Efficacy of robotic exoskeleton for gait rehabilitation in patients with subacute stroke : a systematic review

Calafiore, Dario; Negrini, Francesco; Tottoli, Nicola; Ferraro, Francesco; Taşkıran, Özden Özyemişçi; Sire, Alessandro de

doi:10.23736/s1973-9087.21.06846-5

Cited by 54 publications

(43 citation statements)

References 60 publications

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“…Clinicians should strike the right balance between too difficult and too easy tasks and as such keeping the motivation of the patients high. Objective progression and extrinsic feedback encourage robot-assisted rehabilitation that might play a critical role on neuroplasticity (69,70). Lastly, it should be considered that VR might be home based, with a telerehabilitation approach, which is highly encouraged during coronavirus disease 2019 (COVID-19) pandemic, due to psychological and hospitalization issues (71)(72)(73).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Virtual Reality and Exergaming in Improving Balance in Patients With Multiple Sclerosis: A Systematic Review and Meta-Analysis

et al. 2021

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Multiple sclerosis (MS) is one of the most common causes of neurological progressive disease and can lead to loss of mobility, walk impairment, and balance disturbance. Among several rehabilitative approaches proposed, exergaming and virtual reality (VR) have been studied in the recent years. Active video game therapy could reduce the boredom of the rehabilitation process, increasing patient motivation, providing direct feedback, and enabling dual-task training. Aim of this systematic review was to assess the efficacy of exergaming and VR for balance recovery in patients with MS. PubMed, Scopus, and Web of Science were systematically searched from the inception until May 14, 2021 to identify randomized controlled trials (RCTs) presenting: patients with MS as participants, exergaming and VR as intervention, conventional rehabilitation as comparator, and balance assessment [Berg Balance Scale (BBS)] as outcome measure. We also performed a meta-analysis of the mean difference in the BBS via the random-effects method. Out of 93 records, this systematic review included and analyzed 7 RCTs, involving a total of 209 patients affected by MS, of which 97 patients performed exergaming or VR and 112 patients underwent conventional rehabilitation. The meta-analysis reported a significant overall ES of 4.25 (p < 0.0001), showing in the subgroup analysis a non-significant ES of 1.85 (p = 0.39) for the VR and a significant ES of 4.49 (p < 0.0001) for the exergames in terms of the BBS improvement. Taken together, these findings suggested that balance rehabilitation using exergames appears to be more effective than conventional rehabilitation in patients affected by MS.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Virtual Reality and Exergaming in Improving Balance in Patients With Multiple Sclerosis: A Systematic Review and Meta-Analysis

et al. 2021

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“…Taken together, our findings suggested that robotic devices for upper limbs might be considered safe, tolerable, and feasible in the complex rehabilitative management of SCI patients. However, to date, safety, tolerance, and feasibility of robot-assisted training have been primarily investigated in patients with other neurological diseases (i.e., stroke and multiple sclerosis) [ 36 , 37 , 38 ] and these outcomes should be deeply assessed in SCI patients, starting from the findings reported by the present systematic review.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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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 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.

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“…In the Yeh et al (2020) systematic review, it was found that patients undergoing RAGT showed decreased perceived fatigue and spasticity as well as improved global mobility, compared to patients undergoing conventional walking therapies. However, although the benefits of robotic technologies have been demonstrated, further investigation into the differences between conventional gait therapies and RAGT still warrant investigation, particularly among distinct patient populations (Calafiore et al, 2021).…”

Section: Literature Reviewmentioning

confidence: 99%

The Experiences of Robot-Assisted Gait Training in Patients With Neurological Disorders: A Qualitative Study

Chang

Xiao

et al. 2022

Rehabilitation Nursing

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Purpose: The aim of this study was to explore the rehabilitation experiences and perceptions of patients with neurological disorders who have used the Lokomat Augmented Feedback module, a robot-assisted gait training device. Design: A qualitative descriptive study was conducted. Methods: Purposive sampling was employed to recruit participants with neurological disorders who have used the Lokomat. Semistructured face-to-face interviews were completed in northern Taiwan. Interviews were recorded and transcribed verbatim. Thematic analysis was used. Results: Thirteen interviews were analyzed. Three themes were identified: learning to walk again, inspiring the fighting spirit, and the joys and worries of technological innovation. Conclusions: Strong positive emotions and logistical concerns were associated with the use of the Lokomat. Clinical Relevance: Encouraging patients while also being transparent about the challenges involved in the rehabilitation process and helping set realistic goals is critical. Furthermore, attention directed toward anticipating and mitigating the physical strain associated with the Lokomat is important.

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Efficacy of robotic exoskeleton for gait rehabilitation in patients with subacute stroke : a systematic review

Cited by 54 publications

References 60 publications

Efficacy of Virtual Reality and Exergaming in Improving Balance in Patients With Multiple Sclerosis: A Systematic Review and Meta-Analysis

Efficacy of Virtual Reality and Exergaming in Improving Balance in Patients With Multiple Sclerosis: A Systematic Review and Meta-Analysis

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

The Experiences of Robot-Assisted Gait Training in Patients With Neurological Disorders: A Qualitative Study

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