Gandolfi Marialuisa, Mazzoleni Stefano, Morone Giovanni, Iosa Marco, Galletti Filippo, Smania Nicola
Department of Neurosciences, Biomedicine and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Centre (CRRNC), University of Verona, 37134 Verona, Italy.
Department of Electrical and Information Engineering, Politecnico di Bari, Italy.
Expert Rev Med Devices. 2023 Jan;20(1):35-44. doi: 10.1080/17434440.2023.2169129. Epub 2023 Jan 29.
Robotic-assisted upper limb rehabilitation might improve upper limb recovery in people with multiple sclerosis (PwMS) with moderate-to-severe disability. In the few existing studies, the training effects have been related to the type of intervention, if intensive, repetitive, or task-oriented training might promote neuroplasticity and recovery. Notably, most of these devices operate within a serious game context providing different feedback. Since feedback is a key component of motor control and thus involved in motor and cognitive rehabilitation, clinicians cannot desist from considering the potential contribution of feedback in the upper limb robot-assisted rehabilitation effects.
In this systematic review, we reported the rehabilitation protocols used in the robot-assisted upper limb training in PwMS to provide state-of-the-art on the role of feedback in robotic-assisted Upper Limb rehabilitation. PubMed, the Cochrane Library, and the Physiotherapy Evidence Database databases were systematically searched from inception to March 2022. After a literature search, the classification systems for feedback and the serious game were applied.
There is a need for sharing standard definitions and components of feedback and serious game in technologically assisted upper limb rehabilitation. Indeed, improving these aspects might further improve the effectiveness of such training in the management of PwMS.
机器人辅助上肢康复可能会改善中度至重度残疾的多发性硬化症患者（PwMS）的上肢恢复情况。在现有的少数研究中，训练效果与干预类型有关，即强化、重复或任务导向训练是否能促进神经可塑性和恢复。值得注意的是，这些设备大多在严肃游戏环境中运行并提供不同反馈。由于反馈是运动控制的关键组成部分，因此参与运动和认知康复，临床医生不能忽视反馈在机器人辅助上肢康复效果中的潜在作用。
在本系统评价中，我们报告了PwMS机器人辅助上肢训练中使用的康复方案，以提供关于反馈在机器人辅助上肢康复中作用的最新信息。从数据库建立到2022年3月，我们系统检索了PubMed、Cochrane图书馆和物理治疗证据数据库。在文献检索后，应用了反馈和严肃游戏的分类系统。
在技术辅助上肢康复中，需要共享反馈和严肃游戏的标准定义及组成部分。事实上，改善这些方面可能会进一步提高此类训练在PwMS管理中的有效性。
