Skip to main content

SYSTEMATIC REVIEW article

Front. Neurol.
Sec. Pediatric Neurology
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1499249

Robot-assisted upper limb therapy in children with cerebral palsy for a personalized-centered-patient rehab approach: a comprehensive systematic review

Provisionally accepted
Daniela Cardone Daniela Cardone 1David Perpetuini David Perpetuini 1Marta Di Nicola Marta Di Nicola 2Arcangelo Merla Arcangelo Merla 1Giovanni Morone Giovanni Morone 3Irene Ciancarelli Irene Ciancarelli 3Antimo Moretti Antimo Moretti 4Francesca Gimigliano Francesca Gimigliano 4Alice Cichelli Alice Cichelli 5Francesco De Flaviis Francesco De Flaviis 5Alex Martino Cinnera Alex Martino Cinnera 6*Teresa Paolucci Teresa Paolucci 5
  • 1 Department of Engineering and Geology, G. d'Annunzio University of Chieti and Pescara, Pescara, Italy
  • 2 Department of Medical, Oral and Biotechnological Sciences, University of Studies G. d'Annunzio Chieti and Pescara, Chieti, Italy
  • 3 Department of Life, Health and Environmental Sciences, University of L'Aquila, L’Aquila, Abruzzo, Italy
  • 4 Department of Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Napels, Campania, Italy
  • 5 Department of Medical, Oral and Biotechnological Sciences, School of Medicine and Health Sciences, G. D'Annunzio University of Chieti-Pescara, Chieti, Abruzzo, Italy
  • 6 Santa Lucia Foundation (IRCCS), Rome, Italy

The final, formatted version of the article will be published soon.

    Cerebral palsy (CP) is a group of permanent disorders of movement development that may cause activity limitations. In this context, robot-assisted therapy might play a key role in clinical management. This comprehensive systematic review aimed to investigate the efficacy of robotic systems in improving upper limb (UL) functions in children with CP. PubMed, EMBASE, Scopus, and PEDro were searched from inception to February 2024. The risk of bias was assessed with the Joanna Briggs Institute critical appraisal tools battery. Of 756 articles identified, 14 studies involving 193 children with CP with a judged to be of good methodological quality, but with a lack in the study design, were included in the final synthesis. In the included studies a wide range of devices was used, both exoskeletons and end-effectors, both wearable and non-wearable. The CP children who underwent robot-assisted therapy reported a significant overall increase in clinical assessment, specifically in UL movements and manual dexterity. The clinical improvement was often accompanied by a gain also in instrumental assessments (i.e., kinematic analysis, EMG). In Conclusion, the present review suggested that robot-assisted therapy can improve UL motor functions in children with CP. Moreover, the availability of different devices with adjustable parameters can represent an important resource in proposing patient-centered-personalized rehabilitation protocols to enhance the efficacy of rehabilitation and integration into daily life. However, the limited sample size and lack of standardized and clearly reproducible protocols impose to recommend the use of robot-assisted therapy as an integration to usual rehabilitation and not as a replacement.

    Keywords: Rehabilitation, Robotics, Hemiplegia, Upper extremities, exoskeleton, endeffector

    Received: 27 Sep 2024; Accepted: 25 Nov 2024.

    Copyright: © 2024 Cardone, Perpetuini, Di Nicola, Merla, Morone, Ciancarelli, Moretti, Gimigliano, Cichelli, De Flaviis, Martino Cinnera and Paolucci. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Alex Martino Cinnera, Santa Lucia Foundation (IRCCS), Rome, Italy

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.