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  4. Upper Limb Robotic Rehabilitation for Patients with Cervical Spinal Cord Injury: A Comprehensive Review

Upper Limb Robotic Rehabilitation for Patients with Cervical Spinal Cord Injury: A Comprehensive Review

Brain Sciences, 2021 · DOI: 10.3390/brainsci11121630 · Published: December 10, 2021

Spinal Cord InjuryAssistive TechnologyRehabilitation

Simple Explanation

This review focuses on using robots to help people with cervical spinal cord injuries improve the function of their arms. It looks at current research on how well this robotic-assisted arm training (RAT) works for motor and functional recovery. The review analyzed studies from various databases up to September 2021, assessing the quality and level of evidence of each study. A total of 11 studies were included, ranging from systematic reviews to case series. The findings suggest that RAT is feasible and safe, with initial positive effects on arm function and movement quality when combined with traditional therapy. However, differences in treatment programs and robot types make it difficult to generalize the results.

Study Duration
Not specified
Participants
11 studies included: Five case series, one parallel-group controlled trial, two RCT, two systematic reviews and one longitudinal intervention study
Evidence Level
Systematic Reviews (Level 1), RCT (Level 2), parallel-group controlled trial and longitudinal intervention trial (Level 3), case series (Level 4)

Key Findings

  • 1
    Robotic-assisted training is safe, tolerable, and feasible in the rehabilitation of SCI patients, but this has been primarily investigated in patients with other neurological diseases.
  • 2
    SCI patients with more residual function could benefit more from robot-assisted therapy.
  • 3
    Significant improvements in muscle strength might have potential benefits in terms of short-distance mobility and electrical wheelchair manipulation.

Research Summary

The systematic review summarizes the state-of-the-art robotic-assisted rehabilitation treatments available for patients suffering from cervical SCI. Robotic-assisted training is still experimental, but recent studies provided preliminary evidence showing intriguing positive effects on functional outcomes in SCI patients. The high clinical heterogeneity of treatment programs and the variety of robot devices could severely affect the generalizability of the study results.

Practical Implications

Standardize Interventions

Future studies should standardize the type of robotic intervention to allow for better comparison and generalizability of results.

Patient-Tailored Rehabilitation

Rehabilitation programs should be tailored to the individual patient's SCI level, taking into account the clinical heterogeneity of functional disability occurring in cervical SCI.

Combination Therapies

Further research should investigate the combination of robotic-assisted rehabilitation with other advanced technologies like non-invasive brain stimulation.

Study Limitations

  • 1
    Small sample sizes
  • 2
    Lack of control groups in some studies
  • 3
    Wide variability in robotic devices, training protocols, and outcome measures

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