Effectiveness of Upper Extremity Exoskeletons in Children With Cerebral Palsy Within International Classification of
Ghodsiyeh Joveini1, Sahar Boozari2, Armin Zareiyan3,4
1Department of Occupational Therapy, School of Rehabilitation Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Insights
Upper extremity exoskeletons show promise for children with cerebral palsy (CP), improving body functions. However, further research is needed to confirm benefits in activity and participation for CP rehabilitation.
Area of Science:
- Rehabilitation technology
- Pediatric neurology
- Assistive devices
Background:
- Children with cerebral palsy (CP) often experience upper extremity impairments, leading to functional limitations.
- Exoskeleton technology presents a novel approach to improving rehabilitation outcomes in this population.
- This review examines upper extremity exoskeleton use in children with CP through the ICF framework.
Purpose of the Study:
- To systematically review the impact of upper extremity exoskeletons on children with cerebral palsy.
- To analyze effectiveness across different domains of the International Classification of Functioning, Disability and Health (ICF).
Main Methods:
- A systematic literature search was conducted across five databases following PRISMA guidelines.
- Included studies were randomized and non-randomized trials of upper extremity exoskeletons for children with CP.
- Risk of bias was assessed using established tools for both study types.
Main Results:
- Twenty-two studies with 274 participants were analyzed, focusing on exoskeleton effectiveness in children with CP.
- The majority of studies emphasized improvements in body functions and structures.
- Diverse study designs were observed, including RCTs, cohort studies, and case series.
Conclusions:
- While upper extremity exoskeletons demonstrate positive effects on body functions and structures in children with CP, this does not automatically translate to improved activity and participation.
- Further research is crucial to ascertain the efficacy of these devices in enhancing participation outcomes for children with CP.
Background:
Upper extremity impairments in children with cerebral palsy (CP) often lead to activity limitation and participation restrictions. Recent advances in exoskeleton technology offer promising potential for enhancing rehabilitation outcomes. This systematic review investigates the impact of upper extremity exoskeletons on children with CP using the International Classification of Functioning, Disability and Health (ICF) framework.
Methods:
Following PRISMA guidelines, five electronic databases were searched without time limitations (PROSPERO ID: CRD42021282377). Studies included randomized and non-randomized trials, focusing on upper extremity exoskeleton interventions for children with CP and published in English. Data were screened and extracted by two independent reviewers. The risk of bias was evaluated using the Revised Cochrane Risk of Bias Tool and the Risk of Bias in Non-Randomized Studies of Interventions for randomized and non-randomized studies, respectively.
Results:
A review of 22 studies involving 274 participants assessed the effectiveness of upper extremity exoskeletons on children with CP across different ICF domains. The studies employed various designs, including randomized controlled trials, cohort studies and case series, with a primary emphasis on body functions and structures.
Conclusion:
While advancements in body function and structure are noteworthy, they do not inherently lead to improved activity and participation, highlighting the importance of conducting further research to evaluate the effectiveness of exoskeletons, particularly in enhancing participation outcomes among children with CP.
