What does evidence tell us about the use of gait robotic devices in patients with multiple sclerosis? A comprehensive systematic review on functional outcomes and clinical recommendations
| Autor: | Donatella Bonaiuti, Simona Cerulli, Vincenzo Falabella, Valeria Gazzotti, Miryam Mazzucchelli, Rocco Salvatore Calabrò, Stefania Dalise, Anna Cassio, Corrado Melegari, Giuseppe Turchetti, Stefano Mazzon, Paolo Benanti, Silvia Galeri, Michele Senatore, Daniele Mazzoleni, Federico Posteraro, Stefano Mazzoleni, Elisa Andrenelli, Simona M. Carmignano, Enrico Castelli, Maurizio Petrarca, Giulia Stampacchia, Valentina Colombo, Emiliana Bizzarini, Mauro Grigioni, Andrea Merlo, Carmelo Chisari, Giovanni Morone, Alessandro Picelli, Cira Fundarò, Franco Molteni, D. Mazzoli, Francesco Draicchio, Paolo Boldrini, Isabella Campanini, Francesca Gimigliano |
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| Přispěvatelé: | Calabro, R. S., Cassio, A., Mazzoli, D., Andrenelli, E., Bizzarini, E., Campanini, I., Carmignano, S. M., Cerulli, S., Chisari, C., Colombo, V., Dalise, S., Fundaro, C., Gazzotti, V., Mazzoleni, D., Mazzucchelli, M., Melegari, C., Merlo, A., Stampacchia, G., Boldrini, P., Mazzoleni, S., Posteraro, F., Benanti, P., Castelli, E., Draicchio, F., Falabella, V., Galeri, S., Gimigliano, F., Grigioni, M., Mazzon, S., Molteni, F., Petrarca, M., Picelli, A., Senatore, M., Turchetti, G., Morone, G., Bonaiuti, D. |
| Rok vydání: | 2021 |
| Předmět: |
Gait
Humans Quality of Life Exoskeleton Device Gait Disorders Neurologic Multiple Sclerosis medicine.medical_specialty medicine.medical_treatment MEDLINE Physical Therapy Sports Therapy and Rehabilitation Cochrane Library law.invention Multiple sclerosis Physical medicine and rehabilitation Quality of life (healthcare) Gait (human) Gait training Randomized controlled trial law Neurologic medicine Multiple sclerosi Gait Disorders Lower extremity Rehabilitation business.industry Robotics Robotic body regions Systematic review business human activities Human |
| Zdroj: | European Journal of Physical and Rehabilitation Medicine. 57 |
| ISSN: | 1973-9095 1973-9087 |
| Popis: | INTRODUCTION: There is growing evidence on the efficacy of gait robotic rehabilitation in patients with multiple sclerosis (MS), but most of the studies have focused on gait parameters. Moreover, clear indications on the clinical use of robotics still lack. As part of the CICERONE Italian Consensus on Robotic Rehabilitation, the aim of this systematic review was to investigate the existing evidence concerning the role of lower limb robotic rehabilitation in improving functional recovery in patients with MS. EVIDENCE ACQUISITION: We searched for and systematically reviewed evidence-based studies on gait robotic rehabilitation in MS, between January 1st, 2010 and December 31st, 2020, in the following databases: Cochrane Library, PEDro, PubMed and Google Scholar. The study quality was assessed by the 16-item assessment of multiple systematic reviews 2 (AMSTAR 2) and the 10-item PEDro scale for the other research studies. EVIDENCE SYNTHESIS: After an accurate screening, only 17 papers were included in the review, and most of them (13 RCT) had a level II evidence. Most of the studies used the Lokomat as a grounded robotic device, two investigated the efficacy of end-effectors and two powered exoskeletons. Generally speaking, robotic treatment has beneficial effects on gait speed, endurance and balance with comparable outcomes to those of conventional treatments. However, in more severe patients (EDSS >6), robotics leads to better functional outcomes. Notably, after gait training with robotics (especially when coupled to virtual reality) MS patients also reach better non-motor outcomes, including spasticity, fatigue, pain, psychological well-being and quality of life. Unfortunately, no clinical indications emerge on the treatment protocols. CONCLUSIONS: The present comprehensive systematic review highlights the potential beneficial role on functional outcomes of the lower limb robotic devices in people with MS. Future studies are warranted to evaluate the role of robotics not only for walking and balance outcomes, but also for other gait-training-related benefits, to identify appropriate outcome measures related to a specific subgroup of MS subjects' disease severity. |
| Databáze: | OpenAIRE |
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