A new, international meta-analysis on patients with genetic and acquired neuromuscular disorders breaks good news for assisted movement therapy. The study, published in a peer reviewed journal, shows improved clinical outcome in 94% of the patients.
Adding the robotic Innowalk training to conventional therapy, significantly improved passive range of motion in the lower extremities. Other improved clinical outcomes were seen in the following areas:- Walking or weight-bearing transfer
- Control/strength of the trunk or head
- Joint mobility
- Sleep
- Muscle strength
- Vital functions
- Bowel function
- Attention/orientation
You find the full article “Effects of assisted walking-movement in patients with genetic and acquired neuromuscular disorders with the motorised Innowalk device: an international case study meta-analysis” in the peer reviewed journal PeerJ here.
However, to give you a brief overview of the study, here is an article summary:
Introduction
It is well known that people with physical disabilities, with permanent motor impairments, for example CP, suffer from consequences as a result of disease progression. This is related both to the complex symptoms due to their diagnoses, but also to secondary conditions. The aim of multidisciplinary treatment is to increase the quality of life of patients and caregivers, preserve body structure and function, and increase activity and participation in everyday life.
Aim of the study
The Innowalk is a motorised assistive device for dynamic standing with weight-bearing. The study aimed to evaluate the Innowalk's ability to improve clinical outcome in combination with standard therapy in a meta-analysis of the available studies.
The research focuses mainly on impact-related to passive range of motion (PROM) of lower extremity joints, quality of life, as well as defining risks and undesired effects of the motorised assistive device for dynamic standing.
Meta-analysis
– Method used to combine data from multiple studies
– Increases the statistical power
– Identifies common effect
– Meta-analysis can play a key role in planning of new studies
Material and methods
A total of 11 completed, non-randomised prospective studies, involving 83 patients were identified in studies conducted from 2009-2017, mostly from unpublished, non-journal sources. 52 patients were excluded due to missing key variables (n=51) and duplicate (n=1), ending up analysing 9 studies and a total of 31 patients. The study population includes case studies of patients with various neuromuscular disabilities who used dynamic standing in the Innowalk as part of or in addition to their standard treatment.
Results
The study sample was representative of a population with severe disabilities with 90% being underage and 58% males, the majority with spasticity. All but five patients had CP (86%).
Other underlying or additional diagnoses were spinal muscular atrophy type 3, Rett syndrome, acquired brain injury, bronchopulmonary dysplasia, microcephaly, and congenital muscular dystrophy. GMFCS-E&R was classified at least as level IV in 78% of patients with CP. Only four patients were able to self-transfer or sit freely with none or minor difficulties (See table 2 in the article for characteristics and demographic variables). Out of 15 patients who provided information about pain, all but three pain-free patients reported mild (n=8) to moderate (n=4) pain.
Patients practiced dynamic standing for at least 4 weeks for 30-60 minutes sessions with a frequency of 2-7.5 times a week.
94% of the patients had improved clinical outcome within following areas:
– Walking or weight-bearing transfer (n=13)
– Control/strength of the trunk or head (n=6)
– Joint mobility (n=14)
– Sleep (n=4 out of 6/67%)
– Muscle strength (n=17)
– Vital functions (n=16)
– Bowel function (n=10)
– Attention/orientation (n=2)
– Passive range of motion of lower extremities:
– Hip (flexion, abduction and adduction) significantly increased after 1 month and further after 5 months in contrast to a control group with conventional therapy (see table 7 in the article for more details).
No adverse events or unacceptable experiences were reported.
Discussion
This pooled analysis found that regular usage of the Innowalk assistive device in this population, significantly improved passive range of motion in the lower extremities, when added to conventional therapy. In addition, the study shows diverse improvements related to muscular tone and general well-being associated with physical exercise. Cumulatively, the Innowalk is a promising tool with high potential to further improve current evidence-based treatment for patients with severe physical disability. This analysis has limitations inherent to the pooling of data, but the data is suitable to form the basis for a randomised controlled study in the future.
For more in-depth knowledge we encourage you to read the full article.
