Robot-Assisted Intensive Physiotherapy in Individuals With Spinal Cord Injury

This randomized controlled trial aims to investigate the effects of robot-assisted intensive physiotherapy on trunk control, posture, and activities of daily living in individuals with spinal cord injury. A total of 52 participants will be randomly assigned to an experimental group or a control group. Both groups will receive 45-minute treatment sessions 7 days per week for 8 weeks. The experimental group will receive robot-assisted physiotherapy 3 days per week and trunk-focused conventional physiotherapy 4 days per week, whereas the control group will receive trunk-focused conventional physiotherapy 7 days per week. Participants will be evaluated at baseline, at the end of week 4, and at the end of week 8.

Inclusion Criteria: * Aged 18-55 years * American Spinal Injury Association (ASIA) Impairment Scale grade C or D * Incomplete upper motor neuron spinal cord injury * Neurological level of injury at T10 or above * Normal range of motion of the hip, knee, and ankle joints * Receiving inpatient rehabilitation * At least 6 months since spinal cord injury Exclusion Criteria: * Receiving outpatient rehabilitation * Concurrent participation in another physiotherapy or rehabilitation program * Spasticity of grade 3 or higher according to the Modified Ashworth Scale in any lower-extremity muscle that limits movement * Lower motor neuron injury * Body weight greater than 130 kg * Open skin ulceration in areas contacting the exoskeleton or harness * Active heterotopic ossification * Hip dislocation and/or hip or knee alignment abnormalities * Diagnosed psychiatric disorder * Insufficient ability to cooperate with robot-assisted rehabilitation * Uncontrolled epilepsy * Osteoporosis * Unhealed fracture * Metal implants in the lower extremities