Li B, Cunha AB, Lobo MA. Effectiveness and Users' Perceptions of Upper Extremity Exoskeletons and Robot-Assisted Devices in Children with Physical Disabilities: Systematic Review.
Phys Occup Ther Pediatr 2023;
44:336-379. [PMID:
37635151 DOI:
10.1080/01942638.2023.2248241]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 07/26/2023] [Accepted: 08/02/2023] [Indexed: 08/29/2023]
Abstract
AIM
Systematically determine the effectiveness and users' perceptions of upper extremity (UE) exoskeletons and robot-assisted devices for pediatric rehabilitation.
METHODS
PubMed/Medline, Web of Science, Scopus, and Cochrane Library were searched for studies with "exoskeletons"/"robot-assisted devices", children with disabilities, effectiveness data, and English publication. Intervention effectiveness outcomes were classified within components of the International Classification of Functioning, Disability, and Health, Children and Youth Version (ICF-CY). Secondary data (users' perceptions; implementation setting) were extracted. Risk of bias and methodological quality were assessed. Descriptive analyses were performed.
RESULTS
Seventy-two articles were included. Most evaluated body structure and function and activity outcomes with less emphasis on participation. Most effects across all ICF-CY levels were positive. Devices were primarily evaluated in clinical or laboratory rather than natural environments. Perceptions about device effectiveness were mostly positive, while those about expression, accessibility, and esthetics were mostly negative. A need for increased rigor in research study design was detected.
CONCLUSIONS
Across populations, devices, settings, interventions, and dosing schedules, UE exoskeletons and robot-assisted devices may improve function, activity, and perhaps participation for children with physical disabilities. Future work should transition devices into natural environments, design devices and implementation strategies to address users' negative perceptions, and increase research rigor.
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