Background:
Improving upper limb function is a core element of stroke rehabilitation, needed to maximise recovery and reduce disability. There is an increasing number of medical devices available to improve motor control of the upper limb following stroke, but yet there is no systematic review combining information about these devices and to evaluate the effectiveness in improving upper limb motor control.
Objective:
(1) identify all existing sensor-based assistive technology targeted at improving motor control of the upper limb following stroke, and (2) investigate the effectiveness of current sensor-based assistive technology for improving the motor control of the upper limb following stroke.
Search Methods:
The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); MEDLINE; EMBASE; CINAHL; AMED; IEEE Explorer; ProQuest Dissertations and Theses (International), ISI Proceedings (Conference) databases, and occupational therapy (OT Seeker) and physiotherapy (PEDRO) databases.
Data collection and analysis:
Following exclusion of irrelevant titles by one review author, two review authors independently screened abstracts according to inclusion and exclusion criteria. The quality of evidence was determined independently by two authors using the Pedro levels of evidence scale. We systematically tabulated data and performed meta-analysis where studies used the same outcome measures.
Results:
2364 records were screened, and 221 full-text articles were evaluated for eligibility. Finally, 65 studies for objective 1, and 29 randomized controlled trials for objective 2 were included. Studies were divided into 7 groups for objective 2. Results were statistically significant for EMG and Electrical Simulation (standardised mean difference (SMD) 0.46, 95% confidence intervals (CI) -0.03 to 0.96, based on 2 studies with 65 participants). However, results were not statistically significant for the other device groups.
Authors’ Conclusions:
EMG and Electrical Stimulation showed a significant effect in improving upper limb function, but it is unknown whether effects are sustained in the longer term. Further studies are needed to investigate the effectiveness of sensor-based devices to improve upper limb motor control.
Introduction and preliminary evaluation of the Tongue Drive System: Wireless tongue-operated assistive technology for people with little or no upper-limb function
