Integrating Assistive Technologies and Smart Home Systems in Neuromuscular Disorders: A Systematic Narrative Review of Clinical Outcomes and Occupational Therapy Perspectives.

Abstract

Introduction: Individuals living with neuromuscular disorders experience progressive functional decline that severely impacts their daily autonomy and quality of life. While restorative robotics and compensatory smart home systems (SHSs) offer potential solutions, there is a need for a synthesized clinical framework to guide their integration. This narrative review, supported by systematic search and PRISMA-style selection, explores the synergy between these technologies and the specific role of occupational therapy in optimizing functional outcomes.

Methods: A systematic narrative review was conducted by analyzing 20 primary studies focused on the application of assistive technologies in NMD populations. The synthesis categorized evidence into three primary domains: robotics and wearable systems, augmentative and alternative communication (AAC), and Internet of Things-driven smart home platforms. Clinical efficacy was evaluated based on quantitative performance metrics and qualitative user perspectives.

Results: The review identifies significant functional gains associated with high-tech interventions, including a large effect size (1.06) for robotic upper-limb assistants. AI-driven multimodal smart home platforms demonstrated high technical precision, with monitoring accuracies reaching approximately 94% for motor impairment stages. However, despite this high technical efficacy, real-world utility remains complex, as clinical success is often moderated by nontechnical factors. Implementation is often hindered by barriers such as high costs, technical complexity, and privacy concerns. The findings highlight that successful integration depends on a "person-technology fit," facilitated by occupational therapists through rigorous customization and task adaptation.

Conclusion: Integrating SHSs with traditional assistive technologies significantly enhances independent living for individuals with NMD. However, to move beyond experimental success, future research must prioritize user-centered codesign and the establishment of ethical mapping frameworks. Occupational therapists remain essential in bridging the gap between sophisticated technology and the practical, daily needs of patients.