Deans' stroke musings: Effectiveness of wearable upper limb assistive devices in hemiparesis for improvement of functional abilities: A systematic review

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Sunday, July 22, 2018

Effectiveness of wearable upper limb assistive devices in hemiparesis for improvement of functional abilities: A systematic review

Fuck, research that says we need further research. My god, the complete stroke universe needs to be fired. I would never support these researchers again without them producing useful protocols at the end of research.

Effectiveness of wearable upper limb assistive devices in hemiparesis for improvement of functional abilities: A systematic review

Introduction/Background

Assess short-term benefits of wearable devices in activities of daily living (ADLs) and functional tasks, for people suffering from upper-limb impairment due to acquired brain injuries (ABI).

Material and method

Two independent reviewers conducted a systematic review across Cochrane Database of Clinical Trials, Medline, Web Of Science, PEDro, OT-Seeker and Open Grey databases until November 2017, identifying citations in included studies and systematic reviews. Inclusion criteria included: adults with hemiparesis due to all causes of ABI; wearable devices such as orthosis, prosthesis, exoskeleton, electrical stimulation devices, neuroprosthetics; use of functional outcome measures assessing ADLs and functional tasks with and without device. Methodological quality of articles was assessed according to the Joanna Brigs Institute (JBI) scale for case series.

Results

From 1452 titles initially selected, eleven studies were finally selected (n = 95 participants), all focusing on post-stroke hemiparesis. Nine were self-controlled case-series and two were single-case reports. Six studies described functional electrical stimulation devices, three described use of exoskeletons and two passive devices. Command of the nine active devices included electromyography, kinematic data, push-button, inertial unit measurement and force sensors. Quality assessment using JBI Scale found low quality evidence of all studies with heterogeneity of outcomes. One of the two studies describing passive assistive devices demonstrated significant improvement in the size of block lifted during the box and block test (BBT). Only one of the three studies using exoskeleton found significant improvement in the BBT and various functional tasks. Four of the six neuroprosthetics studies found moderate to significant improvement across outcomes.

Conclusion

Considering high heterogeneity of studied assistive devices, small samples sizes and study designs implicating insufficient high quality evidence, it is not possible to either support or reject the use of assistive devices on the ABI population. Further research is needed to investigate the use of these devices on functional outcomes.