Colamarino Emma, Morone Giovanni, Toppi Jlenia, Riccio Angela, Cincotti Febo, Mattia Donatella, Pichiorri Floriana
Department of Computer, Control, and Management Engineering "Antonio Ruberti", Sapienza University of Rome, 00185 Rome, Italy.
IRCCS Fondazione Santa Lucia, 00179 Rome, Italy.
J Clin Med. 2024 Sep 12;13(18):5414. doi: 10.3390/jcm13185414.
Technology-based approaches for upper limb (UL) motor rehabilitation after stroke are mostly designed for severely affected patients to increase their recovery chances. However, the available randomized controlled trials (RCTs) focused on the efficacy of technology-based interventions often include patients with a wide range of motor impairment. This scoping review aims at overviewing the actual severity of stroke patients enrolled in RCTs that claim to specifically address UL severe motor impairment. The literature search was conducted on the Scopus and PubMed databases and included articles from 2008 to May 2024, specifically RCTs investigating the impact of technology-based interventions on UL motor functional recovery after stroke. Forty-eight studies were selected. They showed that, upon patients' enrollment, the values of the UL Fugl-Meyer Assessment and Action Research Arm Test covered the whole range of both scales, thus revealing the non-selective inclusion of severely impaired patients. Heterogeneity in terms of numerosity, characteristics of enrolled patients, trial design, implementation, and reporting was present across the studies. No clear difference in the severity of the included patients according to the intervention type was found. Patient stratification upon enrollment is crucial to best direct resources to those patients who will benefit the most from a given technology-assisted approach (personalized rehabilitation).
基于技术的中风后上肢运动康复方法大多是为重度受影响患者设计的,以增加他们的康复机会。然而,专注于基于技术的干预措施疗效的现有随机对照试验(RCT)通常纳入了运动障碍程度广泛的患者。本综述旨在概述那些声称专门针对上肢严重运动障碍的随机对照试验中所纳入中风患者的实际严重程度。在Scopus和PubMed数据库上进行了文献检索,纳入了2008年至2024年5月的文章,特别是调查基于技术的干预措施对中风后上肢运动功能恢复影响的随机对照试验。共筛选出48项研究。这些研究表明,在患者入组时,上肢Fugl-Meyer评估和动作研究臂测试的值涵盖了两个量表的整个范围,从而揭示了对重度受损患者的非选择性纳入。各项研究在数量、入组患者特征、试验设计、实施和报告方面存在异质性。未发现根据干预类型纳入患者的严重程度有明显差异。入组时对患者进行分层对于将资源最佳地导向那些将从特定技术辅助方法(个性化康复)中获益最大的患者至关重要。