The cognitive level does not interfere with recovery after robot-assisted gait training in traumatic brain injury: A 10-year cohort study

BACKGROUND: There is still no clear evidence available on the role of robot-assisted gait training (RAGT) in severe traumatic brain injury (TBI) and on the relationship between this intervention and cognitive impairment. OBJECTIVE: This study investigates the impact of the cognitive level at admission on functional recovery in a cohort of patients with severe TBI who received RAGT training within a multidisciplinary rehabilitation setting. METHODS: We included patients with gait disturbance due to a severe TBI. Patients were grouped into three classes according to their level of cognitive functioning (LCF) at admission (LCF 2-3; LCF 4-5-6; LCF 7-8). We collected demographics (sex, age), clinical data, and a set of outcome measures at admission and discharge. RESULTS: We registered 80 patients, 19 females and 61 males, 35.3 ± 14.85 years. Patients with a low cognitive level at admission were mostly subacute (p= 0.001). Cognitive impairment despite longer length stay in the hospital (LOS) (p= 0.001) did not preclude recovery after RAGT in terms of cognition (R2= 0.68; p< 0.0001), functional independence (R2= 0.30; p< 0.0001) and overall disability (R2= 0.32; p< 0.0001). CONCLUSION: Irrespective of their level of cognition, patients with severe TBI might benefit from RAGT during a multidisciplinary program.