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Review
. 2021 Dec 10;11(12):1630.
doi: 10.3390/brainsci11121630.

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

Giovanni Morone  1 , Alessandro de Sire  2 , Alex Martino Cinnera  1 , Matteo Paci  3 , Luca Perrero  4 , Marco Invernizzi  5   6 , Lorenzo Lippi  5 , Michela Agostini  7 , Irene Aprile  8 , Emanuela Casanova  9 , Dario Marino  10 , Giuseppe La Rosa  11 , Federica Bressi  12 , Silvia Sterzi  12 , Daniele Giansanti  13 , Alberto Battistini  9 , Sandra Miccinilli  12 , Serena Filoni  14 , Monica Sicari  15 , Salvatore Petrozzino  15 , Claudio Marcello Solaro  16 , Stefano Gargano  17 , Paolo Benanti  18 , Paolo Boldrini  19 , Donatella Bonaiuti  19 , Enrico Castelli  20 , Francesco Draicchio  21 , Vincenzo Falabella  22 , Silvia Galeri  23 , Francesca Gimigliano  24 , Mauro Grigioni  13 , Stefano Mazzoleni  25 , Stefano Mazzon  26 , Franco Molteni  27 , Maurizio Petrarca  28 , Alessandro Picelli  29 , Marialuisa Gandolfi  29 , Federico Posteraro  30 , Michele Senatore  31 , Giuseppe Turchetti  32 , Sofia Straudi  33
Affiliations
Review

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

Giovanni Morone et al. Brain Sci. .

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: arm function; cervical spinal cord injury; exoskeleton; rehabilitation; robot-assisted therapy; robotic therapy.

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Conflict of interest statement

The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.

Figures

Figure 1
Figure 1
Prisma Flow chart.
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