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吉兰-巴雷综合征的机器人辅助治疗:原始证据的系统评价及一项随机临床试验的研究方案

Robot-Assisted Therapy in Guillain-Barrè Syndrome: Systematic Review of Primary Evidence and Study Protocol for a Randomized Clinical Trial.

作者信息

Martino Cinnera Alex, D'Arienzo Martina, Piatti Diego, Casagrande Conti Laura, Deledda Pietro, Tenore Alberto, Paolucci Stefano, Grasso Maria Grazia

机构信息

Scientific Institute for Research, Hospitalisation and Health Care IRCCS Santa Lucia Foundation, 00179 Rome, Italy.

School of Physiotherapy, Faculty of Medicine and Surgery, University of Rome Tor Vergata, 00133 Rome, Italy.

出版信息

J Clin Med. 2024 Nov 26;13(23):7153. doi: 10.3390/jcm13237153.

Abstract

Guillain-Barré syndrome (GBS) is an immune-mediated polyradiculoneuropathy that represents a leading cause of motor impairment. Robot-assisted therapy (RAT) has been widely applied in various neurological conditions. However, the use of RAT in GBS remains underexplored. This systematic review (SR) aims to evaluate the preliminary evidence regarding the efficacy of RAT in terms of motor recovery in people with GBS (pwGBSs). Secondly, the study protocol for a randomized RCT is reported. A comprehensive SR was conducted on PubMed, Scopus, EMBASE, Cochrane Library, and Epistemikos. Risk of bias was assessed using the National Institute of Health (NIH) study quality assessment. The SR's protocol was recorded in the PROSPERO database. Out of 116 articles found, four studies published in the past four years met the inclusion criteria. These studies investigated the effects of RAT on lower limbs (three studies) and upper limbs (one study) in four pwGBSs. The results showed improvements in motor function and patient engagement, but it is impossible to generalize the findings. Our SRs supports the rationale for an RCT to assess the efficacy of RAT in pwGBSs. We present the protocol for a double-blind RCT to evaluate the effects of RAT on upper limb motor function in pwGBSs.

摘要

吉兰-巴雷综合征(GBS)是一种免疫介导的多发性神经根神经病,是导致运动功能障碍的主要原因之一。机器人辅助治疗(RAT)已广泛应用于各种神经系统疾病。然而,RAT在GBS中的应用仍未得到充分探索。本系统评价(SR)旨在评估RAT对GBS患者(pwGBSs)运动恢复疗效的初步证据。其次,报告了一项随机对照试验(RCT)的研究方案。我们在PubMed、Scopus、EMBASE、Cochrane图书馆和Epistemikos上进行了全面的系统评价。使用美国国立卫生研究院(NIH)研究质量评估工具评估偏倚风险。该系统评价的方案已记录在PROSPERO数据库中。在检索到的116篇文章中,过去四年发表的四项研究符合纳入标准。这些研究调查了RAT对4例pwGBSs患者下肢(三项研究)和上肢(一项研究)的影响。结果显示运动功能和患者参与度有所改善,但这些结果无法推广。我们的系统评价支持开展一项RCT以评估RAT对pwGBSs疗效的基本原理。我们展示了一项双盲RCT的方案,以评估RAT对pwGBSs患者上肢运动功能的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecc7/11641865/c0031a42c401/jcm-13-07153-g001.jpg

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