Abstract
In the last two decades, a growing interest has been focused on gait and balance robot-assisted rehabilitation in children with neurological disabilities. Robotic devices allow the implementation of intensive, task-specific training fostering functional recovery and neuroplasticity phenomena. However, limited attention has been paid to the protocols used in this research framework. This systematic review aims to provide an overview of the existing literature on robotic systems for the rehabilitation of gait and balance in children with neurological disabilities and their rehabilitation applications. The literature search was carried out independently and synchronously by three authors on the following databases: MEDLINE, Cochrane Library, PeDro, Institute of Electrical and Electronics Engineers, ScienceDirect, and Google Scholar. The data collected included three subsections referring to clinical, technical, and regulatory aspects. Thirty-one articles out of 81 found on the primary literature search were included in the systematic review. Most studies involved children with cerebral palsy. Only one-third of the studies were randomized controlled trials. Overall, 17 devices (nine end-effector systems and eight exoskeletons) were investigated, among which only 4 (24%) were bore the CE mark. Studies differ on rehabilitation protocols duration, intensity, and outcome measures. Future research should improve both rehabilitation protocols’ and devices’ descriptions.
Highlights
Many neurologic disorders can affect children’s neuromotor development and their ability to participate actively in daily life impacting children’s social and cognitive development and increasing disability and caregiver burden [1].In the last decades, extensive research on rehabilitation intervention in children with neurological disorders has been conducted
Among the ten included randomised controlled trials (RCTs) studies, six were classified as good to excellent quality according to the PEDro score [26,27,28,29,30,31], three as fair quality [32,33,34] and one as poor quality (Table 3) [35]
This work is a systematic review of the existing literature on robotic devices for gait and balance rehabilitation in children with neurological disabilities
Summary
Many neurologic disorders can affect children’s neuromotor development and their ability to participate actively in daily life (i.e., cerebral palsy, traumatic brain injury) impacting children’s social and cognitive development and increasing disability and caregiver burden [1].In the last decades, extensive research on rehabilitation intervention in children with neurological disorders has been conducted. The focus of rehabilitation in this context is walking and mobility [2] For this aim, the literature has increasingly emphasized the promotion of active therapies, including intensive, repetitive, and task-specific training to enhance gait recovery and neuroplasticity, which is the ultimate factor to consider when designing personalized neurorehabilitation interventions [3,4,5,6]. The field of neuromotor rehabilitation in children is rapidly evolving This is confirmed by the relatively recent institution of the neuropsychomotor therapist, specialising in the motor, cognitive and emotional-relational rehabilitation of the child. In this dynamic rehabilitation context, new technologies such as robots for rehabilitation could be a valuable tool for improving and enriching rehabilitation approaches, especially when considering the specific needs of children with neurologic diseases
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