Brain Sciences (Dec 2021)
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,
- 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,
- Marialuisa Gandolfi,
- Federico Posteraro,
- Michele Senatore,
- Giuseppe Turchetti,
- Sofia Straudi
Affiliations
- Giovanni Morone
- IRCCS Santa Lucia Foundation, 00179 Rome, Italy
- Alessandro de Sire
- Physical and Rehabilitative Medicine, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
- Alex Martino Cinnera
- IRCCS Santa Lucia Foundation, 00179 Rome, Italy
- Matteo Paci
- AUSL (Unique Sanitary Local Company), 50123 Florence, Italy
- Luca Perrero
- Neurorehabilitation Unit, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
- Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 10121 Novara, Italy
- Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 10121 Novara, Italy
- Michela Agostini
- Section of Rehabilitation, Department of Neuroscience, University General Hospital of Padova, 35128 Padua, Italy
- Irene Aprile
- IRCCS Fondazione Don Carlo Gnocchi, 50123 Florence, Italy
- Emanuela Casanova
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Medicina Riabilitativa e Neuroriabilitazione, 40139 Bologna, Italy
- Dario Marino
- IRCCS Neurolysis Center “Bonino Pulejo”, 98124 Messina, Italy
- Giuseppe La Rosa
- C.S.R.—Consorzio Siciliano di Riabilitazione, 95123 Catania, Italy
- Federica Bressi
- Campus Bio-Medico University Hospital, University of Rome, 00128 Rome, Italy
- Silvia Sterzi
- Campus Bio-Medico University Hospital, University of Rome, 00128 Rome, Italy
- Daniele Giansanti
- National Center for Innovative Technologies in Public Health, Italian National Institute of Health, 00161 Rome, Italy
- Alberto Battistini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Medicina Riabilitativa e Neuroriabilitazione, 40139 Bologna, Italy
- Sandra Miccinilli
- Campus Bio-Medico University Hospital, University of Rome, 00128 Rome, Italy
- Serena Filoni
- Padre Pio Foundation and Rehabilitation Center, San Giovanni Rotondo 71013, Italy
- Monica Sicari
- A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, Italy
- Salvatore Petrozzino
- A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, Italy
- Claudio Marcello Solaro
- CRRF “Mons. Luigi Novarese”, 13040 Moncrivello, Italy
- Stefano Gargano
- Fondazione Don Carlo Gnocchi, 10143 Torino, Italy
- Paolo Benanti
- Department of Moral Theology, Pontifical Gregorian University, 00187 Rome, Italy
- Paolo Boldrini
- Società Italiana di Medicina Fisica e Riabilitativa (SIMFER), 00198 Rome, Italy
- Donatella Bonaiuti
- Società Italiana di Medicina Fisica e Riabilitativa (SIMFER), 00198 Rome, Italy
- Enrico Castelli
- Paediatric Neurorehabilitation Department, IRCCS Bambino Gesù Children’s Hospital, 00163 Rome, Italy
- Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, 00185 Rome, Italy
- Vincenzo Falabella
- Italian Federation of Persons with Spinal Cord Injuries (Faip Onlus), 00195 Rome, Italy
- Silvia Galeri
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy
- Francesca Gimigliano
- Multidisciplinary Department of Medicine for Surgery and Orthodontics, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Mauro Grigioni
- National Center for Innovative Technologies in Public Health, Italian National Institute of Health, 00161 Rome, Italy
- Stefano Mazzoleni
- Department of Electrical and Information Engineering, Politecnico di Bari, 70125 Bari, Italy
- Stefano Mazzon
- AULSS6 (Unique Sanitary Local Company) Euganea Padova, Rehabilitation Department, 35128 Padua, Italy
- Franco Molteni
- Villa Beretta Rehabilitation Center, Department of Rehabilitation Medicine, Valduce Hospital, 23845 Costa Masnaga, Italy
- Maurizio Petrarca
- Movement Analysis and Robotics Laboratory MARlab, IRCCS Bambino Gesù Children’s Hospital, 00163 Rome, Italy
- Alessandro Picelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37129 Verona, Italy
- Marialuisa Gandolfi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37129 Verona, Italy
- Federico Posteraro
- Rehabilitation Department Versilia Hospital, Versilia Hospital AUSL Toscana Nord Ovest, 55049 Lido di Camaiore, Italy
- Michele Senatore
- AITO (Associazione Italiana Terapisti Occupazionali), 00136 Rome, Italy
- Giuseppe Turchetti
- Management Institute, Sant’Anna School of Advanced Studies, 56127 Pisa, Italy
- Sofia Straudi
- Neuroscience and Rehabilitation Department, Ferrara University Hospital, 44121 Ferrara, Italy
- DOI
- https://doi.org/10.3390/brainsci11121630
- Journal volume & issue
-
Vol. 11,
no. 12
p. 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 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.
Keywords
- cervical spinal cord injury
- arm function
- exoskeleton
- robot-assisted therapy
- robotic therapy
- rehabilitation
