Chinese Journal of Tissue Engineering Research ›› 2021, Vol. 25 ›› Issue (14): 2287-2296.doi: 10.3969/j.issn.2095-4344.3132

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Gait training for spinal cord injury based on radar plotting: an overview of systematic reviews

Wu Cunshu1, Zhan Xiaoxuan1, Zhao Siyi2, Huang Fan2, Zhang Yue1, Qiu Mingwang1, Xia Jingxian1, Lu Xiaobo3#br#

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  1. 1Acupuncture and Rehabilitation School of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China; 2The Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China; 3Department of Rehabilitation, Jieyang Hospital of Traditional Chinese Medicine, Jieyang 522000, Guangdong Province, China
  • Received:2020-05-25 Revised:2020-05-26 Accepted:2020-08-19 Online:2021-05-18 Published:2020-12-31
  • Contact: Lu Xiaobo, Department of Rehabilitation, Jieyang Hospital of Traditional Chinese Medicine, Jieyang 522000, Guangdong Province, China
  • About author:Wu Cunshu, Acupuncture and Rehabilitation School of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
  • Supported by:
    the National College Student Innovation and Entrepreneurship Training Project in 2019, No. 201910572001 (to ZSY)

Abstract: OBJECTIVE: Whether a systematic review/meta-analysis is of high quality is the premise for the reliability of clinical evidence. However, there is still no quality evaluation of systematic review/meta-analysis regarding the walking training after spinal cord injury at home and abroad. This paper aims to evaluate the systematic reviews/meta-analysis regarding the effect of different gait training methods on walking function of patients with spinal cord injury by radar plotting, so as to provide intuitive basis for clinical research. 
METHODS: Nine Chinese or English databases were searched by computer for collecting systematical reviews/meta-analysis regarding gait training for spinal cord injury. The retrieval time was from inception to October 2019. Literature quality was analyzed from six dimensions: publication year, design type, AMSTAR-2 methodological quality score, PRISMA publication quality score, homogeneity and publication bias risk, and the rank average score was then calculated. For the evidence level of outcome indicators, GRADE tool was used to evaluate the included systematic reviews/meta-analysis. Excel 2016 was used to draw and optimize radar plot for further analysis. 
RESULTS: A total of 20 eligible literatures were included. Radar plots showed that the average scores on the year of publication, design type, AMSTAR-2 methodological quality score, PRISMA publication quality score, homogeneity, and publication bias risk were 11.50, 14.25, 10.90, 10.95, 14.85, and 14.95, respectively. The average rank score of all the included literatures was 12.90. The GRADE tool evaluation indicated that 17 outcome indicators were of low quality, 40 of medium quality, and only 2 of high quality. The main problems are the low quality of methodology and research report, such as the project failed to register in the international pre-registration database and explain the study protocol, did not explain the comprehensive and systematic retrieval strategy, did not report the included research content in detail, did not carry out heterogeneity test or did not explain the results.
CONCLUSION: The quality of systematic reviews/meta-analysis literature regarding gait training of spinal cord injury is not high, and the quality of methodology and research report should be strengthened to further improve the quality of literature. The research and analysis should be conducted in strict accordance with the standards proposed by AMSTAR-2 and PRISMA. Most of the systematic reviews/meta-analyses included show that gait training can improve walking function of patients with spinal cord injury. Among them, orthosis therapy with higher literature quality and higher level of evidence is more effective for patients with spinal cord injury, and orthosis therapy can be used as much as possible in clinical practice. Radar plot is an intuitive, scientific and effective graphical evaluation method, which is worthy of popularization and application in rehabilitation medicine in the future.


Key words: radar plot, spinal cord injury, gait training, overview of systematic review, multiple evaluation, report quality, AMSTAR-2, PRISMA

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