Clinical Benefits and Acceptability of Two Commercial Arm Exoskeletons for Patients with Muscular Dystrophy

The Effectiveness of Wearable Upper Limb Assistive Devices in Degenerative Neuromuscular Diseases: A Systematic Review and Meta-Analysis

“…However, even if a remarkable number of works have been published dealing with the development of innovative electromechanical technologies (e.g., Ragonesi et al, 2013;Jung et al, 2014;Dunning et al, 2015;Sin et al, 2015;Dalla Gasperina et al, 2018), scientific evidence for the benefits of these technologies is still lacking, which could justify costs and effort. When dealing with Assistive Devices, or in general with complex technologies, the demonstration of the effectiveness of their use is rather difficult to be demonstrated following the canonical research studies design [i.e., Randomized Control Trial (RCT) design], even if some effort in this direction is currently ongoing (Antonietti et al, 2019). This is due to several reasons, such as the difficulty to demonstrate the validity of the proposed approach independently from the users' placebo effect (e.g., it is impossible to perform a blind session), the high cost of the technology and therefore the impossibility to recruit many volunteers contemporary, and the Ethical Committee procedures for non CE-marked devices.…”

Research Technologies for Assistance During Daily Life Activities

“…58.9 ± 54.1% [2] 6.5 ± 17.0% [3] 65.3 ± 48.8% [4] 67.5 ± 33.4% [5] 15 ± 15.7% [6] 12.4 ± 10.3% [7] 22.0 ± 23.8% [8] 7.7 ± 21.8% [10] 18 ± 34.4% [11] 19.5 ± 10.8% [12] 13.2 ± 10.8% [13] 10.8 ± 44.2% [14] 5.0 ± 22.7% [15] 37.4 ± 19.9% [16] 29.6 ± 21.7% [17] 23.8 ± 46.1% Table 1. Percentage improvement in the performances (∆Perf) measured with the AD with respect to the performances without the AD (mean ± standard deviation).…”

“…All included studies compared patients' ability to perform functional tasks with and without ADs. Most of the studies (11) included at least one subject affected by MD, involving overall 73 MD subjects [6,15,16,13,4,8,11,17,10,2,5], while 3 studies included 33 stroke subjects [12,7,14], one study included 3 SCI patients [1], and another study included 4 MS patients [3].…”

“…All the included studies involved the use of wearable ADs for the upper limb, in particular, seven studies used passive devices [4,6,7,10,[13][14][15], five studies involved active devices [1,3,5,11,12], while other four studies included both active and passive ones [2,8,16,17]. ADs used in thirteen studies are available on the market [2-4, 6-8, 11-17], while the ones involved in the other three are still laboratory prototypes [1,5,10].…”

“…The included studies considered different outcome measures, here we have considered only the primary outcome measures. Three studies used the Performance of the Upper Limb scale (PUL), a new tool recently designed for specifically assessing arm functionality in Duchenne MD patients [3,2,5], three studies used the Range Of Motion (ROM) of the shoulder and elbow joint [4,17,3], two studies used the upper extremity section of Fugl-Meyer scale [12,14], while the other studies used the Five-point Likert scale [6], the Canadian Occupational Performance Measure [15], the Perceived Functional Benefit [16], the Jebsen Hand Function Test [13], the Fraction Of Reach scale [7], the Action Research Arm Test [8], the Individually Prioritized Problem Assessment [11], and the Root Mean Square Error between the actual and the target angle during elbow flexion and extension [1].…”