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

Giovanni Morone; Alessandro De Sire; Alex Martino Cinnera; Matteo Paci; Luca Perrero; Marco Invernizzi; Lorenzo Lippi; Marialuisa Gandolfi; Michela Agostini; Irene Aprile; Emanuela Casanova; Dario Marino; Giuseppe La Rosa; Federica Bressi; Silvia Sterzi; Daniele Giansanti; Alberto Battistini; Sandra Miccinilli; Serena Filoni; Monica Sicari; Salvatore Petrozzino; Claudio Marcello Solaro; Stefano Gargano; Paolo Benanti; Paolo Boldrini; Donatella Bonaiuti; Enrico Castelli; Francesco Draicchio; Vincenzo Falabella; Silvia Galeri; Francesca Gimigliano; Mauro Grigioni; Stefano Mazzoleni; Stefano Mazzon; Franco Molteni; Maurizio Petrarca; Alessandro Picelli; Federico Posteraro; Michele Senatore; Giuseppe Turchetti; Sofia Straudi

doi:10.20944/preprints202111.0065.v1

A peer-reviewed article of this Preprint also exists.

Morone, G.; de Sire, A.; Martino Cinnera, A.; Paci, M.; Perrero, L.; Invernizzi, M.; Lippi, L.; Agostini, M.; Aprile, I.; Casanova, E.; Marino, D.; La Rosa, G.; Bressi, F.; Sterzi, S.; Giansanti, D.; Battistini, A.; Miccinilli, S.; Filoni, S.; Sicari, M.; Petrozzino, S.; Solaro, C.M.M.; Gargano, S.; Benanti, P.; Boldrini, P.; Bonaiuti, D.; Castelli, E.; Draicchio, F.; Falabella, V.; Galeri, S.; Gimigliano, F.; Grigioni, M.; Mazzoleni, S.; Mazzon, S.; Molteni, F.; Petrarca, M.; Picelli, A.; Gandolfi, M.; Posteraro, F.; Senatore, M.; Turchetti, G.; Straudi, S. Upper Limb Robotic Rehabilitation for Patients with Cervical Spinal Cord Injury: A Comprehensive Review. Brain Sci. 2021, 11, 1630. Morone, G.; de Sire, A.; Martino Cinnera, A.; Paci, M.; Perrero, L.; Invernizzi, M.; Lippi, L.; Agostini, M.; Aprile, I.; Casanova, E.; Marino, D.; La Rosa, G.; Bressi, F.; Sterzi, S.; Giansanti, D.; Battistini, A.; Miccinilli, S.; Filoni, S.; Sicari, M.; Petrozzino, S.; Solaro, C.M.M.; Gargano, S.; Benanti, P.; Boldrini, P.; Bonaiuti, D.; Castelli, E.; Draicchio, F.; Falabella, V.; Galeri, S.; Gimigliano, F.; Grigioni, M.; Mazzoleni, S.; Mazzon, S.; Molteni, F.; Petrarca, M.; Picelli, A.; Gandolfi, M.; Posteraro, F.; Senatore, M.; Turchetti, G.; Straudi, S. Upper Limb Robotic Rehabilitation for Patients with Cervical Spinal Cord Injury: A Comprehensive Review. Brain Sci. 2021, 11, 1630.

Abstract

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 5-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.

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

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