Dobkin et al. 2006; USA
PEDro = 7
RCT
N=292 (enrolled)
N=117 (analyzed)

Population: 117 males and females; age 16-69 yrs; AIS B-D; <8 wks post-injury.
Treatments: BWSTT vs. overground mobility training: 5x/wk, 9-12 wks, 30-45 min/session.
Outcome measures: FIM-L, walking speed, 6MWT, WISCI at 3 and 6 months

No difference in FIM Locomotor Scale (AIS B & C) or walking speed (AIS C & D) between groups.

1. AIS C & D subjects in both groups improved walking function. No improvement of functional ambulation in the AIS B subjects with either intervention.

Dobkin et al. 2007; USA and Canada
PEDro = 5
RCT
N=112

Population: 112 males and females; 29 subject with diagnosis of AIS B , 83 subject with diagnosis of AIS C-D; age 16-70 yrs; mean 4.5 wks post-injury
Treatment: BWSTT vs. overground mobility training (control): 5x/wk, 9-12 wks, 30-45 min/session.
Outcome measures: FIM-L (range from 1 (total physical dependence) to 7 (independence to walk > 150 feet)), walking speed, 6MWT, lower extremity motor score (LEMS).

1. At 12 weeks, no differences were found between patients who received BWSTT versus control for FIM-L, walking speed, LEMS, or distance walked in 6 minutes.
2. Combining both interventions, a FIM-L ≥ 4 was achieved in < 10% of AIS B patients, 92% of AIS C patients, and all of AIS D patients; few AIS B and most AIS C and D patients achieved functional walking ability by the end of 12 weeks of BWSTT and control.
3. Time after injury is an important variable for planning interventions to lessen walking disability.  Patients who started their rehabilitation sooner (<4 weeks after onset) had better outcomes. This does not imply that an earlier start of rehabilitation for walking led to better outcomes. Rather, entry within 4 weeks allowed some patients to start at a lower level of function.
4. By 6 weeks after entry, most patients who will recover have improved their FIM-L to >3 and are improving in walking speed. 

Wernig et al. 1995; Germany
Downs & Black =10
Case Control
N=97

Population:  Study 1: 12 males and females; 0-4.5 mos post injury. Study 2: 85 males and females; 2-30 wks post-injury.
Treatment: Study 1) BWSTT: 30-60 min, 5x/wk, 3-20 wks (median 10.5 wks). Study 2) 45 subjects underwent 2-22 wks of BWSTT vs. 40 subjects (historical controls) underwent conventional rehabilitation.
Outcome measures: Wernig Scale of Ambulatory Capacity.

1. Study 1: 9/12 initially wheelchair-bound could walk without assistance after BWSTT.
2. Study 2: 33/36 initially non-ambulatory subjects could walk after BWSTT.
3. 7/9 initially ambulatory subjects improved walking distance after BWSTT.
4. 12/24 initially non-ambulatory subjects improved to functional ambulation after conventional rehabilitation.
5. Results from the remaining 16 subjects (who were initially ambulatory) in historical control group not reported.

Wernig et al. 1998; Germany
Downs & Black =9
Pre-post
N=41

Population: 41 males and females with incomplete SCI; 3-16 wks post-injury.
Treatment: BWSTT: 30-60 min, 5x/week, 3-22 weeks.
Outcome measures: Wernig Scale of Ambulatory Capacity.

1. 29/37 initially non-ambulatory subjects improved to walking with aids.
2. Follow-up (6 months to 6 years post-training): 15 subjects showed continued improvement, 26 had no change.