TY  - JOUR
PY  - 2021//
TI  - What does evidence tell us about the use of gait robotic devices in patients with multiple sclerosis? A comprehensive systematic review on functional outcomes and clinical recommendations
JO  - European journal of physical and rehabilitation medicine
A1  - Calabrò, Rocco S.
A1  - Cassio, Anna
A1  - Mazzoli, Davide
A1  - Andrenelli, Elisa
A1  - Bizzarini, Emiliana
A1  - Campanini, Isabella
A1  - Carmignano, Simona M.
A1  - Cerulli, Simona
A1  - Chisari, Carmelo
A1  - Colombo, Valentina
A1  - Dalise, Stefania
A1  - Fundarò, Cira
A1  - Gazzotti, Valeria
A1  - Mazzoleni, Daniele
A1  - Mazzucchelli, Miryam
A1  - Melegari, Corrado
A1  - Merlo, Andrea
A1  - Stampacchia, Giulia
A1  - Boldrini, Paolo
A1  - Mazzoleni, Stefano
A1  - Posteraro, Federico
A1  - Benanti, Paolo
A1  - Castelli, Enrico
A1  - Draicchio, Francesco
A1  - Falabella, Vincenzo
A1  - Galeri, Silvia
A1  - Gimigliano, Francesca
A1  - Grigioni, Mauro
A1  - Mazzon, Stefano
A1  - Molteni, Franco
A1  - Petrarca, Maurizio
A1  - Picelli, Alessandro
A1  - Senatore, Michele
A1  - Turchetti, Giuseppe
A1  - Morone, Giovanni
A1  - Bonaiuti, Donatella
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - INTRODUCTION: There is growing evidence on the efficacy of gait robotic rehabilitation in patients with multiple sclerosis (MS), but most of the studies have focused on gait parameters. Moreover, clear indications on the clinical use of robotics still lack. As part of the CICERONE Italian Consensus on Robotic Rehabilitation, the aim of this systematic review was to investigate the existing evidence concerning the role of lower limb robotic rehabilitation in improving functional recovery in patients with MS. EVIDENCE ACQUISITION: We searched for and systematically reviewed evidence-based studies on gait robotic rehabilitation in MS, between January 1st, 2010 and December 31st, 2020, in the following databases: Cochrane Library, PEDro, PubMed and Google Scholar. The study quality was assessed by the 16-item assessment of multiple systematic reviews 2 (AMSTAR 2) and the 10-item PEDro scale for the other research studies. EVIDENCE SYNTHESIS: After an accurate screening, only 17 papers were included in the review, and most of them (13 RCT) had a level II evidence. Most of the studies used the Lokomat as a grounded robotic device, two investigated the efficacy of end-effectors and two powered exoskeletons. Generally speaking, robotic treatment has beneficial effects on gait speed, endurance and balance with comparable outcomes to those of conventional treatments. However, in more severe patients (EDSS >6), robotics leads to better functional outcomes. Notably, after gait training with robotics (especially when coupled to virtual reality) MS patients also reach better non-motor outcomes, including spasticity, fatigue, pain, psychological well-being and quality of life. Unfortunately, no clinical indications emerge on the treatment protocols. <br><br>CONCLUSIONS: The present comprehensive systematic review highlights the potential beneficial role on functional outcomes of the lower limb robotic devices in people with MS. Future studies are warranted to evaluate the role of robotics not only for walking and balance outcomes, but also for other gait-training-related benefits, to identify appropriate outcome measures related to a specific subgroup of MS subjects' disease severity.<p />  <p>Language: en</p>
LA  - en
SN  - 1973-9087
UR  - http://dx.doi.org/10.23736/S1973-9087.21.06915-X
ID  - ref1
ER  -