Effectiveness of robotic rehabilitation for gait and balance in people with multiple sclerosis: a systematic review.

IF 4.8 2区 医学 Q1 CLINICAL NEUROLOGY Journal of Neurology Pub Date : 2024-11-01 Epub Date: 2024-10-10 DOI:10.1007/s00415-024-12715-4
Salvatore Facciorusso, Calogero Malfitano, Martino Giordano, Matteo Johann Del Furia, Bianca Mosconi, Chiara Arienti, Claudio Cordani
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Abstract

This review investigated the effectiveness of robotic-assisted gait training (RAGT) in improving gait and balance performance in adults with multiple sclerosis (MS). Databases and registers were searched from inception to December 2023 to identify randomized controlled trials (RCTs) that analyzed the effects of RAGT on gait speed, function, balance, fatigue, and adverse events. Three reviewers screened studies for eligibility and extracted key information such as participants and intervention characteristics, as well as outcomes of interest. The reviewers assessed the risk of bias of included studies using Cochrane Risk of Bias tool. From the 948 records identified, 8 RCTs were included, involving 335 participants. The studies have demonstrated significant heterogeneity in patient characteristics, intervention protocols, and outcomes measured. The risk of bias assessment revealed concerns, mainly in terms of performance and detection bias. The evidence is uncertain on the effectiveness of RAGT on balance and gait in people with MS, but a multimodal rehabilitation approach, including RAGT, should be encouraged. No serious adverse events seem to be associated with RAGT, suggesting that these interventions are generally safe for use in people with MS. Further studies of higher methodological quality should be led to confirm these positive results.

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机器人康复对多发性硬化症患者步态和平衡能力的影响:系统性综述。
本综述调查了机器人辅助步态训练(RAGT)在改善成人多发性硬化症(MS)患者步态和平衡表现方面的有效性。我们检索了从开始到 2023 年 12 月的数据库和登记册,以确定分析 RAGT 对步态速度、功能、平衡、疲劳和不良事件影响的随机对照试验 (RCT)。三位评审员筛选了符合条件的研究,并提取了关键信息,如参与者和干预特征以及相关结果。审稿人使用 Cochrane 偏倚风险工具评估了纳入研究的偏倚风险。在确定的 948 条记录中,共纳入了 8 项 RCT 研究,涉及 335 名参与者。这些研究在患者特征、干预方案和测量结果等方面存在明显的异质性。偏倚风险评估显示,主要在绩效和检测偏倚方面存在问题。关于RAGT对多发性硬化症患者平衡和步态的有效性,目前尚无明确证据,但应鼓励采用包括RAGT在内的多模式康复方法。RAGT似乎没有引起严重的不良反应,这表明对多发性硬化症患者使用这些干预措施总体上是安全的。应进一步开展方法学质量更高的研究,以证实这些积极的结果。
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来源期刊
Journal of Neurology
Journal of Neurology 医学-临床神经学
CiteScore
10.00
自引率
5.00%
发文量
558
审稿时长
1 months
期刊介绍: The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.
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