Effect of Robot-Assisted Therapy on Participation of People with Limited Upper Limb Functioning: A Systematic Review with GRADE Recommendations

Background. Previous studies have suggested that robot-assisted therapy (RT) is effective in treating impairment and that it may also improve individuals’ participation. Objective. To investigate the effect of RT on the participation of individuals with limited upper limb functioning (PROSPERO: CRD4...

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Main Authors: Fernanda M. R. M. Ferreira, Maria Emília A. Chaves, Vinícius C. Oliveira, Jordana S. R. Martins, Claysson B. S. Vimieiro, Adriana M. V. N. Van Petten
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Occupational Therapy International
Online Access:http://dx.doi.org/10.1155/2021/6649549
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author Fernanda M. R. M. Ferreira
Maria Emília A. Chaves
Vinícius C. Oliveira
Jordana S. R. Martins
Claysson B. S. Vimieiro
Adriana M. V. N. Van Petten
author_facet Fernanda M. R. M. Ferreira
Maria Emília A. Chaves
Vinícius C. Oliveira
Jordana S. R. Martins
Claysson B. S. Vimieiro
Adriana M. V. N. Van Petten
author_sort Fernanda M. R. M. Ferreira
collection DOAJ
description Background. Previous studies have suggested that robot-assisted therapy (RT) is effective in treating impairment and that it may also improve individuals’ participation. Objective. To investigate the effect of RT on the participation of individuals with limited upper limb functioning (PROSPERO: CRD42019133880). Data Sources: PEDro, Embase, MEDLINE, CINAHL, Cochrane, AMED, and Compendex. Inclusion Criteria. We selected randomized or quasirandomized controlled studies comparing the effects of RT with minimal or other interventions on participation of individuals with limited upper limb functioning. Data Extraction and Synthesis. Methodological quality of the included studies was assessed using the 0-10 PEDro scale, and effect estimates were reported using standardized mean differences (SMDs) with 95% confidence intervals (CIs), and the certainty of the current evidence was assessed using the GRADE. Results. Twelve randomized controlled studies involving 845 participants were included. The estimates of medium effects between RT and minimal intervention (MI) at a short-term follow-up were pooled, but there are no short-term effects between RT and OI. Standardized differences in means were as follows: 0.6 (95% CI 0.1 to 1.2) and 0.2 (95% CI -0.0 to 0.4). There were also no effects of additional RT in the short- or medium-term follow-up periods. Standardized differences in means were as follows: -0.6 (95% CI -1.1 to -0.1) and 0.2 (95% CI -0.3 to 0.8). The methodological quality of the included studies potentially compromised the effect estimates of RT. The existing evidence was very low-quality with many confounding variables between studies. Conclusions. For patients with upper limb neurological dysfunction, low-quality evidence supports RT over MI in terms of improving individual participation in the short term. The existing low- to very low-quality evidence does not support RT over OI in either the short- or medium-term follow-up periods with respect to community participation.
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spelling doaj-art-7110dfefaca64f8b82c50366eba370492025-08-20T02:06:35ZengWileyOccupational Therapy International0966-79031557-07032021-01-01202110.1155/2021/66495496649549Effect of Robot-Assisted Therapy on Participation of People with Limited Upper Limb Functioning: A Systematic Review with GRADE RecommendationsFernanda M. R. M. Ferreira0Maria Emília A. Chaves1Vinícius C. Oliveira2Jordana S. R. Martins3Claysson B. S. Vimieiro4Adriana M. V. N. Van Petten5Graduate Program in Mechanical Engineering, Universidade Federal de Minas Gerais, Bioengineering Laboratory, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte MG 31270-901, BrazilGraduate Program in Physical Therapy, Centro Universitário UNA, Rua Aimorés, 1451, Lourdes, Belo Horizonte MG 30140-071, BrazilGraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Campus JK-MGT 367-Km 583, no. 5000, Alto da Jacuba, Diamantina MG 39100-000, BrazilGraduate Program in Mechanical Engineering, Pontifícia Universidade Católica de Minas Gerais, Av. Dom José Gaspar, 500-Coração Eucarístico, Belo Horizonte MG 30535-901, BrazilGraduate Program in Mechanical Engineering, Universidade Federal de Minas Gerais, Bioengineering Laboratory, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte MG 31270-901, BrazilDepartment of Occupational Therapy, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte MG 31270-901, BrazilBackground. Previous studies have suggested that robot-assisted therapy (RT) is effective in treating impairment and that it may also improve individuals’ participation. Objective. To investigate the effect of RT on the participation of individuals with limited upper limb functioning (PROSPERO: CRD42019133880). Data Sources: PEDro, Embase, MEDLINE, CINAHL, Cochrane, AMED, and Compendex. Inclusion Criteria. We selected randomized or quasirandomized controlled studies comparing the effects of RT with minimal or other interventions on participation of individuals with limited upper limb functioning. Data Extraction and Synthesis. Methodological quality of the included studies was assessed using the 0-10 PEDro scale, and effect estimates were reported using standardized mean differences (SMDs) with 95% confidence intervals (CIs), and the certainty of the current evidence was assessed using the GRADE. Results. Twelve randomized controlled studies involving 845 participants were included. The estimates of medium effects between RT and minimal intervention (MI) at a short-term follow-up were pooled, but there are no short-term effects between RT and OI. Standardized differences in means were as follows: 0.6 (95% CI 0.1 to 1.2) and 0.2 (95% CI -0.0 to 0.4). There were also no effects of additional RT in the short- or medium-term follow-up periods. Standardized differences in means were as follows: -0.6 (95% CI -1.1 to -0.1) and 0.2 (95% CI -0.3 to 0.8). The methodological quality of the included studies potentially compromised the effect estimates of RT. The existing evidence was very low-quality with many confounding variables between studies. Conclusions. For patients with upper limb neurological dysfunction, low-quality evidence supports RT over MI in terms of improving individual participation in the short term. The existing low- to very low-quality evidence does not support RT over OI in either the short- or medium-term follow-up periods with respect to community participation.http://dx.doi.org/10.1155/2021/6649549
spellingShingle Fernanda M. R. M. Ferreira
Maria Emília A. Chaves
Vinícius C. Oliveira
Jordana S. R. Martins
Claysson B. S. Vimieiro
Adriana M. V. N. Van Petten
Effect of Robot-Assisted Therapy on Participation of People with Limited Upper Limb Functioning: A Systematic Review with GRADE Recommendations
Occupational Therapy International
title Effect of Robot-Assisted Therapy on Participation of People with Limited Upper Limb Functioning: A Systematic Review with GRADE Recommendations
title_full Effect of Robot-Assisted Therapy on Participation of People with Limited Upper Limb Functioning: A Systematic Review with GRADE Recommendations
title_fullStr Effect of Robot-Assisted Therapy on Participation of People with Limited Upper Limb Functioning: A Systematic Review with GRADE Recommendations
title_full_unstemmed Effect of Robot-Assisted Therapy on Participation of People with Limited Upper Limb Functioning: A Systematic Review with GRADE Recommendations
title_short Effect of Robot-Assisted Therapy on Participation of People with Limited Upper Limb Functioning: A Systematic Review with GRADE Recommendations
title_sort effect of robot assisted therapy on participation of people with limited upper limb functioning a systematic review with grade recommendations
url http://dx.doi.org/10.1155/2021/6649549
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