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journal article·2021-12-27Open access

Robot-Assisted Upper Limb Training for Patients with Multiple Sclerosis: An Evidence-Based Review of Clinical Applications and Effectiveness

Sofia Straudi, Marco Tramontano, Emanuele Francesco Russo, Luca Perrero, Michela Agostini, Marialuisa Gandolfi, Irene Aprile, Matteo Paci, 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, Giovanni Morone, Working Group Upper Limb “CICERONE” Italian Consensus Conference on Robotic Rehabilitation

Applied Sciences· Volume 12· Issue 1
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Source abstract

Abstract

Upper extremities limitation is a common functional impairment in patients with Multiple Sclerosis (PwMS). Novel technological devices are increasingly used in neurorehabilitation to support motor function improvement and the quantitative assessment of motor performance during training in patients with neurological diseases. In this review, we systematically report the evidence on clinical applications and robotic-assisted arm training (RAT) in functional recovery in PwMS. PubMed/MEDLINE, the Cochrane Library, and the Physiotherapy Evidence Database (PEDro) databases were systematically searched from inception to March 2021. The 10-item PEDro scale assessed the study quality for the RCT, and the AMSTAR-2 was used to assess the quality of the systematic review. The 5-item Oxford CEBM scale was used to rate the level of evidence. A total of 10 studies (161 subjects) were included. The selected studies included one systematic review, four RCTs, one randomized crossover, and four case series. The RCTs were scored as high-quality studies, while the systematic review was determined to be of low quality. Shoulder range of motion, handgrip strength, and proximal arm impairment improved after RAT. Manual dexterity, arm function, and use in daily life also ameliorated arm function. The high clinical heterogeneity of treatment programs and the variety of robot devices affects the generalizability of the study results; therefore, we emphasize the need to standardize the intervention type in future studies that evaluate the role of robotic-assisted training in PwMS. Robot-assisted treatment seems safe and useful to increase manual dexterity and the quality of movement execution in PwMS with moderate to severe disability. Additional studies with an adequate sample size and methodological rigour are warranted to drive definite conclusions.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Multiple Sclerosis Research Studies · Peripheral Neuropathies and Disorders · Amyotrophic Lateral Sclerosis Research

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Neuroscience and Rehabilitation Department, Ferrara University Hospital, 44122 Ferrara, Italy

Santa Lucia Foundation, IRCCS, 00179 Rome, Italy

Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy

Neurorehabilitation Unit, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy

Department of Neuroscience, Section of Rehabilitation, University-General Hospital of Padova, 35122 Padova, Italy

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy

IRCCS Fondazione Don Carlo Gnocchi ONLUS, 50143 Florence, Italy

AUSL (Unique Sanitary Local Company) District of Central Tuscany, 50122 Florence, Italy

IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Medicina Riabilitativa e Neuroriabilitazione, 40139 Bologna, Italy

IRCCS Neurolysis Center “Bonino Pulejo”, 98124 Messina, Italy

C.S.R. Consorzio Siciliano di Riabilitazione, 95123 Catania, Italy

Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University, 00128 Rome, Italy

National Center for Innovative Technologies in Public Health, Italian National Institute of Health, 00161 Rome, Italy

A.O.U. Città della Salute e della Scienza di Torino, 10126 Torino, Italy

CRRF “Mons. Luigi Novarese”, 13040 Moncrivello, Italy

IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy

Faculty of Theology, Pontifical Gregorian University, 00187 Rome, Italy

Società Italiana di Medicina Fisica e Riabilitativa (SIMFER), 00198 Roma, Italy

Paediatric Neurorehabilitation, IRCCS Bambino Gesù Children’s Hospital, 00165 Rome, Italy

Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, 00185 Rome, Italy

President Italian Federation of Persons with Spinal Cord Injuries (Faip Onlus), 00195 Rome, Italy

Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy

Department of Electrical and Information Engineering, Politecnico di Bari, 70125 Bari, Italy

AULSS6 (Unique Sanitary Local Company) Euganea Padova, 35131 Padova, Italy

Villa Beretta Rehabilitation Center, Department of Rehabilitation Medicine, Valduce Hospital, 23845 Costa Masnaga, Italy

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