Table 2.
Main characteristics of the studies included in this systematic review.
| Article | Nation | Design | Aim | Number Participants (Drop-Outs) |
Gender and Age | SCI Stage | SCI According to AIS | SCI Level | Methodological Quality | CBIM |
|---|---|---|---|---|---|---|---|---|---|---|
| Zariffa 2012 [25] | Canada | Case Series | To assess the feasibility and efficacy of upper limb robotic rehabilitation device in subacute cervical SCI | 15 (3) | 14 M, 1 F 19–75 years |
Subacute | AIS A (n = 2) AIS B (n = 4) AIS C (n = 1) AIS D (n = 5) |
C4–C6 | n/a | 4 |
| Cortes 2013 [26] | USA | Case Series | To assess feasibility, safety, and effectiveness of robotic-assisted training in chronic SCI | 10 (0) | 8 M, 2 F 17–70 years |
Chronic | AIS A (n = 3) AIS B (n = 4) AIS C (n = 1) AIS D (n = 2) |
C4–C6 | n/a | 4 |
| Fitle 2015 [27] | USA | Case series | To assess feasibility and effectiveness of a robotic exoskeleton designed to train elbow, forearm and wrist movements | 10 (2) | 8 M, 2 F, age: NR |
Chronic | AIS C–D (n = 2) | C2–C6 | n/a | 4 |
| Vanmulken 2015 [28] | Netherlands | Case Series | To assess feasibility and effectiveness (arm-hand function and performance) of haptic robot technology | 5 (2) | 4 M, 1 F 25–70 years |
Chronic | AIS A (n = 1) AIS B (n = 2) |
C3–C7 | n/a | 4 |
| Francisco 2017 [29] | USA | Case Series | To assess feasibility, tolerability, and effectiveness of robotic-assisted arm training |
10 (2) | 8 M, 2 F, 19–76 years |
Chronic | AIS C (n = 4) AIS D (n = 4) |
C2–C7 | n/a | 4 |
| Frullo 2017 [30] | USA | Parallel group controlled trial | To assess feasibility of subject-adaptive robotic-assisted therapy: AAN vs. ST training modality | 17 (3) | 12 M and 2 F, 3 NR 53.5 years |
Chronic | AIS C–D (n = 17) | C3–C8 | n/a | 4 |
| Kim 2019 [31] | Republic of Korea | RCT | To assess the clinical efficacy of upper limb robotic therapy in people with tetraplegia | 34 (4) RT: 17 (2) CT: 17 (2) |
28 M, 6 F, RT: 56.7 ± 13.6 years CT: 47.1 ± 14.9 years |
Subacute/Chronic | AIS A (n = 8) AIS B (n = 6) AIS C (n = 4) AIS D (n = 16) |
C2–C8 | 8/10 | 2 |
| Singh 2018 [32] | Canada | Systematic review | To summarize feasibility and outcomes of robotic-assisted upper extremity training for patients with cervical SCI | 73 (11) | 46 M, 8 F, 7 NR 17–75 years |
Subacute/Chronic | AIS A-B (n = 16) AIS C-D (n = 46) |
C2–C8 | Critically low quality | 3 |
| Yozbatiran 2019 [33] | USA | Systematic review | To summarize the current evidence of robot-assisted rehabilitation in patients with tetraplegia | 88 (13) | 69 M, 13 F, 6 NR 17–76 years |
Subacute/Chronic | AIS A–B (n = 14) AIS C–D (n = 58) 3 NR |
C2–C7 | Low quality | 3 |
| Jung 2019 [34] | Republic of Korea | RCT | To assess the effects of combined upper limb robotic therapy (RT) as compared to conventional occupational therapy (OT) in SCI patients | 38 (8) RT: 22 (5) CT: 16 (3) |
24 M, 6 F RT: 47.23 ± 14 CT: 53 ± 13.5 |
Subacute | AIS A (n = 3) AIS B (n = 4) AIS C (n = 7) AIS D (n = 16) |
C2–C7 | 4/10 | 3 |
| Osuagwu 2020 [35] | UK | Interventional longitudinal clinical trial design | To investigate the therapeutic effect of a self-administered home-based hand rehabilitation programme for people with cervical SCI using the soft extra muscle (SEM) Glove | 15 (0) | 11 M, 4 F 50.3 (33–60) |
Chronic | AIS C (n = 3) AIS D (n = 11) Untested (n = 1) |
C2–C5 | n/a | 4 |
| Zariffa 2012 [25] | Canada | Case Series | To assess the feasibility and efficacy of upper limb robotic rehabilitation device in subacute cervical SCI | 15 (3) | 14 M, 1 F 19–75 years |
Subacute | AIS A (n = 2) AIS B (n = 4) AIS C (n = 1) AIS D (n = 5) |
C4–C6 | n/a | 4 |
| Cortes 2013 [26] | USA | Case Series | To assess feasibility, safety, and effectiveness of robotic-assisted training in chronic SCI | 10 (0) | 8 M, 2 F 17–70 years |
Chronic | AIS A (n = 3) AIS B (n = 4) AIS C (n = 1) AIS D (n = 2) |
C4–C6 | n/a | 4 |
| Fitle 2015 [27] | USA | Case series | To assess feasibility and effectiveness of a robotic exoskeleton designed to train elbow, forearm and wrist movements | 10 (2) | 8 M, 2 F, age: NR |
Chronic | AIS C-D (n = 2) | C2–C6 | n/a | 4 |
| Vanmulken 2015 [28] |
Netherlands | Case Series | To assess feasibility and effectiveness (arm-hand function and performance) of haptic robot technology | 5 (2) | 4 M, 1 F 25–70 years |
Chronic | AIS A (n = 1) AIS B (n = 2) |
C3–C7 | n/a | 4 |
| Francisco 2017 [29] | USA | Case Series | To assess feasibility, tolerability, and effectiveness of robotic-assisted arm training |
10 (2) | 8 M, 2 F, 19–76 years |
Chronic | AIS C (n = 4) AIS D (n = 4) |
C2–C7 | n/a | 4 |
| Frullo 2017 [30] | USA | Parallel group controlled trial | To assess feasibility of subject-adaptive robotic-assisted therapy: AAN vs. ST training modality | 17 (3) | 12 M and 2 F, 3 NR 53.5 years |
Chronic | AIS C–D (n = 17) | C3–C8 | n/a | 4 |
| Kim 2019 [31] | Republic of Korea | RCT | To assess the clinical efficacy of upper limb robotic therapy in people with tetraplegia | 34 (4) RT: 17 (2) CT: 17 (2) |
28 M, 6 F, RT: 56.7 ± 13.6 years CT: 47.1 ± 14.9 years |
Subacute/Chronic | AIS A (n = 8) AIS B (n = 6) AIS C (n = 4) AIS D (n = 16) |
C2–C8 | 8/10 | 2 |
| Singh 2018 [32] | Canada | Systematic review | To summarize feasibility and outcomes of robotic-assisted upper extremity training for patients with cervical SCI | 73 (11) | 46 M, 8 F, 7 NR 17–75 years |
Subacute/Chronic | AIS A-B (n = 16) AIS C–D (n = 46) |
C2–C8 | Critically low quality | 3 |
| Yozbatiran 2019 [33] | USA | Systematic review | To summarize the current evidence of robot-assisted rehabilitation in patients with tetraplegia | 88 (13) | 69 M, 13 F, 6 NR 17–76 years |
Subacute/Chronic | AIS A–B(n = 14) AIS C–D (n = 58) 3 NR |
C2–C7 | Low quality | 3 |
| Jung 2019 [34] | Republic of Korea | RCT | To assess the effects of combined upper limb robotic therapy (RT) as compared to conventional occupational therapy (OT) in SCI patients | 38 (8) RT: 22 (5) CT: 16 (3) |
24 M, 6 F RT: 47.23 ± 14 CT: 53 ± 13.5 |
Subacute | AIS A (n = 3) AIS B (n = 4) AIS C (n = 7) AIS D (n = 16) |
C2–C7 | 4/10 | 3 |
| Osuagwu 2020 [35] | UK | Interventional longitudinal clinical trial design | To investigate the therapeutic effect of a self-administered home-based hand rehabilitation programme for people with cervical SCI using the soft extra muscle (SEM) Glove | 15 (0) | 11 M, 4 F 50.3 (33–60) |
Chronic | AIS C (n = 3) AIS D (n = 11) Untested (n = 1) |
C2–C5 | n/a | 4 |
Abbreviations: AAN: assist-as-needed; AIS: American Spinal Injury Association Impairment Scale; CT: conventional therapy; F: Female; M: Male; NR: not reported; RCT: Randomized Controlled Trial; RT: robotic training; SCI: Spinal Cord Injury; ST: subject-triggered; USA: United States of America; CBIM.