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Master Thesis

L'intérêt du réentraînement à la marche sur tapis avec allégement du poids du corps chez les patients blessés médullaires incomplets

Abstract : Background: A spinal cord injury is a disease of the central nervous system that will disrupt and significantly impact the lives of patients. The impairment of motor functions and therefore the inability or difficulty to walk is one of the most disabling consequences and is considered the most difficult to live with by spinal cord injured patients, making activities of daily living more complicated and having a considerable impact on their quality of life. Restoring locomotor function is therefore a priority for patients. Objective : The purpose of this review is to determine whether body weight supported treadmill training (BWSTT) in incompletely injured spinal cord patients is more effective than conventional rehabilitation in improving gait parameters (walking speed and distance), muscle strength, and walking abilities. Method: The literature search was performed in the Pubmed, PEDro, Lissa, and Kinedoc databases. The included studies were randomized controlled trials of patients with incomplete spinal cord injury in acute or chronic phase undergoing BWSTT without functional electrical stimulation and without the use of robotic assistance. The PEDro scale was used to assess the methodological quality of the studies and the level of evidence of the results was evaluated using the GRADE system. The AMSTAR-2 scale was used to rate the methodological quality of our review. A descriptive and qualitative synthesis was conducted in this review. Results: A total of 10 studies were included and analyzed in this review. No study showed a statistically and clinically significant difference between the experimental (BWSTT) and control groups (conventional treatment and overground gait training) for the 10MWT and WISCI II. For the 6MWT, two studies showed statistically significant results in favor of the experimental group, but these results were not clinically significant. For LEMS, only one study presented statistically and clinically significant results in favour of the experimental group. Nevertheless, the various biases inherent in each study as well as the small number of participants and differences in studies may be a source of bias in the results obtained. Discussion: BWSTT does not appear to be more effective than overground gait training and conventional rehabilitation. However, studies are needed to determine an optimal and standardized training protocol with well-described modalities of use (frequency and duration of training, speed of the treadmill, percentage of body weight reduction) so that other studies with larger samples of populations and high methodological quality can be conducted to confirm the results, especially those on walking distance and muscle strength which are quite heterogeneous.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03358735
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Submitted on : Wednesday, September 29, 2021 - 3:32:36 PM
Last modification on : Tuesday, October 19, 2021 - 10:35:24 PM

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Véronica Suarez. L'intérêt du réentraînement à la marche sur tapis avec allégement du poids du corps chez les patients blessés médullaires incomplets. Médecine humaine et pathologie. 2021. ⟨dumas-03358735⟩

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