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Table 1 Characteristics of included studies

From: Over-ground walking or robot-assisted gait training in people with multiple sclerosis: does the effect depend on baseline walking speed and disease related disabilities? A systematic review and meta-regression

Study

Country

N randomised (RAGT/CGT)

N post-treatment (RAGT/CGT)

Mean age (RAGT/CGT)

EDSS (RAGT/CGT)

Mean walking speed at baseline (m/s) (RAGT/CGT)

Follow up points

Procedures in RAGT group

Procedures in CGT group

Primary outcome measure

Secondary outcome measure

Beer et al. [11]

Switzerland

35 (19/16)

29 (14/15)

49.7 (SD: 11.0)/51.0 (SD: 15.5)

6.5 (r: 6–7.5)/6.5 (r: 6–7.5)

0.21 (IQR: 0.09–0.27)/0.24 (IQR: 0.17–0.49)

6 months

RAGT (Lokomat); 15 sessions (30 min) over 3 weeks, maximal speed: 2.8 km/h

Conventional walking training; 30 min training with assistance of a physiotherapist, 15 sessions over 3 weeks

20MWT (walking velocity)

6MWT (walking distance), stride length, knee extensor strength, EBI (ADL independence), VAS (walking safety and satisfaction)

Lo and Triche [12]

US

13 (6/7)

13 (6/7)

50.2 (SD: 11.4)/49.8 (SD: 11.8)

5.0 (SD: 1.6)/4.9 (SD: 0.9)

0.87 (SD: 0.31) 0.70 (SD 0.32)

No follow up

RAGT (Lokomat): 6 sessions (40 min) over 3 weeks, maximal speed 2.5 km/h

BWSTT; 6 sessions (40 min) over 3 weeks, maximal speed 2.5 km/h

T25FW (walking velocity)

6MWT (walking distance), double support time and step length ratio (spatiotemporal gait kinematics)

Giesser et al. [22]

US

36 (18/18)

36 (18/18)

n.a.

6.5/6.0

n.a.

No follow up

RAGT (Lokomat): 3 sessions (30–40 min) per week over 12–16 weeks

Resistance training with elastic bands and weights; 3 sessions (30–40 min) per week over 12–16 weeks

T25FW (walking velocity)

6MWT (walking distance), fatigue, depression

Wier et al. [34]

as reported in [12]

MS Quality of Life Inventory

FSS (fatigue), Life Satisfaction

Vaney et al. [19]

Switzerland

67 (34/33)

49 (26/23)

58.23 (SD: 9.42)/54.22 (SD: 11.28)

5.88 (SD: 0.9)/5.72 (SD: 1.06)

0.52 (SD: 0.32)/0.6 (SD: 0.34)

9 months

RAGT (Lokomat): 9 sessions of 30 min

Walking in a group with a physiotherapist (inside and outside); 9 sessions of 30 min

Well-Being VAS (QoL), EQ-5D (QoL), accelerometer (activity level), 10MWT (walking speed), 3MWT (walking distance)

BBS (balance), Würzburger Erschöpfungsinventar bei MS (fatigue), RMI (mobility), modified Ashworth Scale (spasticity), NRS (pain)

Schwartz et al. [13]

Israel

32 (15/17)

28 (12/16)

46.8 (SD: 11.5)/50.5 (SD: 11.5)

6.2 (SD: 0.5)/6 (SD: 0.6)

0.49 (SD: 0.3)/0.53 (SD: 0.31)

3 and 6 months

RAGT (Lokomat): 2–3 sessions (30 min) per week for 4 weeks, maximal speed: 3 km/h

Gait, dynamic balance and standing from sitting exercises, 2–3 sessions (30 min) per week for 4 weeks

10MWT (walking speed), 6MWT (walking distance), TUG (mobility)

BBS (balance), FIM (daily living functions), RAND-36 (health-related QoL)

Straudi et al. [21]

Italy

18 (9/9)

16 (8/8)

49.6 (SD: 12.0)/61.0 (SD: 8.8)

5.8 (SD: 0.8)/5.7 (SD: 0.7)

0.55 (SD: 0.24)/0.46 (SD: 0.22)

3 months

RAGT (Lokomat): 12 sessions (30 min) over 6 weeks, maximal speed: 3 km/h

Conventional therapy: Stretching and strengthening of lower limb muscles, optional motor coordination and balance exercises were integrated), 12 sessions (1 h) over 6 weeks

6MWT (walking distance), TUG (mobility)

FSS (fatigue), spatiotemporal gait parameters (gait speed, cadence, double support, step length and time), pelvis and hip kinematic profiles

Straudi et al. [20]

Italy

58 (30/28)

55 (27/28)

52.26 (SD: 11.1)/54.12 (SD: 11.4)

6.43 (SD: 0.38)/6.46 (SD: 0.43)

0.59 (SD: 0.37)/0.45 (SD: 0.24)

3 months

RAGT (Lokomat): 12 sessions (1 h) over 6 weeks, maximal speed: 3 km/h

Conventional therapy: Stretching and strengthening of lower limb muscles, motor coordination and gait and balance exercises,å 12 sessions (1 h) over 6 weeks

10MWT (walking speed), 6MWT (walking distance)

BBS (balance), TUG (mobility), FSS (fatigue), PHQ-9 (depression), SF-36 (health-related QoL), VAS (treatment acceptance)

Pompa et al. [23]

Italy

50 (25/25)

43 (21/22)

47.00 (SD: 11.2)/49.86 (SD: 8.21)

6.62 (SD: 0.42)/6.50 (SD: 0.49)

0.28 (SD: 0.13) /0.34 (SD: 0.19)

n.a.

RAGT (Gait Trainer GT II): 3 sessions (40 min) a week over 4 weeks, maximal speed: 1.8 km/h

Conventional walking therapy: Preparation exercises within parallel bars, trunk and pelvis control exercises, balance and coordination exercises and walking exercises, 3 sessions (40 min) a week over 4 weeks

2MWT (walking distance), FAC (ambulation)

RMI (global mobility), mBI (independence in ADL), EDSS (MS severity), FSS (fatigue), VAS (spasticity)

  1. 20MWT 20 Metre Timed Walking Test, 10MWT 10 Metre Walk Test, 6MWT 6 Minute Walk Test, 3MWT 3 Minute Walk Test, 2MWT 2 Minute Walk Test, ADL Activities of daily living, BWSTT Body weight supported treadmill training, CGT Conventional over-ground walking training, EBI Extended Barthel Index, EQ-5D EuroQol-5D, FAC Functional Ambulation Categories, FIM Functional Independence Measure, IQR Interquartile range, mBI Modified Barthel Index, NRS Numeric rating scale, QoL Quality of Life, RAGT that robot-assisted gait training, r Range, RMI Rivermead Mobility Index, SD Standard deviation, SF-36 (or RAND-36) Short Form (36) Health Survey, T25FW Timed 25-ft walk, VAS Visual analogue scale