Upper Limb Neurorehabilitation Using a Hybrid Technology-Enabled Therapy Approach-A Scoping Review

There is growing evidence of benefits for a multimodal or 'hybrid' technology approach where more than one technology type is applied for upper limb (UL) neurorehabilitation. However, translation of this approach into real world clinical settings remains unclear. Exploration of multimodal technology use for UL neurorehabilitation in hospital settings is warranted to determine practice trends, efficacy, benefits and barriers. A scoping review was conducted to explore hybrid technology-enabled rehabilitation approaches for UL neurorehabilitation focusing on combined use of robotics, virtual reality and sensor-based therapy. Seven electronic databases were searched for studies on adult participants with neurological UL impairment who participated in hospital rehabilitation and used two or more technology devices. Of 25 333 articles screened, full text review was completed on 20 articles with nine progressed for data extraction. An additional article found from hand searching was included for data extraction resulting in ten articles in total. Included studies found hybrid technology-enabled UL rehabilitation was used mainly with stroke participants ranging from 25 to 91 years in a hospital setting. Most studies were observational or pilot in nature and focused on clinical feasibility. All studies showed positive patient outcomes and feasibility studies reported on factors to support implementation in the clinical setting. Further research is warranted to determine impact on participation, long-term outcomes, sustainability, and economic impacts in the clinical hospital setting.