No abstract

The progressive miniaturization of electronic devices and their exponential increase in processing, storage and transmission capabilities, represent key factors of the current digital transformation, also sustaining the great development of Ambient Assisted Living (AAL) and the Internet of Things. Although most of the investigations in the recent years focused on remote monitoring and diagnostics, rehabilitation too could be positively affected by the widespread integrated use of these devices. Smart Objects in particular may be among the enablers to new quantitative approaches. In this paper, we present a proofof-concept and some preliminary results of an innovative pediatric rehabilitation protocol based on Smart Objects and biofeedback, which we administered to a sample of children with unilateral cerebral palsy. The novelty of the approach mainly consists in placing the sensing device into a common toy (a ball in our protocol) and using the information measured by the device to administer multimedia-enriched type of exercises, more engaging if compared to the usual rehabilitation activities used in clinical settings. We also introduce a couple of performance indexes, which could be helpful for a quantitative continuous evaluation of movements during the exercises. Even if the number of children involved and sessions performed are not suitable to assess any change in the subjects' abilities, nor to derive solid statistical inferences, the novel approach resulted very engaging and enjoyable by all the children participating in the study. Moreover, given the almost non-existent literature on the use of Smart Objects in pediatric rehabilitation, the few qualitative/quantitative results here reported may promote the scientific and clinical discussion regarding AAL solutions in a "Computer Assisted Rehabilitation" perspective, towards what can be defined "Pediatric Rehabilitation 2.0".

BACKGROUND: The use of robotic technologies in pediatric rehabilitation has seen a large increase, but with a lack of a comprehensive framework about their effectiveness. OBJECTIVE: An Italian Consensus Conference has been promoted to develop recommendations on these technologies: definitions and classification criteria of devices, indications and limits of their use in neurological diseases, theoretical models, ethical and legal implications. In this paper, we present the results for the pediatric age. METHODS: A systematic search on Cochrane library, PEDro and Pub Med was performed. Papers published up to March 1st, 2020, in English, were included and analyzed using the methodology of the Centre for Evidence-Based Medicine in Oxford, AMSTAR2 and PEDro scales for systematic reviews and RCT, respectively. RESULTS: Some positives aspects emerged in the area of gait: an increased number of children reaching the stance, an improvement in walking distance, speed and endurance. Critical aspects include the heterogeneity of the studied cases, measurements and training protocols. CONCLUSION: Many studies demonstrate the benefits of robotic training in developmental age. However, it is necessary to increase the number of trials to achieve greater homogeneity between protocols and to confirm the effectiveness of pediatric robotic rehabilitation.