Rehabilitation robots for the treatment of sensorimotor deficits: a neurophysiological perspective.
Roger Gassert, Volker Dietz
PMID 29866106WHAT IT FOUND
Robot-assisted therapy can increase repetitions and standardize training, and may help walking recovery, but many devices lack clinical evaluation and superiority over dose-matched conventional therapy is not established.
Key findings
01Robot-assisted therapy can increase movement repetitions and provide standardized training, but most devices have not been clinically evaluated.
02For walking, robot-assisted body-weight supported treadmill training has been reported as effective as therapist-assisted overground stepping, and a review found more independent walking with such devices.
03For the arm and hand, recovery depends strongly on corticospinal tract integrity, and devices should focus on gravity support, reach and grasp, bimanual tasks, and hand opening and closing relevant to daily life.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a narrative review, not a systematic review or original trial, so the authors did not describe how they selected studies or how they graded evidence. Many statements are design recommendations and neurophysiological interpretations rather than patient outcomes. Most rehabilitation robots have not been clinically evaluated, and few trials compare robots with dose-matched conventional therapy. Evidence from stroke is often generalized to spinal cord injury, but upper-limb recovery differs by lesion level and corticospinal tract integrity. The review discusses future wearable assistive technology, but much of that is not yet established.
Declared interests
No author conflict-of-interest statement is provided in the supplied text; the metadata lists non-U.S. government research support.
The easy way to misread this
Do not conclude that rehabilitation robots are proven superior to conventional therapy. The review reports equivalence to dose-matched conventional therapy in a few randomized trials, not consistent superiority, and many devices were never clinically evaluated.