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Combining robot-assisted therapy with virtual reality or using it alone? A systematic review on health-related quality of life in neurological patients
BACKGROUND: In the field of neurorehabilitation, robot-assisted therapy (RAT) and virtual reality (VR) have so far shown promising evidence on multiple motor and functional outcomes. The related effectiveness on patients’ health-related quality of life (HRQoL) has been investigated across neurologic...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9942343/ https://www.ncbi.nlm.nih.gov/pubmed/36810124 http://dx.doi.org/10.1186/s12955-023-02097-y |
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author | Zanatta, Francesco Farhane-Medina, Naima Z. Adorni, Roberta Steca, Patrizia Giardini, Anna D’Addario, Marco Pierobon, Antonia |
author_facet | Zanatta, Francesco Farhane-Medina, Naima Z. Adorni, Roberta Steca, Patrizia Giardini, Anna D’Addario, Marco Pierobon, Antonia |
author_sort | Zanatta, Francesco |
collection | PubMed |
description | BACKGROUND: In the field of neurorehabilitation, robot-assisted therapy (RAT) and virtual reality (VR) have so far shown promising evidence on multiple motor and functional outcomes. The related effectiveness on patients’ health-related quality of life (HRQoL) has been investigated across neurological populations but still remains unclear. The present study aimed to systematically review the studies investigating the effects of RAT alone and with VR on HRQoL in patients with different neurological diseases. METHODS: A systematic review of the studies evaluating the impact of RAT alone and combined with VR on HRQoL in patients affected by neurological diseases (i.e., stroke, multiple sclerosis, spinal cord injury, Parkinson’s Disease) was conducted according to PRISMA guidelines. Electronic searches of PubMed, Web of Science, Cochrane Library, CINAHL, Embase, and PsychINFO (2000–2022) were performed. Risk of bias was evaluated through the National Institute of Health Quality Assessment Tool. Descriptive data regarding the study design, participants, intervention, rehabilitation outcomes, robotic device typology, HRQoL measures, non-motor factors concurrently investigated, and main results were extracted and meta-synthetized. RESULTS: The searches identified 3025 studies, of which 70 met the inclusion criteria. An overall heterogeneous configuration was found regarding the study design adopted, intervention procedures and technological devices implemented, rehabilitation outcomes (i.e., related to both upper and lower limb impairment), HRQoL measures administered, and main evidence. Most of the studies reported significant effects of both RAT and RAT plus VR on patients HRQoL, whether they adopted generic or disease-specific HRQoL measures. Significant post-intervention within-group changes were mainly found across neurological populations, while fewer studies reported significant between-group comparisons, and then, mostly in patients with stroke. Longitudinal investigations were also observed (up to 36 months), but significant longitudinal effects were exclusively found in patients with stroke or multiple sclerosis. Finally, concurrent evaluations on non-motor outcomes beside HRQoL included cognitive (i.e., memory, attention, executive functions) and psychological (i.e., mood, satisfaction with the treatment, device usability, fear of falling, motivation, self-efficacy, coping, and well-being) variables. CONCLUSIONS: Despite the heterogeneity observed among the studies included, promising evidence was found on the effectiveness of RAT and RAT plus VR on HRQoL. However, further targeted short- and long-term investigations, are strongly recommended for specific HRQoL subcomponents and neurological populations, through the adoption of defined intervention procedures and disease-specific assessment methodology. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12955-023-02097-y. |
format | Online Article Text |
id | pubmed-9942343 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-99423432023-02-22 Combining robot-assisted therapy with virtual reality or using it alone? A systematic review on health-related quality of life in neurological patients Zanatta, Francesco Farhane-Medina, Naima Z. Adorni, Roberta Steca, Patrizia Giardini, Anna D’Addario, Marco Pierobon, Antonia Health Qual Life Outcomes Review BACKGROUND: In the field of neurorehabilitation, robot-assisted therapy (RAT) and virtual reality (VR) have so far shown promising evidence on multiple motor and functional outcomes. The related effectiveness on patients’ health-related quality of life (HRQoL) has been investigated across neurological populations but still remains unclear. The present study aimed to systematically review the studies investigating the effects of RAT alone and with VR on HRQoL in patients with different neurological diseases. METHODS: A systematic review of the studies evaluating the impact of RAT alone and combined with VR on HRQoL in patients affected by neurological diseases (i.e., stroke, multiple sclerosis, spinal cord injury, Parkinson’s Disease) was conducted according to PRISMA guidelines. Electronic searches of PubMed, Web of Science, Cochrane Library, CINAHL, Embase, and PsychINFO (2000–2022) were performed. Risk of bias was evaluated through the National Institute of Health Quality Assessment Tool. Descriptive data regarding the study design, participants, intervention, rehabilitation outcomes, robotic device typology, HRQoL measures, non-motor factors concurrently investigated, and main results were extracted and meta-synthetized. RESULTS: The searches identified 3025 studies, of which 70 met the inclusion criteria. An overall heterogeneous configuration was found regarding the study design adopted, intervention procedures and technological devices implemented, rehabilitation outcomes (i.e., related to both upper and lower limb impairment), HRQoL measures administered, and main evidence. Most of the studies reported significant effects of both RAT and RAT plus VR on patients HRQoL, whether they adopted generic or disease-specific HRQoL measures. Significant post-intervention within-group changes were mainly found across neurological populations, while fewer studies reported significant between-group comparisons, and then, mostly in patients with stroke. Longitudinal investigations were also observed (up to 36 months), but significant longitudinal effects were exclusively found in patients with stroke or multiple sclerosis. Finally, concurrent evaluations on non-motor outcomes beside HRQoL included cognitive (i.e., memory, attention, executive functions) and psychological (i.e., mood, satisfaction with the treatment, device usability, fear of falling, motivation, self-efficacy, coping, and well-being) variables. CONCLUSIONS: Despite the heterogeneity observed among the studies included, promising evidence was found on the effectiveness of RAT and RAT plus VR on HRQoL. However, further targeted short- and long-term investigations, are strongly recommended for specific HRQoL subcomponents and neurological populations, through the adoption of defined intervention procedures and disease-specific assessment methodology. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12955-023-02097-y. BioMed Central 2023-02-21 /pmc/articles/PMC9942343/ /pubmed/36810124 http://dx.doi.org/10.1186/s12955-023-02097-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Review Zanatta, Francesco Farhane-Medina, Naima Z. Adorni, Roberta Steca, Patrizia Giardini, Anna D’Addario, Marco Pierobon, Antonia Combining robot-assisted therapy with virtual reality or using it alone? A systematic review on health-related quality of life in neurological patients |
title | Combining robot-assisted therapy with virtual reality or using it alone? A systematic review on health-related quality of life in neurological patients |
title_full | Combining robot-assisted therapy with virtual reality or using it alone? A systematic review on health-related quality of life in neurological patients |
title_fullStr | Combining robot-assisted therapy with virtual reality or using it alone? A systematic review on health-related quality of life in neurological patients |
title_full_unstemmed | Combining robot-assisted therapy with virtual reality or using it alone? A systematic review on health-related quality of life in neurological patients |
title_short | Combining robot-assisted therapy with virtual reality or using it alone? A systematic review on health-related quality of life in neurological patients |
title_sort | combining robot-assisted therapy with virtual reality or using it alone? a systematic review on health-related quality of life in neurological patients |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9942343/ https://www.ncbi.nlm.nih.gov/pubmed/36810124 http://dx.doi.org/10.1186/s12955-023-02097-y |
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