The effectiveness of robotic-assisted upper limb rehabilitation to improve upper limb function in patients with cervical spinal cord injuries: a systematic literature review

Frontiers in Neurology

Neurology

Koko Shaau-yiu Ko¹  Jocelyn Sze-wing Ho¹  Sheung Wai Law²  Gene Chi-wai Man³ 

[1] Department of Orthopaedics and Traumatology, The Faculty of Medicine, The Chinese University of Hong Kong, The Prince of Wales Hospital, Hong Kong SAR, China;[e-mail];null;

关键词: limb activation;    robot-assisted therapy;    spinal cord injury;    exoskeleton;    adults;   

DOI  :  10.3389/fneur.2023.1126755

 received in 2022-12-18, accepted in 2023-07-26,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundSpinal Cord Injury (SCI) damages corticospinal tracts and descending motor pathways responsible for transmitting signals from the brain to the spinal cord, leading to temporary or permanent changes in sensation, motor function, strength, and body function below the site of injury. Cervical SCI (cSCI), which leads to tetraplegia, causes severe functional upper limb (UL) impairments that increase falls risk, limits independence, and leads to difficulties with activities of daily living (ADLs). Robotic therapy (RT) has been developed in recent decades as a new treatment approach for people with cervical spinal cord injuries (cSCI). The present review aimed to explore current available evidence and studies regarding the effectiveness of RT for individuals with cSCI in improving UL function, identify current research gaps and future research directions.MethodThis review was conducted by searching PubMed, CINAHL, Medline, Embase, and APA PsycInfo for relevant studies published from January 2010 to January 2022. Selected studies were analyzed with a focus on the patients’ self-perception of limited UL function and level of independence in activities of daily living. In addition, the JBI Critical Appraisal checklist was used to assess study quality.ResultsA total of 7 articles involving 87 patients (74 males and 13 females) were included in the analysis, with four studies utilizing exoskeleton and three studies utilizing end-effector robotic devices, respectively. The quality of these studies varied between JBI Critical Appraisal scores of 4 to 8. Several studies lacked blinding and a control group which affected internal validity. Nevertheless, four out of seven studies demonstrated statistically significant improvements in outcome measurements on UL function and strength after RT.ConclusionThis review provided mixed evidence regarding the effectiveness of RT as a promising intervention approach to improve upper limb function in participants with cSCI. Although RT was shown to be safe, feasible, and reduces active therapist time, further research on the long-term effects of UL RT is still needed. Nevertheless, this review serves as a useful reference for researchers to further develop exoskeletons with practical and plausible applications toward geriatric orthopaedics.

【 授权许可】

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Copyright © 2023 Ho, Ko, Law and Man.