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Enabling Functional Independence: A Scoping Review of Upper Extremity Assistive Devices for Adults With Progressive
Katherine M Burke1,2, Stephanie Johnson3,4, Kayla Chomko5
1Neurological Clinical Research Institute and Sean M. Healey & AMG Center for ALS, Massachusetts General Hospital, Boston, Massachusetts, USA.
Background:
Assistive technology offers an important means of compensating for lost upper extremity function in adults with progressive neuromuscular diseases (NMD), enabling participation in daily activities, supporting independence, and promoting quality of life. However, the range of available technologies and the evidence supporting their use have not been comprehensively summarized.
Aim:
The aim of this scoping review was to identify and characterize upper extremity assistive technologies tested in adults with NMD and to summarize the current evidence regarding their functional applications and clinical outcomes.
Materials And Methods:
Electronic searches for published and unpublished literature were conducted using MEDLINE, Embase.com, Web of Science, Cochrane Central, and IEEE Xplore. The search strategy incorporated controlled vocabulary and free-text synonyms for the concepts of upper extremity, rehabilitation, selected progressive neurodegenerative diseases, and assistive equipment. Following title/abstract and full-text screening, studies evaluating assistive devices tested on adults with NMD during functional task performance were included.
Results:
After screening 2289 articles, 27 studies met the inclusion criteria. The studies collectively demonstrate the potential benefits and diverse range of assistive devices available to support upper extremity function. These devices ranged from low-tech solutions, such as static mobile arm supports and fabricated splints, to high-tech devices, including dynamic mobile arm supports, robotic systems, exoskeletons, and brain-computer interface systems. However, most studies were feasibility or case studies that primarily demonstrated proof of concept, with limited evidence regarding long-term effectiveness, functional outcomes, or quality of life.
Discussion:
The findings illustrate the rapidly evolving landscape of upper extremity assistive devices for adults with NMD and their potential to improve functional performance, while highlighting the need for prospective studies that assess meaningful improvements in function, participation, and quality of life.
Conclusions:
As advances in disease-modifying therapies extend survival and preserve function for individuals with NMD, interdisciplinary collaboration among engineers, clinicians, therapists, individuals with NMD, caregivers, and regulators will be essential to develop, evaluate, and implement assistive technologies that meet users' evolving needs.
