Clinical efficacy of upper limb robotic therapy in people with tetraplegia: a pilot randomized controlled trial

Kim, Junsik; Lee, Bum Suk; Lee, Hyejin; Kim, Hyeri; Cho, Duk-Youn; Lim, Jung-Eun; Kim, Jin Ju; Kim, Ha Yeon; Han, Zee-A

doi:10.1038/s41393-018-0190-z

Cited by 12 publications

(51 citation statements)

References 39 publications

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“…Cortes et al [14] found the InMotion wrist robot to be feasible, safe, and associated with significant results for motor performance in 10 persons with chronic SCI. Kim et al [15] found some improvements in strength and independence, but not significant, in a group of SCI inpatients. Other studies, all case studies, have found similar systems (e.g., the Mahi Exo II, the Rice Wrist and the ReoGo) to be feasible, safe, and exhibit some functional improvements [16][17][18].…”

Section: Introductionmentioning

confidence: 94%

A single-subject study of robotic upper limb training in the subacute phase for four persons with cervical spinal cord injury

Sorensen

Månum

2019

Spinal Cord Ser Cases

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Study design Single-subject design, standard training ("B") compared with Robotic training ("C"). Objectives To explore the impact of robotic training on upper limb function, activities of daily living (ADL) and training experience in subacute tetraplegic inpatients. Setting Inpatient subacute Norwegian spinal cord injury (SCI) unit. Methods Four participants (C4-7, AIS A-C) completed 11 sessions of robotic training using a passive robotic exoskeleton (Armeo Spring®). Descriptive statistics and visual analyses were used for comparing standard occupational therapy and robotic training. Outcome measures included the Spinal Cord Independence Measure (SCIM-III), the Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP), and a questionnaire.Results All of the participants exhibited an increase in assessments of upper limb function (GRASSP-total) right side (0.4%-61.2%), and all except for one participant (−8%) showed an increase on their left side (20.9%-106.2%). Three out of four participants had improvements in ADL function SCIM-III (ranging from 5.6% to 46.7%). Results demonstrated improvements during the robotic intervention period in five out of 28 measurements. The participants enjoyed the exercise, and found it motivating and relevant to their injury (median ranged from 3.5 to 6.5 on a 0-7 scale). Conclusions Three out of four participants improved upper limb function and ADL independence, but the study could not confirm that improvements were due to the robotic intervention. The participants enjoyed the robotic training and found it relevant to their injury.

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Section: Introductionmentioning

confidence: 94%

A single-subject study of robotic upper limb training in the subacute phase for four persons with cervical spinal cord injury

Sorensen

Månum

2019

Spinal Cord Ser Cases

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“…Subsequently, 39 articles were excluded because they did not respect eligibility criteria. As a result, 11 papers were included in the qualitative synthesis (PRISMA flow diagram was depicted by Figure 1): 5 case series, [25][26][27][28][29] 1 parallel-group controlled trial, [30] 2 RCT, [31,34] 2 systematic reviews [32,33] and one longitudinal intervention study. [35] The studies included in this systematic review were published from 201225 to 202034, covering several Nations from all over the world; more in detail, seven studies were from the Americas (two from Canada [25,32] and five from USA [26,27,29,30,33]), two from Europe (1 from Netherlands [28] and one from UK [35]), and two from Asia (Republic of Korea [31,34]).…”

Section: Evidence Synthesismentioning

confidence: 99%

“…Evidence level and study quality of the included studies Due to the high clinical heterogeneity of the included studies; thus, the results are described qualitatively. Based on the Oxford Centre for Evidence-Based (OCEBM) 2011 Levels of Evidence, [34] we included two systematic reviews [32,33] (Level 1), 2 RCT [31,34] (Level 2), one parallel-group controlled trial [30] (Level 3), one longitudinal intervention trial [35] (Level 3), and five case series (Level 4). [25][26][27][28][29] The study cohort sample sizes were highly heterogeneous in the research studies, ranging from 5 (case series) [28] to 34 (RCT) [31] for clinical trials; nevertheless, the systematic reviews included larger samples (73 study participants by Singh et al [32] and 88 by Yozbatiran et al [33]).…”

Section: Evidence Synthesismentioning

confidence: 99%

Section: Evidence Synthesismentioning

confidence: 99%

“…Concerning the study quality of the clinical studies, we reported one good-quality [31], one fair-quality [34], according to the PEDro scale. [24] The two systematic reviews showed a low quality [31] and a critically low quality [33] according to AMSTAR 2 scale. [23] Clinical characteristics of study participants Six studies included SCI patients in the chronic phase [26,27-30,34,] two in the subacute phase [25,35], and three papers [31][32][33] included both chronic and subacute SCI patients.…”

Section: Evidence Synthesismentioning

confidence: 99%

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

Morone¹,

Sire²,

Cinnera³

et al. 2021

Preprint

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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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Three-Dimensional Multi-Degree-of-Freedom Arm Therapy Robot (ARMin)

Nef

Klamroth-Marganska

Keller

et al. 2022

Neurorehabilitation Technology

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Clinical efficacy of upper limb robotic therapy in people with tetraplegia: a pilot randomized controlled trial

Abstract: There were small improvements in motor strength and SCIM-III scores in the RT group, but there were no statistically significant differences between the groups. Further studies are required for a better understanding of the effects of RT for people with tetraplegia.

Cited by 12 publications

References 39 publications

A single-subject study of robotic upper limb training in the subacute phase for four persons with cervical spinal cord injury

A single-subject study of robotic upper limb training in the subacute phase for four persons with cervical spinal cord injury

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

Three-Dimensional Multi-Degree-of-Freedom Arm Therapy Robot (ARMin)

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