TY - JOUR
T1 - Upper limb robotic rehabilitation for patients with cervical spinal cord injury
T2 - A comprehensive review
AU - on behalf of Working Group Upper Limb “CICERONE” Italian Consensus Conference on Robotic Rehabilitation
AU - Morone, Giovanni
AU - de Sire, Alessandro
AU - Cinnera, Alex Martino
AU - Paci, Matteo
AU - Perrero, Luca
AU - Invernizzi, Marco
AU - Lippi, Lorenzo
AU - Agostini, Michela
AU - Aprile, Irene
AU - Casanova, Emanuela
AU - Marino, Dario
AU - La Rosa, Giuseppe
AU - Bressi, Federica
AU - Sterzi, Silvia
AU - Giansanti, Daniele
AU - Battistini, Alberto
AU - Miccinilli, Sandra
AU - Filoni, Serena
AU - Sicari, Monica
AU - Petrozzino, Salvatore
AU - Solaro, Claudio Marcello
AU - Gargano, Stefano
AU - Benanti, Paolo
AU - Boldrini, Paolo
AU - Bonaiuti, Donatella
AU - Castelli, Enrico
AU - Draicchio, Francesco
AU - Falabella, Vincenzo
AU - Galeri, Silvia
AU - Gimigliano, Francesca
AU - Grigioni, Mauro
AU - Mazzoleni, Stefano
AU - Mazzon, Stefano
AU - Molteni, Franco
AU - Petrarca, Maurizio
AU - Picelli, Alessandro
AU - Gandolfi, Marialuisa
AU - Posteraro, Federico
AU - Senatore, Michele
AU - Turchetti, Giuseppe
AU - Straudi, Sofia
N1 - Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/12
Y1 - 2021/12
N2 - The upper extremities limitation represents one of the essential functional impairments in patients with cervical spinal cord injury. Electromechanics assisted devices and robots are increasingly used in neurorehabilitation to help functional improvement in patients with neurological diseases. This review aimed to systematically report the evidence-based, state-of-art on clinical applications and robotic-assisted arm training (RAT) in motor and functional recovery in subjects affected by cervical spinal cord injury. The present study has been carried out within the framework of the Italian Consensus Conference on “Rehabilitation assisted by robotic and electromechanical devices for persons with disability of neurological origin” (CICERONE). PubMed/MEDLINE, Cochrane Library, and Physiotherapy Evidence Database (PEDro) databases were systematically searched from inception to September 2021. The 10-item PEDro scale assessed the study quality for the RCT and the AMSTAR-2 for the systematic review. Two different authors rated the studies included in this review. If consensus was not achieved after discussion, a third reviewer was interrogated. The five-item Oxford CEBM scale was used to rate the level of evidence. A total of 11 studies were included. The selected studies were: two systematic reviews, two RCTs, one parallel-group controlled trial, one longitudinal intervention study and five case series. One RCT was scored as a high-quality study, while the systematic review was of low quality. RAT was reported as feasible and safe. Initial positive effects of RAT were found for arm function and quality of movement in addition to conventional therapy. The high clinical heterogeneity of treatment programs and the variety of robot devices could severely affect the generalizability of the study results. Therefore, future studies are warranted to standardize the type of intervention and evaluate the role of robotic-assisted training in subjects affected by cervical spinal cord injury.
AB - The upper extremities limitation represents one of the essential functional impairments in patients with cervical spinal cord injury. Electromechanics assisted devices and robots are increasingly used in neurorehabilitation to help functional improvement in patients with neurological diseases. This review aimed to systematically report the evidence-based, state-of-art on clinical applications and robotic-assisted arm training (RAT) in motor and functional recovery in subjects affected by cervical spinal cord injury. The present study has been carried out within the framework of the Italian Consensus Conference on “Rehabilitation assisted by robotic and electromechanical devices for persons with disability of neurological origin” (CICERONE). PubMed/MEDLINE, Cochrane Library, and Physiotherapy Evidence Database (PEDro) databases were systematically searched from inception to September 2021. The 10-item PEDro scale assessed the study quality for the RCT and the AMSTAR-2 for the systematic review. Two different authors rated the studies included in this review. If consensus was not achieved after discussion, a third reviewer was interrogated. The five-item Oxford CEBM scale was used to rate the level of evidence. A total of 11 studies were included. The selected studies were: two systematic reviews, two RCTs, one parallel-group controlled trial, one longitudinal intervention study and five case series. One RCT was scored as a high-quality study, while the systematic review was of low quality. RAT was reported as feasible and safe. Initial positive effects of RAT were found for arm function and quality of movement in addition to conventional therapy. The high clinical heterogeneity of treatment programs and the variety of robot devices could severely affect the generalizability of the study results. Therefore, future studies are warranted to standardize the type of intervention and evaluate the role of robotic-assisted training in subjects affected by cervical spinal cord injury.
KW - Arm function
KW - Cervical spinal cord injury
KW - Exoskeleton
KW - Rehabilitation
KW - Robot-assisted therapy
KW - Robotic therapy
UR - http://www.scopus.com/inward/record.url?scp=85121678207&partnerID=8YFLogxK
U2 - 10.3390/brainsci11121630
DO - 10.3390/brainsci11121630
M3 - Review article
SN - 2076-3425
VL - 11
JO - Brain Sciences
JF - Brain Sciences
IS - 12
M1 - 1630
ER -