用于上肢康复的便携式外骨骼：系统综述

IF 2.7 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2025-09-22 DOI:10.1002/jeo2.70416

Arianna Carnevale, Guido Nicodemi, Matteo Giuseppe Pisani, Alberto Lalli, Francesco Scotto di Luzio, Pieter D'Hooghe, Loredana Zollo, Emiliano Schena, Umile Giuseppe Longo

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引用次数: 0

摘要

目的本系统评价便携式外骨骼用于脑卒中后及术后神经系统并发症患者上肢康复的疗效和可行性。它侧重于运动功能，运动范围（ROM），减少痉挛和改善日常生活活动。方法根据PRISMA指南[12]，检索PubMed、Cochrane和Scopus数据库，检索截止到2024年10月的关键词和MeSH术语，如“外骨骼设备”和“肩部康复”。纳入的研究（2008年1月至2023年10月）评估了便携式外骨骼对慢性卒中或术后神经系统并发症患者上肢功能的影响。排除了非便携式机器人的研究、动物研究、方案、没有定量结果的研究和不涉及人类患者的研究。乔安娜布里格斯研究所（JBI）的关键评估工具和风险偏倚2 （ROB2）工具评估研究偏倚。结果5项入选研究共纳入70例患者。评估的外骨骼包括tenodesis - inducated - grip Exoskeleton Robot （TIGER）、Wilmington Robotic Exoskeleton （WREX）、Hybrid Exoskeleton上肢30A （HEXO-UR30A）和Hybrid assistance Limb （HAL）。这些装置在运动功能、ROM、痉挛减少和运动学参数方面有显著改善。高依从性和无严重不良事件支持可行性。结论便携式外骨骼是脑卒中后和神经外科手术后上肢康复的理想工具。它们能增强运动恢复和功能预后。然而，在骨科研究中，偏倚风险适中、样本量小、数据有限——尤其是与传统康复的比较——强调了进一步高质量随机对照试验的必要性。证据等级四级。

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Portable exoskeletons for upper limb rehabilitation: A systematic review

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Portable exoskeletons for upper limb rehabilitation: A systematic review

Purpose

This systematic review evaluates the efficacy and feasibility of portable exoskeletons for upper limb rehabilitation in patients post-stroke and with postoperative neurological complications. It focuses on motor function, range of motion (ROM), spasticity reduction and improvements in daily living activities.

Methods

Following PRISMA guidelines [12], PubMed, Cochrane, and Scopus databases were searched up to October 2024 using combinations of keywords and MeSH terms such as “exoskeleton devices” and “shoulder rehabilitation.” Included studies (January 2008–October 2023) assessed portable exoskeletons for upper limb function in patients with chronic stroke or postoperative neurological complications. Excluded were studies on non-portable robots, animal studies, protocols, those without quantitative outcomes, and those not involving human patients. The Joanna Briggs Institute (JBI) Critical Appraisal tool, and the Risk Of Bias 2 (ROB2) tool assessed study bias.

Results

Five selected studies included 70 patients. Evaluated exoskeletons included the Tenodesis-Induced-Grip Exoskeleton Robot (TIGER), Wilmington Robotic Exoskeleton (WREX), Hybrid Exoskeleton Upper Limb 30A (HEXO-UR30A), and Hybrid Assistive Limb (HAL). These devices demonstrated significant improvements in motor function, ROM, spasticity reduction, and kinematic parameters. High adherence and absence of severe adverse events supported feasibility.

Conclusion

Portable exoskeletons are promising tools for upper limb rehabilitation post-stroke and after neurological surgery. They enhance motor recovery and functional outcomes. However, moderate risk of bias, small sample sizes, and limited data in orthopedic contexts—especially comparisons with conventional rehabilitation—underscore the need for further high-quality RCTs.