The effectiveness of physical interventions for people with spinal cord injuries: a systematic review

Study design: Systematic review. Objectives: To provide a quantitative analysis of all randomized controlled trials designed to determine the effectiveness of physical interventions for people with spinal cord injury (SCI). Setting: Sydney, Australia. Methods: A search was conducted for randomized controlled trials involving physical interventions for people with SCI. Two reviewers independently rated methodological quality using the PEDro scale and extracted key findings from the trials. Results: Four thousand five hundred and forty three abstracts were identified of which 31 trials met the inclusion criteria. Trials examined the effectiveness of fitness and strength training (n = 7), gait training (n = 5), hand therapy (n = 3), stretch (n = 4), acupuncture (n = 3), hand splinting (n = 2) and other related therapies (n = 7). Six trials reported a between-group mean difference with a clearly important treatment effect on at least one outcome measure. These trials supported the use of fitness, strength and gait training as well as acupuncture. Conclusion: There is initial evidence supporting the effectiveness of some physical interventions for people with SCI. However, there is a pressing need for high-quality trials to determine the effectiveness of all physical interventions commonly administered in clinical practice.