lower motor neuron lesions: a randomized controlled trial.

Author information

  • 1Department of Physical Medicine and Rehabilitation, National Hospital for Paraplegics, Toledo, Spain. Electronic address:
  • 2Department of Physical Medicine and Rehabilitation, National Hospital for Paraplegics, Toledo, Spain.
  • 3European University of Madrid, Madrid, Spain.



To compare a walking reeducation program with robotic locomotor training plus overground therapy (LKOGT) to conventional overground training (OGT) in individuals with incomplete upper motor neuron (UMN) or lower motor neuron (LMN) injuries having either traumatic or nontraumatic nonprogressive etiology.


Randomized open controlled trial with blind evaluation by an independent observer.


An inpatient spinal cord injury rehabilitation center.


A total of 88 adults within 6 months of spinal cord injury onset (group A, 44 with UMN injury, and group B, 44 with LMN injury) were graded on the American Spinal Injury Association Impairment Scale as C or D. Each of these groups was then randomly allocated to conditions 1 or 2.


Condition 1: Subgroups A1 and B1 were treated with LKOGT for 60 minutes. Condition 2: Subgroups A2 and B2 received 60 minutes of conventional OGT 5 days per week for 8 weeks. Subjects with UMN and LMN were randomized into 2 training groups.


Ten-meter walk test and 6-minute walk test (6MWT). Walking Index for Spinal Cord Injury II, lower extremity motor score (LEMS), and the FIM-Locomotor were secondary outcome measures.


By using the LKOGT program compared with OGT, we found significant differences in the 6MWT for groups A1 and B1. LKOGT also provided higher scores than did OGT in secondary outcomes such as the LEMS and the FIM-Locomotor.


Robotic-assisted step training yielded better results in the 6MWT and the LEMS in patients with UMN and LMN.

Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.


Clinical trial; Locomotor; Rehabilitation; Spinal cord injuries

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