Biomedical Engineering, School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia.
College of Health Sciences, School of Health, Medical and Applied Sciences, Central Queensland University, North Rockhampton, Australia.
J Neuroeng Rehabil. 2022 Jun 30;19(1):66. doi: 10.1186/s12984-022-01043-1.
Recovery of hand function is crucial for the independence of people with spinal cord injury (SCI). Wearable devices based on soft robotics (SR) or functional electrical stimulation (FES) have been employed to assist the recovery of hand function both during activities of daily living (ADLs) and during therapy. However, the implementation of these wearable devices has not been compiled in a review focusing on the functional outcomes they can activate/elicit/stimulate/potentiate. This narrative review aims at providing a guide both for engineers to help in the development of new technologies and for clinicians to serve as clinical guidelines based on the available technology in order to assist and/or recover hand function in people with SCI.
A literature search was performed in Scopus, Pubmed and IEEE Xplore for articles involving SR devices or FES systems designed for hand therapy or assistance, published since 2010. Only studies that reported functional outcomes from individuals with SCI were selected. The final collections of both groups (SR and FES) were analysed based on the technical aspects and reported functional outcomes.
A total of 37 out of 1101 articles were selected, 12 regarding SR and 25 involving FES devices. Most studies were limited to research prototypes, designed either for assistance or therapy. From an engineering perspective, technological improvements for home-based use such as portability, donning/doffing and the time spent with calibration were identified. From the clinician point of view, the most suitable technical features (e.g., user intent detection) and assessment tools should be determined according to the particular patient condition. A wide range of functional assessment tests were adopted, moreover, most studies used non-standardized tests.
SR and FES wearable devices are promising technologies to support hand function recovery in subjects with SCI. Technical improvements in aspects such as the user intent detection, portability or calibration as well as consistent assessment of functional outcomes were the main identified limitations. These limitations seem to be be preventing the translation into clinical practice of these technological devices created in the laboratory.
手部功能的恢复对于脊髓损伤（SCI）患者的独立性至关重要。基于软机器人（SR）或功能性电刺激（FES）的可穿戴设备已被用于辅助日常生活活动（ADL）和治疗期间手部功能的恢复。然而，这些可穿戴设备的实施并未在一篇综述中汇总，该综述重点关注它们可以激活/引出/刺激/增强的功能结果。本叙事性综述旨在为工程师提供指导，帮助他们开发新技术，为临床医生提供临床指南，基于现有的技术来辅助和/或恢复 SCI 患者的手部功能。
在 Scopus、Pubmed 和 IEEE Xplore 中进行了文献检索，检索了自 2010 年以来设计用于手部治疗或辅助的 SR 设备或 FES 系统的文章。仅选择报告了 SCI 患者功能结果的研究。根据技术方面和报告的功能结果对两组（SR 和 FES）的最终研究进行了分析。
从 1101 篇文章中总共选择了 37 篇，其中 12 篇涉及 SR，25 篇涉及 FES 设备。大多数研究仅限于研究原型，设计用于辅助或治疗。从工程角度来看，确定了用于家庭使用的技术改进，例如便携性、穿戴/脱卸和校准时间。从临床医生的角度来看，应根据特定患者的情况确定最合适的技术特征（例如，用户意图检测）和评估工具。此外，采用了广泛的功能评估测试，而且大多数研究使用非标准化测试。
SR 和 FES 可穿戴设备是支持 SCI 患者手部功能恢复的有前途的技术。在用户意图检测、便携性或校准等方面的技术改进以及功能结果的一致评估方面存在主要的局限性。这些局限性似乎阻止了实验室中创建的这些技术设备转化为临床实践。
