A Narrative Review on Multi-Domain Instrumental Approaches to Evaluate Neuromotor Function in Rehabilitation

Abstract

In clinical scenarios, the use of biomedical sensors, devices and multi-parameter assessments is fundamental to provide a comprehensive portrait of patients’ state, in order to adapt and personalize rehabilitation interventions and support clinical decision-making. However, there is a huge gap between the potential of the multidomain techniques available and the limited practical use that is made in the clinical scenario. This paper reviews the current state-of-the-art and provides insights into future directions of multi-domain instrumental approaches in the clinical assessment of patients involved in neuromotor rehabilitation. We also summarize the main achievements and challenges of using multi-domain approaches in the assessment of rehabilitation for various neurological disorders affecting motor functions. Our results showed that multi-domain approaches combine information and measurements from different tools and biological signals, such as kinematics, electromyography (EMG), electroencephalography (EEG), near-infrared spectroscopy (NIRS), and clinical scales, to provide a comprehensive and objective evaluation of patients’ state and recovery. This multi-domain approach permits the progress of research in clinical and rehabilitative practice and the understanding of the pathophysiological changes occurring during and after rehabilitation. We discuss the potential benefits and limitations of multi-domain approaches for clinical decision-making, personalized therapy, and prognosis. We conclude by highlighting the need for more standardized methods, validation studies, and the integration of multi-domain approaches in clinical practice and research.

Metrology in sEMG and movement analysis: the need for training new figures in clinical rehabilitation

“…This will be the responsibility of educational institutions and implies to have competent teachers with time to study and do research. But, even so, time to set up instrumentation, perform measurements, process and interpret results may be unavailable because of the busy schedule of today's PTs and OTs ( 3 ). Then, how can changes be implemented?…”

“…In the sub-field of motor rehabilitation, EBP in PMR is largely based on biomechanics, kinesiology, and surface EMG (sEMG) (1)(2)(3)(4).…”

“…This implies competence, good training and some familiarity with science, technology, engineering and mathematics (STEM) necessary to collect evidence (2,(5)(6)(7)(8)(9)(10)(11). Evidence is also provided by scale evaluations and questionnaires; however quantification, repeatability and bias may be an issue in this case (3,4).…”

Transferring Sensor-Based Assessments to Clinical Practice: The Case of Muscle Synergies

“…Sensor-based assessments in medical practice and rehabilitation include the use of measurement of physiological signals such as electroencephalography (EEG), electromyography (EMG), electrocardiography (ECG), and near-infrared spectroscopy (NIRS), and the recording of movement kinematics and interaction forces [ 1 ]. Even though these measurements are commonly employed in clinics for assessing patients, some of them have not been fully exploited [ 2 ].…”